Can Follow 1 Step Directions… But Not 2? Try This 👦🏽⚽ | Autism Pediatric PT #21

👋🏽 Hi, I’m Amy Sturkey, a retired pediatric physical therapist with over 35 years of experience. I’m glad to share another session with my wonderful co-instructor, Eeshwar 👦🏽 — a 13½-year-old with autism. He is nonverbal and communicates primarily through movement (often pulling adults toward what he wants), with limited prompted use of a communication app. In this session, we focus on **following 2-step directions** during a gross motor activity. --- 🕒 Timestamps 0:00 Introduction 0:30 Setting up motivation (first work, then bubbles) 0:45 Demonstration with sibling (jump → kick) 1:05 Eeshwar attempts the 2-step direction 1:40 Difficulty completing the second step 2:00 Adding hand support during demonstration 2:45 Practicing the second step (kick) 3:20 Reducing cues to avoid giving the second step 4:00 Simplifying language 4:20 Physical assistance for the second step 4:40 Success! 🎉 4:50 Key takeaway: don’t cue the second step --- 🧠 What This Session Targets This video focuses on: • following 2-step directions • motor planning • working memory • attention to task Many children can complete one step successfully, but adding a second step significantly increases the challenge. --- ⚽ What You’ll See We begin with Eeshwar’s younger brother, Maadhav 👦🏾 (4½ years old), demonstrating the activity. The task is: • jump down • then kick a ball Then we transition to Eeshwar. You’ll notice: • he consistently completes the first step • the second step is much harder to remember • the sequence breaks down after the first action This is very common when working on multi-step directions. --- 🪜 Teaching Strategies Used To support success, I use: • demonstration with a sibling model • having him hold my hand during demonstration to increase engagement and help him better process the movement • simple, consistent language • repetition of the full 2-step command • reduced language when needed • physical assistance to help him feel the second step One important strategy: 👉🏾 I avoid telling him the second step after he starts If we cue the second step, it becomes a **1-step direction**, not a true 2-step task. Instead, I use more general prompts like: • “and…” • “go ahead…” • “finish…” This helps build independent recall of the full sequence. --- 🫧 Motivation & Engagement We use a clear structure: 👉🏾 first work, then bubbles This helps maintain motivation and engagement throughout the session. --- 👩🏽‍👦🏾 Family & Sibling Involvement Having Maadhav demonstrate first is incredibly helpful. Siblings can: ✨ increase engagement ✨ support attention ✨ provide a clear model Eeshwar’s mom, Sravani 💜, is also present and supportive throughout the session. --- 🎯 Why This Matters Following multi-step directions is essential for: • daily routines • classroom participation • play and social interaction Building this skill takes time, repetition, and thoughtful cueing. --- 🎥 Watch Eeshwar’s Full Video Series Follow his progress from the beginning: https://www.youtube.com/playlist?list=PLAkJbMrHyKjNhgwqxI9_oTLYJgDFfMmIu --- 🌐 Stay Connected Website: [www.pediatricPTexercises.com](http://www.pediatricPTexercises.com) Facebook: Pediatric Physical Therapy Exercises Email: [amysturkey@gmail.com](mailto:amysturkey@gmail.com) (I cannot provide treatment recommendations for a child I have not personally evaluated.) --- 📚 Children’s Educational Books P is for Poop and Pee Accidents https://www.amazon.com/dp/B0BLSRJ483 A is for Anxiety https://www.amazon.com/dp/B09LXQ3W6V A is for Attention Deficit Hyperactivity Disorder https://www.amazon.com/dp/B08QH9H5HR C is for Cerebral Palsy https://www.amazon.com/dp/B088TSJCYP D is for Down Syndrome https://www.amazon.com/dp/B079P8HH49 A is for Autism https://www.amazon.com/dp/B071F4FFTB --- 📘 Professional Books for Pediatric Therapists Pediatric Physical Therapy Strengthening Exercises for the Hips https://www.amazon.com/dp/0998156736 Pediatric Physical Therapy Strengthening Exercises for the Knees https://www.amazon.com/dp/0998156760 Pediatric Physical Therapy Strengthening Exercises for the Ankles https://www.amazon.com/dp/B08TX2ZCFD --- 🌍 Captions To turn on captions: Click CC To translate captions: Settings → Subtitles/CC → Auto-translate