The Following Instructions, Visualizing and Enacting Program (High FIVE) is designed for students in pre-k to 2nd grade, who present with difficulty following directions due to a receptive language disorder.

Spoken directions are a part of everyday life for adults and children. Appropriate behavior, social interaction, and academic success are all dependent on the ability to understand and follow verbal directions, however, this requires strong knowledge of basic concepts and the ability to process and retain auditory information. (Stuckey and Loraine, 2009). High Five uses classroom and community-oriented tasks, repetition, and visualization strategies explicitly taught and reinforced in the program to strengthen following direction abilities. In addition, paraphrasing and direct imitation, which are other forms of repetition, are directly taught in this program as a strategy for remembering and following directions. Imitation teaching has been shown to provide language-impaired children with a learning advantage that is not demonstrated by the learning patterns of the children learning a language in a typical manner. (Connell, Phil J., 1987).

The program hierarchy is arranged from the most basic to the most complex directions by incorporating elements such as physical properties, negation, and sequences. It was designed according to the typical development of following directions. Starting with a simple, one-step direction using one element, such as “Point to the ball,” the difficulty is increased as more elements are added to the directions, such as color, size, action, or location. The higher levels of the program combine all of these elements. (Stuckey and Loraine, 2009).

High FIVE is designed for students in PK-2nd grade who have difficulty understanding and, therefore, following directions. The program was designed based on Mullen, Robert, and Tracy Schooling’s 2010 finding that 28% of lower elementary school students have Speech-language comprehension therapy (Mullen, Robert, and Tracy Schooling, 2010).

In order to follow verbal instructions, students need a thorough understanding of basic concepts and the ability to process and retain auditory information (Stuckey and Loraine, 2009). Because of this, the integration of basic concepts and appropriate scaffolding for processing and retaining auditory information is fundamental to the program.

High FIVE incorporates several strategies including repetition and visualization, paraphrasing, and direct imitation. Repetition and visualization promote progress in students targeting following direction skills (Gill, Cynthia B., et al, 2003). Paraphrasing (another form of repetition), supports improvement in students’ abilities to remember and follow increasingly long strings of directions. Direct imitation (another form of repetition), promotes progress in language-impaired students who have difficulty acquiring information using the learning patterns of children who are typically developing (Connell, Phil J., 1987). Acoustically modified speech is not used in the program because it has been shown not to improve comprehension (Bishop, Dorothy VM, Caroline V. Adams, and Stuart Rosen, 2006).

The program hierarchy is arranged from the most basic to the most complex directions (Morris, Paul, 2009; Stuckey and Loraine, 2009). High FIVE starts with simple one-step directions using one element. Then, the difficulty level increases as verbal instructions have additional elements added such as color, size, shape, location, action, and negation. The highest level combines multiple elements such as color and action, making the instruction more complex. The program also includes 2-step-directions, which follow the same incremental increase in complexity.