Have you ever encountered students who will not sit in a chair, let alone imitate a verbal target? Sessions like this can be tiring and non-productive for them as well as the clinician. Clinicians can help students make more progress by developing the necessary skill set.

When working with a student who has a hard time sitting in a chair and paying attention, clinicians should address learning readiness skills, such as learning how to sit and attend, remaining on task during a structured activity, and responding appropriately to the therapist. Students must first learn how to learn. Explicit instruction in this area will provide a foundation for work on more complex therapeutic goals.

Working on sitting appropriately can be a difficult task with a preschool-age student, but it is not impossible. Using age-appropriate furniture, the clinician should make sure the student's feet touch the floor when seated. Sit at the table and ask the student to do the same. If the child complies, offer specific verbal praise and let the child play with a toy. This specific and immediate reinforcement will help students to understand the importance of sitting at a table. As they get to be more successful at coming to the table, the clinicians should systematically increase the time they sit in the chair.

Another important learning readiness skill is remaining on task during a structured activity. Pick an activity that the student is interested in. I use an adapted book with matching picture icons. The student can help turn the page and match the appropriate icon to the targeted picture. Keeping the student engaged increases attention to a task.

During the evaluation or initial therapy visit, the clinician should take a baseline measure of how long the student can stay on task without redirection. This information will assist in goal-setting. If a student can sit for one minute without redirection, a functional short-term goal is to sit for five minutes without prompting.

Another area to address is how the student should respond to the therapist. The student needs to understand how to respond to receptive and expressive tasks. If you are working on receptive vocabulary skills, start with only one functional item. Put the item on the table and say to the student, "Give me the [item]." If the student does not respond, give the directive again and prompt him or her to respond appropriately. Complete this cycle until the student completes the task independently. When the student accomplishes this task without assistance, offer specific and immediate reinforcement.

Imitation is a crucial component of the therapeutic process. If a student needs to work on verbal imitation skills but doesn't imitate a verbal target no matter what you do, don't worry. Begin with gross motor imitation. You can work on imitation in a structured format by using the directive "Do this," followed by a physical activity, such as jumping or clapping. When you are finished, the student should do the same physical activity that you modeled. This helps the student learn how to imitate the therapist. Once the student has a grasp of gross motor imitation, work on verbal or gestural communication targets.

We can help students create a foundation for lifelong learning by targeting learning readiness skills. This will allow us to work on a variety of communication goals, which will help our students become more effective communicators.

Rosemarie Donatelli lives in Austin, TX. She can be contacted at harprd@aol.com.