Neurodevelopmental Approach

These two explanations of digit spans and sequential processing are the notes of Ginger Houston-Ludlam, taken during talks at a conference hosted by NACD.

Improving Independent Behavior Utilizing Sequential Processing

speaker: Ellen Doman, MA

Ellen started by giving us all a digit span test. She had one of the other neurodevelopmentalists in the room give a string of digits starting at 6 long and going up to 10. (I transposed 2 at 7, but got 8. I dunno where that leaves me!!) When they got to 9, my brain dropped the previous 8 completely, and I gave up trying at 5 digits in the 10 span. And this was her point. This was a common reaction in the room. She pointed out that when you go beyond what your kid can process, they will quit, just like our brains did.

Our kids are judged by their skills, and we are judged by the skills of our children—can they add 2+2, can they tie their shoes—especially our kids with Down Syndrome.

She told a story of shoe tying—how when her youngest daughter was four, her older kids expected her to be able to tie her shoes. She counted 8 steps in shoe tying, and her four year old did not have a digit span of 8. If you try to teach a skill by repetition, and the sequence is too long, your kids will not learn it. When we tried the digit spans, not only did we not remember the last number, but we forgot most of the first part too. This is what happens when the sequence is too long— the brain totally goes on strike and drops all the information. It does not help to try to teach this 300 times. It will be dropped every time, and it is as if you never taught it at all.

Her other kids would try to teach her daughter shoe-tying, and after ten times she would take her shoe off and throw it at them!! So, she challenged her kids—she said that once a week they could work on teaching the “skill” of tying shoes, but she would work on digit spans so that she could remember that many pieces of information. When her daughter got to 5 (plus chunking the process of shoe tying down to 5 pieces of information) she was able to tie her shoes. You need to know what your child can sequence so you can know what to expect behaviorally.

When a child’s digit span goes up one number, their thinking is more sophisticated as well. She talked about doing digit span exercises by using sequences of colors, and commented that a digit span of 5 colors came well before she could manage 5 sequential steps, because directional steps are more sophisticated than a number.

She encouraged people to try to build sequencing activities into our daily lives. Sequence chains of events (all the things that will happen between dinner and bedtime, lists of errands, etc.) Build it into your life, make it a game. The more you do it, the faster it works.

When you are building to the next digit, give them enough that they can do such that they feel successful. If they can do 2, then give them 80% 2-digits, and slip 3-digits in there once in awhile. As they become successful with 3 digits, drop down the percentage of 2s. If they miss it, tell them the right answer and say, “I know you knew that!”

If you teach a kid something that is way too hard for them, even 100 times, if they drop everything but the first one or two items every time, then it’s as good as if you never taught them at all. If you want them to succeed, and they have a digit span of 2, and you have a 3 step process, tell them the first 2 things, let them do it, then tell them the last one. Don’t work at frustration level for any length of time. When you do, praise them big time. Your child should feel that they are the most beautiful, intelligent child that ever walked the face of the earth.

Treasure hunt is another form of sequencing that is trying to make it fun for the kids—where you tell them to go around the house and fetch a certain number of things and bring them back.

You need to teach kids to anticipate an additional digit when you are working to the next level. Tap sequences work well for that. This is where you do rhythmic taps, with a pause before the last one. Tap tap (pause) tap would be what you would use with a child who is at 2 going on to 3. Builds “mental reach.”

You can also start to build skills with hand-over-hand techniques, then drop the help as they get more competent at the “game.” The praise is the big motivator.

The NACD Neurodevelopmental Approach and the Down Syndrome Spectrum

speaker: Robert J. Doman, Jr.

To develop language, you need both auditory tonal processing and auditory sequential processing.

Digit spans are a measure of how well you process information- how many simultaneous pieces you can keep in your head either by seeing or hearing them. It was originally developed as a measure of processing skills for psychologists, and used nonsense syllables. Bob, who was a Psych major in college, found that by working on developing his own digit span, he found studying easier, and had to spend a lot less time studying to do well in school.

As he began to work with kids with disabilities, and started to look at their function, he found that the most telling piece of information was their auditory sequential processing ability. There was a great correlation between how a child’s digit span develops and how their language and cognitive skills develop.

A normal child of two to three years old has a sequence of 2. For example “Touch your nose and your ear.” Kids who can follow this are normal. Stated another way, if your sequence is 2, you function as a two year old. So, he started working with kids on their sequences and started increasing their function. Your digit span is a good measure of how many pieces of information you can take in, hold together in your head and process or output.

In the literature, digit span is a measurement, nobody has ever worked on increasing it. This is something that not only is doable, but causes global changes in the function of the children.


From the notes of Ginger Houston-Ludlam from the NACD conference, “The Down Syndrome Spectrum,” in Ogden, Utah. Used with permission from NACD.