Saturday, November 1, 2014

The Yes/No Series and 10 Steps to Teach a Head Nod and Shake

The Yes/No was a series of blog entries written in 2012.  The six part series works through ways to indicate yes and no and then many ways to teach and reinforce yes and no responses.  Of course, there is much more to life and to communication than yes and no!  Yet yes and no can be vital in an emergency and is a skill all communicators should have.  Here are links to the series (which I have been asked to collect in one place).

The Yes/No Series Links

And below you can find the text of a hand out designed to help schools and day habiliations facilities teach a head nod and shake as a yes/no response for individuals with complex communication needs.

Teaching Method for Yes and No with a Head Nod and Shake

This method of teaching the universal head gestures in English speaking country is commonly taught by Linda Burkhart and Gayle Porter in PODD training courses (

Candidates for learning to indicate yes and no with a head nod and shake are all learners, young and older, who are developing a yes/no response including children with cerebral palsy, Rett Syndrome, Angelman Syndrome and other genetic disabilities affecting communication. 


1) Model an enthusiastic head nod and shake for yes and no frequently and consistently throughout the day.  Have others model it as well.  Peers and siblings make great models! 

2) Directly teach the child what the head nod and shake mean using multi-sensory teaching methods and motivating interactions.

3) Remember that there are different levels of yes and no responses beginning with yes and no to accept and reject.  Start with accept and reject before moving on to more complex yes and no questions.

4) Provide a target for the child to aim their head movement towards by placing your fingers at his or her cheek and chin about a ¾ of an inch to 1 inch away.  The child touching your fingers with his or her chin and cheek should be accepted and rewarded as a yes or no response.  

5) Some child may need more feedback when they touch the target.  For those children you can use a voice output communication aid such as a talking switch.  You can add picture symbols to the switch if this will help increase understanding for the child.  Again, hold the switch ¾ of an inch to 1 inch from the child’s chin and cheek as a target.  

6) In general you should not be touching the child’s face except a gentle and brief tap as a touch cue if the child is NOT tactile defensive and the child needs such a cue to increase understanding or motor planning.  Your fingers or the switches are a target and can’t function as such if you are touching the face.  (Note picture shows switches during the tap - they were then moved away to be targets.)

7) Continue with enthusiastic modeling of yes and no throughout this process

8) Fade out the targets, whether using your fingers or a switch, as soon as the child has demonstrated some understanding of what is expected in terms of a head nod and shake

9) Continue to provide informative feedback (I see you dropped your head for yes.  Nice job!) as you shape the yes and no response.  

10) Once using yes and no to accept and reject is consistent you can add more complex forms of yes and no 

Switch Options for Targets for This Method:

Thanks to Linda Burkhart for chatting with me and guiding me as I developed the hand out I posted as a blog entry!

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