Here at the OT Toolbox we write about many topics that include “how to” suggestions. One of the suggestions we often recommend is Backward Chaining. There have been several people asking recently about Backward Chaining. In this post, we will review or highlight what “chaining” is, the difference between backward and forward chaining, and explore some usable examples to include in your treatment. As seasoned therapists, we may forget that terms like “backward chaining” were once foreign to us also.
The good news, you are most likely doing some sort of chaining with your learners, but do not realize that is what it is called, or have not given it specific thought. For clinical documentation, as well as treatment, it is effective to understand what techniques you are using.
WHAT IS BACKWARD CHAINING?
Let us start with chaining. What is chaining? When teaching/learning a task that involves a series of steps, it is useful for them to be performed in a certain order. Chaining can help break a complex task into a sequence of simpler steps which are learned one step at a time. When using the chaining method, you can teach each step in sequence, or in isolation.
In occupational therapy, we’re working with kids in therapy on functional tasks…and that might be ADLs or IADLs. Chaining strategies can be used in every one of these tasks.
We use task analysis to break down and define the series of steps needed to finish a task. For the task to get started, or continue, we use stimuli such as a gesture, or a spoken word. Check out this post on Prompting to better understand all the types of physical and verbal gestures we use to elicit a response.
There are three types of chaining:
- Backward chaining
- Forward chaining
- Total task chaining
Each achieves the same result, task completion, but are taught differently. Read on to find out possible reasons to use backward versus forward chaining.
Let’s go over backward chaining in OT sessions to start:
BACKWARD CHAINING in Learning New Tasks
Backward chaining involves learning/mastering the steps in a task chain from the end to the beginning. The instructor (parent, therapist, caregiver, teacher) guides and works with the learner through all the steps of the sequence, leaving the last step for the learner to do on their own. They are praised for their efforts and accomplishments. Once this last step has been mastered. The instructor helps with all the steps except the final two, which the learner does on their own.
The learner continues mastering the steps from the final to beginning steps. They are not learning the task backward, as they continue to work with their therapist from the beginning of the task. In backward chaining, they are showing mastery of the last steps first.
An example of this might be shoe tying. You guide your learner through all the steps of shoe tying, having them pull the two bunny ears tight at the end to complete the task. After they have mastered this step, you can back up to the step right before this, and emphasize this in your teaching. They are still watching and participating with the beginning steps to understand the process, but are performing the end steps independently first.
WHAT IS FORWARD CHAINING?
Forward chaining involves the same task analysis as backward chaining. Whether forward or backward chaining, it is important to break the task down into chunks to better understand the steps to teaching it.
With forward chaining, the instructor (parent, therapist, caregiver, teacher) begins with the first step in the task, prompting the learner to initiate the task themselves. The instructor then helps the learner through all the following steps until completion. Once the learner is proficient at step number one, the instructor will leave steps one and two for them to perform on their own.
You might see forward chaining when brushing teeth. Perhaps your learner starts by getting the toothpaste out of the drawer.
Another task you see this is in baking cookies. We tend to teach our children to measure and pour the ingredients before mixing, pouring onto the tray, or putting them into the oven. After they can measure and pour the ingredients, they can learn to mix them with a spoon or their hands. This progresses until the learner is able to fully bake cookies on their own.
What About TOTAL TASK CHAINING?
Total task chaining is teaching a task step by step, having your learner do the whole task with you, or learn it all at the same time. For some children, this is too complex of a learning style. They often get overwhelmed and shut down halfway through. Teachers and parents often use this style.
Examples of total task chaining to teach a skill:
One example of total task chaining that comes to mind is doing laundry. We teach about using the washing machine as a step of the task, but usually, we walk through the whole process. It can be hard for kids with attention or working memory challenges to remember what to do first when putting their clothes into the washing machine!
Another example of total task chaining in teaching a skill is in handwashing. The whole task is usually taught at once in sequence. With forward chaining your learner would turn on the water as the first part of their task. In backward chaining they can turn off the water or dry their hands, however you do your task analysis.
WHEN TO USE FORWARD VERSUS BACKWARD CHAINING
When we work with students, how do we know which strategy is best: forward chaining, backward chaining, or total task chaining?
Think about how you teach tasks. My guess is that you vary your method based on the learner, the complexity of the task, and learning style. We often do this reflexively without giving it too much forethought. The issue caregivers usually have is, offering too much support, jumping in too soon to help, or helping well beyond mastery.
Backward chaining works well when you want your learner to experience that sense of accomplishment. We have all seen their excitement when they pull the final loops on their shoe laces, or take a bite of something they created. Even though they did not do the task independently, it felt like it, as they finished it.
Forward chaining, on the other hand, is effective when your learner can benefit from mastering all the steps in sequential order. This type of chaining also works to help grab your learner’s attention at the beginning of the task when they are most engaged. Forward chaining is recommended if the child can successfully complete more steps at the start of the behavior chain. It has the advantage of using behavior momentum, as the 1st step is often the simplest, easiest step. Think again about shoe tying. Learners are usually engaged in the first task, then lose interest or sight of the task after the first couple of steps.
Whichever method you choose, the outcome can still be the same. Independence and mastery. This is going to vary with each task and learner. It may be trial and error also, to determine what method works best.
WHAT ABOUT CHAINING WHEN MASTERY IS NOT THE GOAL?
When we imagine that a learner might never have the capability of doing a task independently, it is still important to teach the task to their ability. Many successful adults can not cook independently, but can gather ingredients, mix them together, and help in the kitchen.
This concept is difficult for many caregivers to accept. Why should they spend time and energy working on bathing if their child is never going to be independent? One of the key components of development is autonomy. Learners can take pride in what they are able to do for themselves. While this takes more effort on the caregiver’s part, it is part of being an effective and responsible instructor.
The second reason for continuing to strive for mastery is, that you can never be one hundred percent certain your learner is not going to exceed your expectations. Many parents can tell you they never thought their child could learn to read, get dressed, or feed themselves.
BACKWARD CHAINING EXAMPLES
The best ways to use backward chaining in teaching skills is to take a task and break it down into steps. Then, work through the steps in reverse. The more times you go through the steps, the more trials the child gets of the first steps of the task.
So, if we were teaching a child to put on a shirt, we would first break down it down into steps, with the finals step being emphasized first. Example of steps for putting on a t-shirt.
Break the tasks down into steps:
- Lay the shirt front side down on the bed/table with the bottom edge facing your body
- Pick up the shirt and place it over your head
- Push one arm through the sleeve
- Push the other arm through the sleeve
- Pull the shirt down.
During the backward chain, you would do all the steps for your learner up until “pull the shirt down.” Teach/instruct your learner to pull their shirt down. After this has been mastered, you can teach your learner to push their arm through the sleeve.
When analyzing your task, you can add or subtract details that encompass the task. Does the task include getting the shirt? How about turning it right side out, or smoothing it out?
It is difficult to know when a task begins and ends. Make this part of your task analysis. You can always teach the basics of a task, then add more details once it is mastered.
Then, you can do this process over and over again for any skill you are teaching the child to do!
OTHER RESOURCES FOR CHAINING
- Activity Analysis – an activity analysis is a process of breaking an activity down into its individual steps and its detailed subparts while examining all its components with each activity being evaluated skillfully to determine its therapeutic value.
- How to Teach Task Initiation – sometimes getting started is the hardest part.
- Teaching ADLs and Self Care – these tasks are often where chaining techniques shine.
Forward Chaining and Backward Chaining Resources
Hopefully after reading this post, you did a sigh of relief that you have been using these techniques all along! We often teach by trial and error or instinct. This is a good start, but you can be more efficient and effective with a little forethought and planning. Trying anything new is difficult, but once you try it a few times, it will get easier and more efficient.
Be sure to stop over to The OT Toolbox Membership in January, because we’ll have chaining tools and activities to support life skills coming soon!
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
