Worksheet
Building an exposure ladder for communication goals
A printable worksheet for turning a meaningful communication goal into gradual, observable practice steps.
Braverly Health
2 minute read
Begin with a meaningful goal
Choose a real communication need such as asking for help, joining a peer activity, ordering a familiar item, answering a planned question, or sharing an idea at work. Describe the end goal in observable terms, including the person, place, activity, and communication method.
Then identify a starting step the person can already do or can approach with manageable difficulty. A ladder is individualized; another person’s first or final step may not fit.
Change one feature at a time
Steps can vary the communication method, number or familiarity of people, place, activity, preparation, distance, or spontaneity. Changing several features at once makes it hard to tell what helped and may create a jump that is too large.
Order the steps by expected difficulty, but treat the order as a hypothesis. Practice will provide better information, and steps can move, split, or repeat.
Plan practice and backup
For each step, write when and how often it will be practiced, the adult or partner response, and the backup method if the planned response is unavailable. Reinforcement should recognize completing the agreed practice behavior rather than require a particular voice outcome.
Review distress, independence, response time, and generalization. The next step should be based on patterns across several attempts, not one unusually easy or hard day.
Putting this into practice
Draft three steps with the person and clinician: the current step, a small variation, and a later goal. Test only the current step, then revise the rest of the ladder using what you learned.
If the step is repeatedly unavailable or distress remains high, make it smaller. If it is consistent and increasingly independent, repeat it in a nearby context or change one feature.
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