Big 6
Point
Touch
Grasp
Place
Release
+ 6
Pull
Push
Tap
Squeeze
Shake
Fluency and These Skills
When we think about building these skills in isolation, that means away from the bigger task. So instead of working on squeezing the toothpaste only during hygiene time – you target the skill of squeezing on its own. By target and build – I mean increase fluency. We want the skill done correctly and quickly. If you can increase the speed the learner can accomplish this simple motor movement (such a squeezing), he will have more accuracy and skills related to the more complex task (like putting on toothpaste). Research suggests that when an individual’s speed on the completing the simple motor movement matches that of a typically functioning peer – he or she will have increased skills on the bigger daily living tasks (Twarek, Cihon, & Eshleman, 2010). So basically, the idea is if you practice all the small little skills and get them fast and almost effortless – the bigger tasks that combine all of the little skills will be more successful. It makes sense, right?
How does this apply to my students?
For your students working on foundational level skills and daily living tasks – identify areas of need. Look at what tasks require physical prompting on a daily basis. These are likely areas where the student has weak performance on these big 6 + 6 skills and have some motor delays. Select which skills you want to work on. Conduct a short (15-20) second timing to determine the baseline. Compare it to your performance or a peer’s performance to see if there is a deficit. If there is, practice this skill in a fluency timing every day. Set an aim and work towards that goal. This resource gives some great and simple ways to target each skill.
Reach:
Hold out an object towards the child, once they reach for it – move the object. Continue moving the object and counting the number of times this student reaches for the object during the time interval.
Squeeze:
There are a lot of cool manipulatives you can use for this skill. I have used a large chip clip, squeak toy, and spray bottle. Track how many squeezes the student does in a specific time period.

Grasp & Release:
Combine two movements by working on picking up items and releasing them into a bucket or large bin. This is a great and concrete tasks that really helps not only build these skills but also attention.
References:
Twarek, Melissa & Cihon, Traci & Eshleman, John. (2010). The effects of fluent levels of Big 6 + 6 skill elements on functional motor skills with children with autism. Behavioral Interventions – BEHAV INTERVENT. 25. 10.1002/bin.317.
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2 Responses
I am an ABA therapist, and was introduced to big 6+6 recently. I love how doing these exercises improves motor skills.
🙌🏻🙌🏻🙌🏻