PROMPT, (Prompts for Restructuring Oral Muscular Phonetic Targets) is a holistic, dynamic, multi-sensory therapeutic program developed for the assessment and treatment of speech production disorders.
PROMPT has often been recognised for its use of tactile-kinesthetic articulatory prompts (cues), on the jaw, face and under the chin that help to develop or restructure speech production output. However and more importantly PROMPT is about the dynamic way a child is viewed and treated. Depending on the nature of the delay or disorder this perspective may derive from normal child acquisition models of development or from models that stress maximising the child’s potential in spite of disordered or damaged systems. In its truest sense PROMPT is about developing appropriate, interactive oral communication for use in relationships and learning.
Deborah Hayden, Executive Director and the creator of PROMPT, began developing the technique of PROMPT 30 years ago. Her experiences have included work with infants, toddlers, children, adolescents, adults and geriatrics. As her experience and understanding of the development and breakdown of human systems (sensory, perception, cognition, ideation, planning and action) has evolved, so has PROMPT.
What is unique about PROMPT is that it is a human philosophy that looks to create unique programs for each person based on the combination of many factors to support speech production change.
In brief, PROMPT is concerned with all areas of the child’s development and how he/she uses all domains (Physical, Mental and Social) to interact verbally with significant others. In Assessment all sensory modalities e.g. auditory, visual and tactile-kinesthetic are considered as well as speech sub-system development. For example, tone, breath support, mandibular, labial-facial and lingual control. How these systems have developed and contribute to speech production is assessed fully.
After evaluating how the child functions overall, e.g. how they have developed and are currently using communication strategies and the speech-motor system; treatment suggestions are developed. In treatment planning all of the above information is then taken into account and structured to enable the child to make the most of their physical, cognitive, social and speech sub-system developmental levels.
Usually, the creation of a lexicon (vocabulary), that will enable the child to functionally practice and use the new or rebalanced motor actions is created.
This lexicon is developed with the family and school team members.
PROMPT’S effectiveness is due to several key aspects. The Core elements that are considered essential in PROMPT treatment are:
- The use of tactile-kinesthetic information as a critical modality for recognising, integrating and developing cognitive, linguistic and motor behaviour.
- Determining a Communication Focus e.g. an aspect of development in which to embed and focus communication intervention, for example, self-help or activities of daily living, interactive communication routines, play skills or pre-linguistic, pre-academic or academic learning.
- Developing Goals and embedding objectives that embody the Communication Focus and work towards motor/language, cognitive and social function.
- Determining how the chosen goals then affect activities and toys/materials choices and how these in turn affect the child’s ability to process and produce motor actions.
- Insuring that a high degree of motor/sound practice, for accuracy of productions and generalisation of these into novel syllables and words, (within naturalistic activities) are used within each session.
- The inclusion of reciprocal interaction and choice making in almost every turn.
- Presentation of the same/similar activities over time to provide a structure in which increased motor-language complexity and cognitive learning of events and sequences can be learned.
- Deciding on the purpose of prompting and what types of prompts should be used to support and develop speech-motor control for speech and language. (Deborah Hayden – The Prompt Institute)
In my search for appropriate interventions for David, I was fortunate to find Prompt (see below description of Prompt) through a friend of mine in New York. Shortly thereafter, I hopped on a plane with David and spent some time with one of the prompt therapists in Austin Texas. Having researched the prompt technique before I left, I was pleasantly surprised to find out that it was even better than I had anticipated. In all the time I have spent searching for interventions to get David to speak verbally, prompt is the one intervention that makes complete sense. (Ilana Gerschlowitz – Managing Director Star Academy)