PROMPT® Therapy Services: Evaluation and Treatment
PROMPT stands for "Prompts for Restructuring Oral–Muscular Phonetic Targets"
In our experience, the opportunity to feel movements for speech has a significant impact on motor learning, and in many cases, makes the difference between verbal and non verbal communication.
PROMPT therapy is...
A language–based treatment approach that provides tactile-kinesthetic information to oral musculature (jaw, lips, tongue) to guide the child’s movements for speech production. There is a PROMPT for every sound in the language, vowel or consonant, and four different types of PROMPTs that serve different purposes in teaching single or combined movements for speech production.
PROMPT is a treatment method based a substantial body of research in the areas of motor learning, cognition and social development. (See the PROMPT website).
How PROMPT is different from traditional articulation therapy...
"Traditional" speech language therapy relies on auditory and visual systems to provide information about sound production. PROMPT therapy adds another dimension to the process of learning to talk, which is information provided by the "tactual system". Sensory feedback from movements is stored and feeds forward as the child is provided multiple opportunities for practice. Muscle memory builds, and movement patterns for speech become more and more automatic.
Children who benefit from PROMPT therapy are children with motor speech disorders:
And children having motor speech disorders in association with:
Reasons for the clinical success of PROMPT therapy are numerous:
- Emphasis is placed on feedback, which is known to be an important aspect of treatment in children with motor disorders. In PROMPT therapy, children receive tactile-kinesthetic as well as auditory feedback, which are the two most important sensory systems for learning to talk.
- Emphasis is placed on trust and motivation, which are so important in helping children with motor processing deficits to take maintain the attention and effort required to make changes in speech production.
- Words and word combinations selected are practiced in many varied interactions, both in therapy and in the child’s natural environment, building muscle memory and motor planning skills.
- Successful social interactions are developed in therapy sessions, helping children who may have difficulty with joint attention and turn-taking to establish a firm basis for communication.
Once target sounds, vowels and consonants are selected, a group of words, or a "lexicon" is developed and become the basis for activities used in treatment. The words are selected for two reasons:
- To provide a high level of motor practice
Each stage of motor control that contributes to speech production is assessed, and speech sounds selected for treatment are those that will develop this control. For example, if the sounds selected are /p/, /b/, /m/, /a/, /o/, /h/, /u/, /i/, /d/ and /n/, words and phrases for motor practice may include "on", "hi", "bye", "Mommy", "up", "new", "no", "do", "want", "need", "one", "two". Sounds, syllables and words are practiced with high levels of repetition during "warm ups" at the beginning of PROMPT therapy sessions.
- To provide varied practice, which is critical for establishing motor skill
Therapy activities are developed to provide meaningful and socially appropriate contexts in which the child will be motivated to use his or her new words regularly. Most motor practice in PROMPT therapy sessions takes place when target sounds and words (lexicon) are practiced within functional communication contexts: "Hi Mommy", "new one", "no up", "I do", "I want two__". Target words and phrases are shared regularly with parents and related professionals to ensure a high a level of practice at home and in school.
Four Levels (Types) of PROMPT May Be Used in Treatment
There are four different levels of PROMPT that are used as needed to build motor skill in children who are learning to talk or to speak more intelligibly. Each level serves a different purpose in providing stability and coordination at varied levels of motor control:
- Parameter PROMPTs provide a base of support to the jaw or information about broad rounding or retraction of the facial muscles for sounds such as /o/ and /i/. Parameter PROMPTs may be taught to parents and related professionals.
- Surface PROMPTs provide the most critical information about the formation of speech sounds and are most helpful for timing and transition from one sound to the next.
- Syllable PROMPTs combine support to the jaw and information about rounding or retraction of the lips for production of syllables such as "me", or "boo".
- Complex PROMPTs provide the most information about the formation of a speech sound, and are used only when teaching single sound productions such as /s/, /r/.
PROMPT was developed by developed by Deborah Hayden, CCC/SLP, founder and director of the PROMPT Institute in Santa Fe, New Mexico. Certified PROMPT Clinicians have met the stringent requirements set by the PROMPT Institute (see FAQs), and are able to use their expertise to help children with motor speech disorders achieve speech production accuracy, improved social interaction and maximum potential for growth in many related areas of development.