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Evaluation and Treatment

Children’s Speech and Language Services, located in Falls Church, Virginia, is proud to offer PROMPT© treatment. We have 3 PROMPT© Certified Instructors on staff, and are considered the leading experts of PROMPT© in the Mid-Atlantic region. Each member of our staff is individually mentored to foster their continued growth and knowledge in PROMPT©.

PROMPT© uses tactile-kinesthetic-proprioceptive input (in addition to visual and auditory cues) to support, develop and improve speech-motor functioning and in turn, increase daily functional communication.

A client’s success in PROMPT© treatment is dependent not only on the finesse of the clinician’s hand technique, but also the knowledge that they bring to each treatment session.

Prompt Testimonial

“Small Steps in Speech” and PROMPT therapy has been life changing. Jordyn will go to kindergarten next year. She will be in a class with her typically developing peers. Although she will probably still need some speech therapy next year, she has a voice to share her feelings and ideas.

Video on The 9 Key Components to the PROMPT© Approach

    • Click here to read: Neural Changes Induced by a Speech Motor Treatment in Childhood Apraxia of Speech: A Case Series, published July 2021 in Journal of Child Neurology
    • Click here to read: PROMPT intervention for children with severe speech motor delay: a randomized control trial, published May 2020 in Pediatric Research

How is a child determined to be a good candidate for PROMPT© ?

If a child is not making progress in their traditional speech therapy sessions which typically employ the use of visual and/or auditory cues, then PROMPT© should be considered. Assessing how the child uses sensory input is critical. The PROMPT© trained clinician looks at how a child uses not only visual and auditory cues, but also the tactile-kinesthetic-proprioceptive input of PROMPT©.

It is not unusual for a child to lean in for additional input, as the child realizes early on that the information provided is quite powerful to their system. Determining which input is most useful in bringing about change in production and performance is important.

What can I expect in typical PROMPT© assessment?

Looking globally at the individual’s Physical-Sensory, Cognitive-Linguistic, and Social-Emotional domains, the PROMPT© trained clinician then evaluates what is under control, what is not under control and what is useable in the speech-motor system. Using the System Analysis Observation in conjunction with the Motor Speech Hierarchy, the priorities for treatment are determined.

Appropriate phonemes (sounds) and sound combinations in words and functional phrases are selected that match with the individual’s level of speech-motor control. Additionally, the clinician must determine how much/what level of tactile-kinesthetic-proprioceptive support is required by the child.

How does PROMPT© follow motor learning principles?

Effective PROMPT© treatment relies on principals of motor learning, combining both mass practice (a high number of repetitions/repetitive productions) with distributive practice in similar but not identical functional language activities. Critical to learning new “motor maps” is connecting the motor movement to the cognitive-linguistic concept in functional language.

What else is critical during the typical PROMPT© session?

Cognitive-linguistic theorists teach that children learn through their interactions with a more able user of language. The PROMPT© trained clinician is therefore highly aware of the need to foster social language interaction through turn-taking activities and/or choice making throughout each session.

How old does a child need to be in order for the clinician to use PROMPT© ?

We are using PROMPT© with children as young as 16-20 months of age. At that young age, we are really helping the child to produce functional syllable shapes through jaw + lips and jaw + tongue movements. If a child is struggling to produce words, it could be that he/she just doesn’t know what to do with his/her mouth. So, the PROMPT© trained clinician helps to guide the jaw through movements such as jaw open to jaw closed. This would be a movement necessary to produce a functional word like up.

Why is PROMPT© used in treatment?

PROMPT© is used for helping to develop, rebalance, restructure the speech-motor subsystems (how a child coordinates movements of the jaw, lips and/or tongue) for oral communication. This is for improved sound production and refinement for greater intelligibility

However, there are two other uses of PROMPT©. Because touch can be so very connecting it is often thought of as the glue that holds our other senses together. Therefore The PROMPT© trained clinician can use PROMPT© to bring attention to turning on the voice (making sound) to express communicative intent (meaning). The tactile-kinesthetic-proprioceptive input enhances the child’s attention to another person’s face, as well as to the task at hand. PROMPT© draws the child into the social interaction, to help to develop enjoyment in interacting with someone. It helps with developing turn-taking skills and with establishing trust in another person.

PROMPT© can also be used for mapping in cognitive or linguistic concepts. For instance, if the PROMPT© trained clinician is working with a child to understand the concept on, then as the child is putting a sock and shoe on his foot, the word is being PROMPTed on his face. A link is made between the cognitive spatial concept of on, with the vocabulary word on, and the motor action of opening and closing the jaw to produce on.

Are there different levels of PROMPT© training available to SLPs?

To become fully trained in PROMPT©, a clinician must go through four essential steps to be able to most completely understand the PROMPT© technique and apply it appropriately to patients. These steps must be taken in the following order:

1. Introduction to PROMPT©: Technique
This intensive 3-day workshop focuses on the technique of PROMPT©, the hands-on application of tactile-kinesthetic-proprioceptive information. The course further explains the need to integrate PROMPT© into a holistic therapy approach.

2. Bridging PROMPT© Technique to Intervention
This is another intensive 3-day course. The focus here is on developing more finesse in the clinician’s hand technique, but also on learning to develop appropriate goals and objectives for their clients. This training allows the clinician to better address the client’s needs not only in the therapy setting but also in the home environment. The focus remains on developing the best communication outcomes for the individual in PROMPT© treatment.

3. The PROMPT© Self-Study Project
This Self-Study supports the learning of PROMPT© Technique through direct suggestions for assessment, target sound selection and development of treatment goals and objectives with a particular patient. Feedback is provided to the clinician by a PROMPT© Certified Instructor.

4. PROMPT© Certification: A Self Study Project
This intensive self study is a 4-month study of one client that the clinician is presently treating. It involves a detailed assessment of the client’s global domains and the development of a holistic intervention plan. This plan includes the identification of priorities identified on the Motor Speech Hierarchy using the System Analysis Observation to select motor phonemes (sounds) for developing words and phrases. The sound, word and phrase lexicons are then incorporated into functional communication activities. Parent/caregiver strategies and goals are developed. This project is scored by a PROMPT© Certified Instructor.

It is only after completion of all 4 of these trainings that a clinician is considered to be a PROMPT© Certified Clinician and is allowed to add PC to her credentials. The PC credential is fully recognized by the American Speech-Language-Hearing Association.

How can parents find out about the level of a clinician’s PROMPT© training and expertise?

Parents can go to the PROMPT© Institute website to search for a therapist in their geographical area. Using the interactive map, parents will find therapists in or around their zip code area and their respective level of training: Visit the PROMPT© Institute

Have more questions about our PROMPT© services?  Please contact us at our Falls Church office so we can help you you!