LLA Therapy, Speech Language Pathologist, Teal Simmons, M.A., CF-SLP, discusses the benefits of PROMPT therapy and why she is getting certified
What is PROMPT?:
The word
‘prompt’ is often associated with a method of eliciting a specific
response/behavior when attempting to teach a skill. For example, “I prompted
her to get her coat off the hook and put it on.” However, PROMPT therapy takes
on a very different meaning. PROMPT is an acronym for ‘Prompts for
Restructuring Oral Muscular Phonetic Targets.’ This method of speech therapy
was originally created to target individuals with severe motor impairments.
PROMPT provides support in a multi-sensory (with focus on tactile-kinesthetic)
and dynamic way to support growth and development of speech and communication
function across all domains.
This
method is supportive of the areas of social interactions and communication, in
addition to the development of motor speech movement/sounds. It sets therapy up
to focus on all aspects, including the systems for social-emotional,
cognitive-linguistic, and physical-sensory(motor), and how these systems work
when interacting within the environment. PROMPT uses a functional lexicon (a
set of words) that correlates with the child’s motor speech ability to support
overall speech/language development. This allows the child to learn
sounds/words that will be useful when they are mastered to support their
communication and social interactions as a whole – not just being able to
correctly make the sound or word. Using the targeted set of words during
everyday situations (to later target production) also allows for the child to
have exposure to the words, engage in simple routine activities, incorporate
turn taking with the routine, and provide opportunities for the child to
"see the word" being verbalized correctly, hear the word, and tie
meaning to the word.
This process supports the motor piece of PROMPT when a child
is ready to receive the kinesthetic-tactile input for learning how to produce
speech sounds. It helps the child correctly and simply connect the meaning
words and activities used and provides exposure to help tie how a speech
sound/word looks and sounds with how it feels when given the prompted motor
input. The purpose of working on a child-based holistic assessment of how all
systems are functioning is to ensure that there is a limited amount of stress
or strain on all other systems (i.e., cognitive/linguistic, social/emotional)
so that the child’s sensory/motor system can be the primary focus without
stressing out other systems. Motor input is exhausting!
Clients
that may benefit from PROMPT:
A wide range of clients, beginning as early as six months
old, could potentially benefit from this method of speech therapy. Most
commonly, client’s treated with PROMPT therapy present with some type of motor
speech disorder, articulation problem, or are considered to be “late talkers.”
This method is a way to reduce a client’s workload for attempting to correctly
place their articulators to produce true speech sounds and sound sequences.
Clients are given tactile-kinesthetic supports, or prompts, to shape the sound
while they feel it, see it, hear it, and make the prompted sound production.
Other clients that have been found to benefit from this method of therapy
include those with apraxia/dyspraxia, dysarthria, aphasia, cerebral palsy,
autism spectrum disorder, pervasive development disorders, aphasia, and other
communication disorders. PROMPT takes the focus off of solely speech-sound
production, and instead aims to focus on improving motor skills for functional
use throughout language development to support social interactions.
Why PROMPT makes sense:
PROMPT
aims to facilitate a client’s ability to produce speech sounds, to modify motor
patterns already created for speech sounds, and to integrate motor,
social-emotional, and cognitive-linguistic functions for the development of
effective communication.
PROMPT
differs from the typical developmental hierarchy of speech sounds and
‘scrambles it up’, so to speak. It ventures to address where a developing motor
system needs support to strengthen and grow, rather than determining therapy
targets based on what sounds should be present in a typically developing child
(and motor system) at a specific age on a developmental scale. This makes sense
to me because some of the earlier developing sounds are, in fact, some of the
most motorically complex. (i.e., a /t/ sound, that is often one of the first
sounds to be targeted takes a large amount of motor skill to move the tongue
independently from everything else). A child whose system presents with a delay
may not be “wired” or “set up” for functioning to produce more complex sounds
that are known to come earlier in more typical developing speech systems.
All
of an individual’s systems (e.g., social emotional, cognitive linguistic,
physical-sensory), as well as the child’s environment, are considered when
using this approach to therapy to ensure that a client’s primary needs are
targeted during therapy. The PROMPT method focuses on a child’s specific needs
for communication based on an assessment of all of their systems functioning
together as a whole unit. If one system requires more support than the motor
system, the focus for therapy should be on that system. This also makes sense
because if the child is receiving motor input and has too much stress/strain on
other systems, therapy won’t be beneficial for the child. If the other systems
are being too “stressed out” or taxed at the same time of motor information
input, the motor system will likely not be able to effectively process/use the
information being provided.
My personal journey to PROMPT:
In my
experience with therapy and working with children with broad ranges of skill
levels and developmental disabilities, I have become a firm believer in the
idea that there is not a “one size fits all” approach for therapy. I feel that
every client is unique and should be assessed and treated on an entirely individualized
basis. As a speech therapist, I have had experience providing services at a
board of developmental disabilities, a head start program, a neurological
center, through telepractice, at private clinics, and at a school for autism. I
have had the opportunity to see, experience, and utilize a wide range of
approaches to treatment. Some examples include The Son-Rise Program, Floor
Time, The Early Start Denver Model, and Applied Behavioral Analysis (ABA),
among other approaches. I do not utilize a favorite or a “standard” method. I
am constantly evaluating, re-evaluating, and changing my approach in therapy
based on what I believe would benefit the client and the client’s family.
I first
learned of PROMPT during my time as a graduate student. I volunteered with a
family to help facilitate The Son-Rise Program for their son who had been
diagnosed with autism and apraxia of speech. The child’s parents continuously
searched for a way to help him learn how to talk. All of their searching lead
them to PROMPT. Their son was eight years old when the family began traveling
almost four hours for PROMPT therapy once a month. In a very short time, he was
beginning to produce sounds that he had never been able to say before taking a
chance with this intervention. I had the privilege of being a part of their
PROMPT journey: learning about what PROMPT means, learning how PROMPT is
effectively implemented, and seeing progress that PROMPT made possible.
Why I wanted to become a PROMPT
trained clinician:
PROMPT is
a method to approach communication and speech sound production therapy in a way
that is holistic and considers all aspects of a child, their environment, and
all of the child’s system. Therapy focuses on all systems fluidly rather than
only targeting the motor speech production piece of communication. It is a
method that allows flexibility and constant evaluation, re-evaluation, and
fluid movement through different phases of treatment to target and put a
spotlight on whatever the child’s needs are during a particular time in their
development or even during one therapy session. This method aligns well with my
belief that therapy is ever changing and that “one size” truly does not fit
all. It also supports the idea that one method of therapy for a specific child may
need to be changed and altered constantly to fit their individual needs as they
change.
So, I
asked to become “PROMPT trained,” and I traveled to New York in September, 2015
for an intensive training. My goal is to become fully PROMPT certified in the future.
I am very passionate about this method to approach communication development,
and I am excited to be using it in practice and to be seeing results (in just a
short time) with my clients!
Questions?:
Labels: Offers for Parents, Offers for Schools
