PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets)

PROMPT is a widely accepted treatment method which focuses on a tactile-kinesthetic approach to speech therapy. During the therapy session, the SLP uses touch cues to shape and support the correct movements of the articulators (jaw, cheeks, lips and tongue) of the client. The SLP and the client progress through the hieracrchy of sounds at a steady pace. The patient learns through the assistance and repetition to plan, organize, and create more advanced vocal sounds. Administration of the therapy is facilitated by a PROMPT-certified SLP (Vollmer, 2020).

Who benefits from PROMPT therapy?

Clients who have a history of stroke, degenerative disease, TBI, surgical trauma, and neurodegenerative diseases such as Alzheimer's disease and progressive supra-nuclear palsy

Motor Speech Target Impairment

Apraxia of Speech is a motor speech disorder which is characterized by a disturbance in a higher level of planning or programming of movements for speech (Duffy, 2013). This impairment is caused by a lesion in the left posterior frontal or parietal lobe or in the insula or basal ganglia

Therapy Goal: In 8 months, given PROMPT tactile cues, the client will produce 15 functional words in 4 out of 5 trials at 80% accuracy as measured by SLP data collection.

Activity Breakdown

Choose functional phrases
Clinician models the target phrase and uses her hands to stabilize the mandible and uses tactile kinesthetics to teach the client how to articulate each sound of the target phrase.
The clinician tells the client "say it with me" and says the target phrase with tactile prompts as the client repeats it.
The clinician repeats the target phrase during conversation and continues and uses less support as he helps the client produce the target phrases.

Hierarchical Cueing

1. Syllable: provides jaw support to produce a vowel. Used at the early stage of therapy to shape muscle groups for single syllable consonant vowel productions

2. Parameter prompting: provides core support to the jaw and inhibits excessive jaw opening. The clinician uses her hands to touch lips, mouth, and jaw to transition the close the jaw to open and back to close

3. Surface prompting: Uses tactile kinesthetics to cue the placement, manner, transition, and timing of articulation

4. Complex: uses single phonemes of a target phrase to refine lingual control and labial facial control. For example, the clinician gives specific tactile kinesthetics for the phoned /sh/ of the target phrase "show me."

Images of Materials

1.Pen

2. Data sheet

3. Functional phrases

motor_speech_hierarchy_ data sheet form.pdf

Data sheet

An Evidence-based Approach

"Finally, the effectiveness of PROMPT has been demonstrated in a number of clinical populations. Freed et al. (1997) documented the acquisition and maintenance of the production of 30 words and phrases by a 24-year-old man with severe apraxia and aphasia who had been treated with PROMPT cueing techniques. Bose et al. (2001) showed that PROMPT treatment resulted in significant improvement in the precision and automaticity of functional phrases in a 30-year-old woman with severe apraxia and Broca's aphasia."

References

Dale, P. S., & Hayden, D. A. (2013). Treating speech subsystems in childhood apraxia of speech with tactual input: The prompt approach. American Journal of Speech-Language Pathology, 22(4), 644–661. https://doi.org/10.1044/1058-0360(2013/12-0055)

Prompt Institute (2015, January 14). 9 Components of PROMPT. YouTube. https://www.youtube.com/watch?v=yXtNYsfNXO4.

Prompt Institute (2018, November 6). What is PROMPT therapy?. YouTube. https://www.youtube.com/watch?v=d1eMHygmIwQ.

Vollmer, E. (2020). Prompt speech therapy for kids. Therapyworks. Retrieved from https://therapyworks.com/blog/language-development/what-is-prompt-method/

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