Prompts – What are they, and how are they used?

When meeting with therapists or reading progress notes from sessions, you may see or hear something like “He needed prompting to match pictures” or “She initiated to a peer with only gestural prompts.” You may wonder what that means, and what are the different prompts that are used?

Prompting is a way to show your child what you want him/her to do after you have given an instruction.

Some children become quickly dependent on prompts, unfortunately, and wait for you to provide that prompt before they make any type of response. Due to this, prompting should be faded as soon as possible. That is, the prompting should be gradually diminished until the child is performing the behavior online counseling service on his own.

Types of Prompts

There are five basic types of prompts:

  • Verbal prompting is the providing of a verbal instruction, cue, or model, or overemphasizing the correct word in an array of choices. A full verbal prompt might involve you saying the entire word or phrase that you are trying to elicit from the child, whereas a partial verbal prompt might be providing only the first sound or syllable to cue the child. Verbal prompts are the hardest to fade and are often overused, so be careful to use them sparingly.
  • Modeling is the acting out of the target behavior by the adult or another child with the hope that the child will imitate.
  • Physical prompting involves actually touching the child. A full physical prompt might involve moving the child through the entirety of the behavior (for example, moving his hand to select the right card from an array, and then moving it further to hand the card to you or someone else). A partial physical prompt might be just touching a hand or shoulder to get the child started on the behavior.
  • Gestural prompting includes pointing to comparing the two online therapy platforms, looking at, moving, or touching an item or area to indicate a correct response.
  • Positional prompting involves arranging the materials so that the correct item is close to or in front of the child. For example, if a task consists of picking a picture of an object from a group of three pictures, you might initially arrange the pictures so that the correct choice is directly in front of your child, while the two incorrect choices are on the other side of the table. As your child progresses, the other cards can be gradually moved closer until they are even with the correct choice.

Prompts are used to help your child learn the response required and then faded so your child can do the task independently. It is always our goal to make your child independent, so we have a “least to most” philosophy regarding prompting. We always use the least amount of prompting needed to help the child realize what is required but make sure the child is not relying on us for the correct response every time.

Since kids on the spectrum are visual, we often use things like picture prompts and written prompts to help a child because these are much easier to fade than verbal prompts occupational therapy activities. It is very difficult for parents to fade the amount of verbal prompting used. Don’t you often feel like you are giving millions of instructions per day? I know I do! As you are giving instructions, be mindful of how many words you are using and think about whether or not all of them are necessary. For example, if your child often washes his hands independently but forgets to dry them, you could simply point to the towel instead of saying “go back and dry your hands.” You could also put pictures on the bathroom wall showing the hand-washing steps and point to the picture if your child misses a step. These prompts are easy to fade and will help your child become more independent.