Wednesday, December 9, 2015

Types of Prompts and How To Use Them Effectively

When teaching children new skills, therapists and teachers provide instruction and prompts to complete the skill.  Many times different prompts are used together to help a child learn a new skill or complete a targeted response.

There are many different types of prompts such as:

1.  verbal prompts - instructions or words to direct a person to complete the skill.  It is the most commonly used prompt.

2.   modeling - demonstrating the skill either in person or on a video.  It is the second most commonly used prompt.

3.  manual prompts - physical contact from a teacher to help the child complete the skill.

4.  gestural prompts - pointing, motioning or nodding toward the child or the objects to complete the skill.

5.  photographs and line drawings - pictures or step by step instructions to complete the skill.

6.  text prompts - written instructions, checklists, scripts and reminder lists.

Prompts are beneficial when teaching children new skills but in order for the child to become fully independent in the skill the prompts need to decrease over time until they are no longer needed.

Here are some techniques to use prompts effectively:

1.  One approach is to start with the least amount of prompts possible (least to more prompting method).  Begin with minimal assistance and only add additional prompts if needed.  Prompt along a continuum of verbal prompt, gestural prompt, modeling and then a manual prompt.  Sometimes even with one type of prompt you can move along a continuum of least to greatest prompts.  For example, use one verbal request.  If needed, add additional verbal requests.  The benefit to this technique is that with every additional prompt needed the child is getting repeated time to respond to requests and more practice time.  This least to most prompts approach is a good choice for skill assessment to determine how much of the skill the child can do independently.

2.  Another approach is to reduce the prompts as the child learns the skill (most to least prompting method).  When children are first learning a new skill they may need physical cues, modeling and verbal prompts.  As the child learns to master parts of the skill, reduce prompts to encourage full independence by the child.  Some research indicates that reducing prompts is the most effective fading prompts technique because it results in fewer errors and quicker skill acquisition than the least to more prompting method.

3.  Delay prompting by increasing the amount of time before you offer the assistance.  For example, when providing a verbal prompt wait 3 seconds before providing the manual prompt.  When the child is ready try to fade the prompt, by providing the verbal prompt, now wait 5 seconds and if the child does not complete the request provide the manual prompt.

4.  Grade the guidance you are providing for manual prompts.  The instructor can gradually change the intensity or location of the manual prompt.  For example, if you need to provide hand over hand manual guidance, slowly grade the guidance to just the wrist, then elbow, then shoulder, then standing behind and finally moving away entirely.

5.  Gradually fade the properties or characteristics of the materials used to elicit the skill.  For example, if you want the child to point to a specific object perhaps you make that object stand out more during early trials (ie "Point to the red circle" and the red circle is bright red versus the other choice which may be dull green circle).  Then as the the child responds correctly decrease the difference between to the two choices.  Perhaps you offer the child motivational and fun tools to complete the skill but over time you gradually fade the use of the fun tools and replace them with everyday objects.

6.  Prevent prompt dependence.  The child should respond to the prompts and relevant cues not just the prompts.  Fade prompts as quickly as possible to avoid prompt dependence.  When a child is first learning a new skill, responding to prompts can be rewarded.  As the child progresses, reward or affirm the child when unprompted responses occur.  Some research indicates that rewarding more unprompted responses than prompted responses results in in more correct responses and more rapid learning.

7.  Return to the previous levels of prompting if errors occur.  When the child practices the skill the next time provide enough prompts to decrease the chance of errors again.

8.  Evaluate the effectiveness of prompts.  Using direct observation and data collection to determine what prompts are successful and when to fade the prompts.  Remember to treat each child and each skill as a whole new set of circumstances and don't necessarily rely on previous observation and data to determine new prompts for different skill sets. Try to do short term trial runs of different types of prompting to create a plan of action.

The next time you are teaching a child a new skill remember to have an ongoing evaluation of what types of prompts you are using, how are you using them and a plan of action to fade the prompts as quickly as possible.  Educate all the people who interact with the child to make sure all of you are utilizing the same prompting techniques.

Reference: MacDuff, Gregory S., Patricia J. Krantz, and Lynn E. McClannahan. "Prompts and prompt-fading strategies for people with autism." Making a difference: Behavioral intervention for autism (2001): 37-50.

Here are two digital downloads that work on fading visual prompts.
Fading Alphabet includes worksheets that gradually increase in visual motor difficulty while decreasing visual input for letter formation.  Find out more at

Fading Lines and Shapes includes worksheets that gradually increase in visual motor difficulty while decreasing visual input for line and shape formation. Find out more at

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