PROMPT Therapy A Procedural Description Presentation by: Christeen Z. Scarpa June 18, 2008 Caldwell College

Overview of Presentation Search Descriptions Definition of terms Brief History Description of procedures Conceptual analysis References

Search Description PsycINFO: PsycINFO: Typed: PROMPT Typed: PROMPT Results: NONE Results: NONE Typed: PROMPT Therapy Typed: PROMPT Therapy Results: NONE Results: NONE Typed: “PROMPT Therapy” Typed: “PROMPT Therapy” Results: 3 peer reviewed journal articles Results: 3 peer reviewed journal articles Key words: “PROMPT therapy”, “PROMPT intervention”, or “PROMPT strategies” Key words: “PROMPT therapy”, “PROMPT intervention”, or “PROMPT strategies” Google: Google: Typed: PROMPT Therapy and autism Typed: PROMPT Therapy and autism Results: NONE Results: NONE Typed: PROMPT Therapy: Typed: PROMPT Therapy: Results: Several results including: http: // & meg.tripod.com/id3.html Results: Several results including: http: // & meg.tripod.com/id3.html

Definition of PROMPT Therapy Tactile based treatment strategy for reshaping the individual’s articulatory phonemes (sounds) and sequences. Tactile based treatment strategy for reshaping the individual’s articulatory phonemes (sounds) and sequences. PROMPT uses a different prompt for each individual phoneme. PROMPT uses a different prompt for each individual phoneme. Method applies external tactile-sensory information in order to create new and more “together” motor sounds & paths Method applies external tactile-sensory information in order to create new and more “together” motor sounds & paths

Why Focus On Speech? Speech is a crucial tool for learning, self-advocacy, social relationships, and participation in community. (Rogers et. al. 2006)

Brief History Of PROMPT Developed by Deborah Hayden, MA, CCC-SLP Developed by Deborah Hayden, MA, CCC-SLP 1970’s 1970’s Explored PROMPT’s for Restructuring Oral Muscular Phonetic Targets Explored PROMPT’s for Restructuring Oral Muscular Phonetic Targets Explored how the interaction and balance or symmetry among all motor systems direction affect speech-motor systems control Explored how the interaction and balance or symmetry among all motor systems direction affect speech-motor systems control Explored how effects of damage or disruption to motor paths could unbalance motor speech system development Explored how effects of damage or disruption to motor paths could unbalance motor speech system development

Brief History of PROMPT (Cont’d) 1980: 1 st Empirical research of Prompt efficacy was conducted 1980: 1 st Empirical research of Prompt efficacy was conducted Leading to 1 st Manual of techniques for conducting and implementing PROMPT Leading to 1 st Manual of techniques for conducting and implementing PROMPT Research attempts continue focusing on autism and motor speech disorders Research attempts continue focusing on autism and motor speech disorders

Why use PROMPT Therapy? Methods used for many speech disorders: Methods used for many speech disorders:  Non verbal children with autism  stuttering,  language formulation,  syntax,  auditory processing disorders  Global Delays  Apraxia

Description of Procedures Technique where the therapists fingers are placed: Technique where the therapists fingers are placed: face, face, jaw, jaw, under the chin under the chin Cues Given: Cues Given: finger placement, finger placement, finger movement, finger movement, pressure from fingers pressure from fingers duration of finger placement on individual. duration of finger placement on individual.

PROMPT Therapy Example of finger placement Example of finger placement

PROMPT Therapy st time session, 22 months old

Description of Procedures (Cont’d) **Claims to help facilitate articulatory postures** Oral tactile kinesthetic cues given: Oral tactile kinesthetic cues given: Signals varieties of movement Signals varieties of movement Includes: place of contact; Includes: place of contact; closure closure manner manner

PROMPT’S PHILOSOPHY Philosophy excepted in treatments: Philosophy excepted in treatments:  Humans are externally & internally motivated by mental, physical, and emotional domains  Those 3 domains are fully integrated in most “typical” developing humans  Communication represents important form of integration involving these domains  Humans need to connect with each other, either mentally, physically, and emotionally

PROMPT’S PHILOSOPHY (Cont’d)  Communication may be disrupted by interruption of any or all of these domains  To strengthen weakest domain all domains must be reincorporate systematically  Restructuring should alternate focus among all domains- must be individualized  No communication intervention can produce permanent change without involving all domains

Motor Speech Treatment Hierarchy Information used to determine target treatment’s for individuals with speech disorders Information used to determine target treatment’s for individuals with speech disorders Stage 1: Body Tone: How is postural support for speech?, how is neck & head control? Stage 2: Breath, Phonation, Voice: How is Breath support, how valving & phonation control to support speech? Stage 3: Jaw: how is control of jaw movement

Motor Speech Treatment Hierarchy (Cont’d) Stage 4: Face & Lips: How is control of the face? How is lip movememt? Stage 5: Tongue: How is control of tongue movement? Stage 6: Sequencing: Precise motor phonmene targets Stage 7: Prosody: temporal aspects of speech production (e.g., rate & intonation/tone)

Can PROMPT Therapy Prove Effective When Implemented Alone? PROMPT simply as a technique to elicit phonemes will not achieve the best outcomes. PROMPT simply as a technique to elicit phonemes will not achieve the best outcomes. (Houghton, Meg) (Houghton, Meg)

Conceptual Analysis Higher Order Conditioned Stimulis → Discriminative Stimuli/Motivating Operations → Response Response → Consequence

Conceptual Analysis Surrounding Environment (e.g., home or classroom (teacher present); a visible, non reachable bag filled with desirable “gold fish” crackers → Direction of task (e.g., “say, fhhh”)/ Child is hungry/or craves “gold fish” crackers → Target behavior occurs (e.g., child says “fhhh”) → Reinforcement (e.g., child receives “gold fish” crackers)

Is PROMPT Therapy Effective? PROMPT may be used to facilitate production, revise or change production or to integrate motor production with cognitive-linguistic function. PROMPT may be used to facilitate production, revise or change production or to integrate motor production with cognitive-linguistic function. (Prompt Institute) (Prompt Institute)

HOWEVER…. Some studies concluded: Some studies concluded: None of the children benefited from PROMPT treatment None of the children benefited from PROMPT treatment (Dodd, B. & Bradford, A.,2000).

PROMPT Therapy Comparison Comparison Child in 10 th session Child in 10 th session Deborah Haydon and youtube Deborah Haydon and youtube

References Bose, A., Square, Paula. A., Schlosser, R., & van Lieshout, P. (2001). Effects of PROMPT therapy on speech motor function in a person with aphasia and apraxia of speech. Aphasiology, 15(8), Bose, A., Square, Paula. A., Schlosser, R., & van Lieshout, P. (2001). Effects of PROMPT therapy on speech motor function in a person with aphasia and apraxia of speech. Aphasiology, 15(8), Davis, Anna F., Rosenthal, Ted L., Kelley, John E. (1981) Actual fear cues, prompt therapy, and rationale enhance participant modeling with adolescents; Behavior Therapy, Vo 12(4), pp Davis, Anna F., Rosenthal, Ted L., Kelley, John E. (1981) Actual fear cues, prompt therapy, and rationale enhance participant modeling with adolescents; Behavior Therapy, Vo 12(4), pp Dodd, B. & Bradford, A. (2000). A comparison of three therapy methods for children with different types of developmental phonological disorder. International Journal of Language and Communication Disorders, 35, Dodd, B. & Bradford, A. (2000). A comparison of three therapy methods for children with different types of developmental phonological disorder. International Journal of Language and Communication Disorders, 35, Hayden, D.A. (2004). PROMPT: A tactually grounded treatment approach to speech production disorders. In I. Stockman (Ed.), Movement and action in learning and development: Clinical implications for pervasive developmental disorders (pp. 255–297). San Diego, CA: Elsevier–Academic Press. Hayden, D.A. (2004). PROMPT: A tactually grounded treatment approach to speech production disorders. In I. Stockman (Ed.), Movement and action in learning and development: Clinical implications for pervasive developmental disorders (pp. 255–297). San Diego, CA: Elsevier–Academic Press. Hayden, D. A. (2006). The PROMPT model: Use and application for children with mixed phonological-motor impairment. Advances in Speech-Language Pathology, 8(3), 265–281. Hayden, D. A. (2006). The PROMPT model: Use and application for children with mixed phonological-motor impairment. Advances in Speech-Language Pathology, 8(3), 265–281. Rogers, Sally J., Hayden, Deborah., Hepburn, Susan., Smith, Renee C., Hall, Terry., Hayes, Athena. (2006). A Pilot Study of the Denver Model and PROMPT Interventions, J Autism Developmental Disorder 36:1007–1024 Houghton, Meg (2008) Online. Internet. Reviewed June 16, 2008, from meg.tripod.com/id3.html Houghton, Meg (2008) Online. Internet. Reviewed June 16, 2008, from meg.tripod.com/id3.html meg.tripod.com/id3.html meg.tripod.com/id3.html Mars, Isa SLP, Speech and Language (2008). Online. Internet reviewed June 16, 2008 from Mars, Isa SLP, Speech and Language (2008). Online. Internet reviewed June 16, 2008 from The PROMPT Institute (2008). Online. Internet reviewed June 16, 2008, from The PROMPT Institute (2008). Online. Internet reviewed June 16, 2008, from Youtube (2008). PROMPT Therapy sample. Retrieved June 16, 2008 from Youtube (2008). PROMPT Therapy sample. Retrieved June 16, 2008 from Speech, Language, and Learning pathways (2008). Online. Internet. Reviewed, June 17, 2008 from Speech, Language, and Learning pathways (2008). Online. Internet. Reviewed, June 17, 2008 from