The PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets)

The PROMPT was devised by Deborah Hayden, MA, CCC-SLP in 1980. To date, the system has been used with phonological, developmentally delayed, dysarthric, dyspraxic, hearing impaired, autism spectrum, and fluency disorders. The PROMPT should not stand alone but should be part of a total therapeutic program incorporating language and pragmatics.

Stages of Treatment: These are arranged in a hierarchy where the lower levels directly impact on the child’s ability to develop skills in the subsequent levels.  For example, if the child does not have adequate control of the jaw (Stage III), that child will not have an adequate base to produce more complex strings of consonants and vowels).

  • I- Muscle tone/strength throughout the body;
  • II- Phonation/respiration;
  • III-Jaw control (vertical plane of movement);
  • IV- Facial Contraction and Rounding (Horizontal plane of movement);
  • V-Tongue Control;
  • VI-Timing between sounds/production of short phrases;
  • VII-Prosody and Suprasegmemtals/Intonation.

Once the clinician evaluates where the child in within this hierarchy, she will develop a series of activities to develop the skills within each stage.  Many of these will include the placement of her hands on different parts of the child’s body, face, and mouth to help direct the muscles in the targeted direction.  The PROMPT has an extremely precise set of guidelines for these movements.

For example, placing the thumb below the bottom lip and gently guiding the jaw slightly downward for the production of “ah” on “hot”.

When working with the PROMPT, the therapist will place the targeted consonants and vowels within a functional lexicon or activity.

For example, when working on the production of “m” and “ah”, the therapist may do an activity with “ma” for mama/mommy so the child is practicing the production of the sounds within a functional context.

Diane Lewis, MA, CCC-SLP has access to a CD ROM produced by the PROMPT Institute which have lexicon/activities for every Stage.