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My daughter started PROMPT speech therapy about a year ago. As a toddler, one of her most significant delays, and the first identified, was speech. It took some time to get words; they came well beyond the 18 month milestone. While she did have a few words, she did not have many, nor could she string them together. This often resulted in frustration because she couldn’t make her needs known. Early intervention included traditional speech therapy, and started at age 3.

Disclaimer: Reviews are based upon personal experiences of those who have tried a particular intervention or strategy. It is NOT medical advice, nor a substitute for medical advice. It is neither an endorsement or opposition to any intervention. This is an opinion piece.

What is PROMPT speech therapy?

According to the PROMPT institute: “PROMPT, an acronym for PROMPTS for Restructuring Oral Muscular Phonetic Targets, is a multidimensional approach to speech production disorders has come to embrace not only the well-known physical-sensory aspects of motor performance, but also its cognitive-linguistic and social-emotional aspects.

PROMPT is about integrating all domains and systems towards positive communication outcome. To achieve the best outcome with PROMPT it should not be thought of or used mainly to facilitate oral-motor skills, produce individual sounds/phonemes or as an articulation program but rather as a program to develop motor skill in the development of language for interaction. “

Although my now-teen does have speech, she remains difficult to understand. This is particularly true for people who don’t know her well. Most frustrating is that people tend to assume she doesn’t understand simply because they don’t understand her.

She receives traditional speech therapy in school three times per week. What interested me in PROMPT was that it works with the muscles that produce speech, rather than working on articulation alone. In my daughter’s case, we found that her jaw slides to the side while talking. We use PROMPT therapy once per week in addition to the services she gets at school.

WHo does prompt help?

PROMPT is used to help develop, re-balance, and restructure how a child coordinates movements of the jaw, lips and/or tongue for oral communication. This is for improved sound production and refinement for greater intelligibility.

If a child is not making progress in their traditional speech therapy sessions which typically employ the use of visual and/or  auditory cues, then consider PROMPT.

impact on reading

My teen also struggles with reading, and recently the school started 1:1 intervention with a specialist using an Orton Gillingham based approach. The combination of PROMPT therapy and the reading intervention seem to work well together. My daughter has improved 2 grade levels in reading in a year.

To my way of thinking, sounding out words is much more difficult when the sound production isn’t correct. Hearing a sound, repeating a sound and sounding out words are interconnected. In fact, a study completed by the American Journal of Educational Research found that children with communication impairments score lower in reading and writing evaluations compared to their peers, making them at a greater risk of having reading difficulties.

prompt Considerations

It’s important to research, find the right practitioner to determine whether PROMPT therapy is right for your child.

• Cost. PROMPT may not be covered by insurance. In our case, it is not, and we pay privately.
• Sensory. Will require the therapist to touch your child’s face. My daughter was OK with this, but not all kids will be.
• Time. It doesn’t work overnight (like any therapy or intervention, it takes time)
• Certification. Speech Pathologists are the only professionals with the educational background to use PROMPT, and therefore are the only professionals able to take training to be certified.

our experience

Overall, we believe that our daughter’s speech has improved with PROMPT. She has better conversational speech and articulation. Her jaw no longer slides to the side. When she uses the strategies she’s been taught, she is easily understood. We also believe that PROMPT has contributed to her improved reading skills, and overall confidence.

We have shared the PROMPT strategies with my daughter’s teachers and with the speech therapist she sees at school to coordinate and focus efforts which also has contributed to her success.

It’s important to note that training speech production muscles takes time. She has had to learn different mouth positions and movements to produce more articulate speech. PROMPT therapy improvements won’t happen over night. At a rate of once per week, we started to notice improvement after about 3 months. The first thing I noticed was an improvement in saying words with the letters “N” and “L”.

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