© David Sponder, L.E.P., BCBA, Floortime C3c
Executive Director, Sponderworks Children’s Services

What you should know about Prompting

Why people prompt

Prompting is a matter of providing people reminders, cues or help to do things.  We can even prompt ourselves.   It is important to think about why prompts are necessary and why they are typically used.  People prompt others – in general for the following reasons:

To bolster someone else’s memory…

To remind them to do something that they forgot to do
To remind them of a rule or requirement

To make them go faster…

To speed up performance
To get them to return to task (i.e. when they disengage or go off task and “waste time”)

To point out or get them to notice things…
To get them to see or focus on things they need to

To get them to see things they have not discovered for themselves

To motivate them…

To get them to do something they are not doing
To make them uncomfortable enough to do things they would rather not do or are not sufficiently motivated to do

This list is not exhaustive.  However, most prompts given to children are to support their memory, make them go faster somehow, or get them to do things they’re not sufficiently internally motivated to do.  The bottom line is that prompting is a compensation for memory, skills, or motivation the child lacks.

Prompting to Compensate for Memory and Sequencing (Motor Planning) Deficits

Here, prompting is used to remind people of steps, rules, or even what they were doing in the first place.  Children with neuroregulatory disorders, due to motor planning deficits, have subsequent deficiencies in working memory, and often lose track of what they were doing.

Prompting to Compensate for Slow or Inadequate Performance

People with autism process slowly.  When activities become too fast or too complex (in other words they have been improperly set up), prompting becomes necessary in order to get the child to “keep up.”  Also, for many children, their performance is characterized by frequent distraction and disengagement of attention – which slows activities down.  This is when prompting is most often used.

Prompting to Compensate for Pattern Finding Deficits

People with autism tend to be absorbed in their own actions and thoughts, failing to “track” what goes on around them.  They don’t detect patterns in other people’s behavior or in the environment that should function as natural cues; therefore, others tend to compensate for these deficits by prompting them to look around and/or to pay attention to certain cues in the environment.

Prompting to Compensate for Motivation Deficits

This becomes really a form of negative reinforcement, where the child’s motivation actually comes from a desire to get the prompter of his back.  Also, if a child needs to be reminded or focused on “what he’s earning” all you really have is an economized relationship where one party offers incentives to the other for motivation.  This is a real barrier to intimacy and normal motivation and is a huge problem.

Forms of Prompts

The above described reasons why people prompt can be considered the “functions” of prompting.  Prompting also has several readily identifiable forms:

Non-verbal Prompts

These come in the forms of physical prompts (touching or providing physical guidance) or non-verbal signals such as pointing, facial expressions and body language (instrumental, social or emotional references), object communication techniques, and embedded prompts (below);

Embedded Prompts

These are prompts that are naturally found in the environment (e.g., a sink full of dirty dishes can function as a cue to wash them; clothing laid out on the bed in order from left to right can help a child put clothes on more independently), or that are purposefully placed in the environment to provide cues (e.g., schedules, checklists, menus, step-by-step guides, etc.).  Essentially these are static references.  They depend on regularly recurring routines that go on pretty much without changing.  This of course can lead to a trap where instead of looking to signs of change that would help one anticipate the flow of events, one looks to the static reference instead.  Unexpected changes then become even more threatening.  (For an example of how embedded prompting can have counterproductive results, please refer to the page about Compensation v. Remediation, or refer to the commentary from autism-pdd.net describing the pitfalls of [some] TEACCH programs that take embedded prompting to an unfortunate extreme.

Verbal Prompts

Verbal prompts are simply words that perform the functions of prompting listed above.

Partial Prompts and “Prompt Fading

Partial prompts are simply less intense versions of the forms listed above.  For example, a partial physical prompt might simply consist of a tap on the shoulder to get someone going or to cue an action.

Non-specific Verbal Prompts

Partial verbal prompts come in the form of less specific forms, often in the form of questions: “What should you be doing?” “What do you say?”

Getting Rid of Prompting

We all need prompting on occasion – even if we have to prompt ourselves with our beneficial compensations like Day Runners and lists.  However, most prompts can be rendered unnecessary if adults allow children to slow down, and they frame the activity in such a way that if they allow the child a little extra time and space[1] to figure out what they should do next.   Further, they should control for distractions or competition for focused attention in order to maximize the person’s ability to get himself back on track.  For a further explanation of this procedure, refer to the Stop the Action Technique for Teaching New Skills[DS8] , which is useful for helping a child maintain his focus and to figure out what to do next.

Prompting and PDDs

When prompting children with autism, one must be very careful, since the child with deficient social referencing experience may not be able to figure out what is the prompt and what is a natural part of the sequence of a routine.  Children acquire the ability to discriminate related from unrelated parts of interactions through experience observing others.  Throughout their lives, they have been observing interactions and following others’ gaze to relevant stimuli, which has given them an education about relevance.

The child with autism missed most opportunities to get such an education.  Therefore, prompting is a trap that once started, requires an exit strategy.

Here’s an example: When teaching a child to wash his hands, the Therapist might say, “Turn on the water” to get the child to turn on the water.  The neurotypical child would be able to recognize that “turn on the water” was merely a cue to do it, whereas the child with ASD might misread it (the prompt or cue) as a necessary step of the routine.  In other words, the child with ASD might just await the prompt, and if the prompt is not given, he might just wait until it comes.  In the mind of the autistic learner, this could be what he or she thinks is correct.

Not only is this incorrect, it puts the Therapist in somewhat of a bind, because due to mislearning like this, the Therapist now has to say the prompt every time, or figure out some way to get rid of the prompt.

Applied Behavioral Analysis: Prompting

ABA has made a science of analyzing prompt forms, and have developed what are termed “prompt-reduction” and “prompt fading” procedures to reduce the reliance on artificial, external prompting.

Most-to-Least Forms of Prompting and Fading

Lessons often begin with the most prompting because the child does not yet have the skills.  Then, prompts are reduced as the child performs a skill more independently, and the reduction/fading process is a key element in this process.  Some general strategies for diminishing the role of prompting in a given task might be:

  • Reducing the frequency of prompting: The “schedule” of prompting is “thinned” so as to reduce the number of prompts given.  When the child is executing steps more from memory and conceptual knowledge, this can be possible.  This can also be difficult or impossible to do if the child continues to believe (mistakenly) that the prompt is actually a [necessary] step in the routine.  Attempts to thin out the schedule of prompting may simply result in getting stuck.
  • Reducing the intensity of prompting: This has to do with reducing the relative intrusiveness[2] of prompts used.  Any prompt that draws attention to itself is too intrusive if you ask me, and the intensity should therefore undergo reduction.  Prompts that are loud, physical, too explicit, etc. are not generally available in normal social or work environments.  The presence of explicit, overly static and non-social embedded cues (below) a la TEACCH can be over-explicit if not carefully thought out, causing the child to withdraw from or ignore important cues going on elsewhere (tracking)..
  • Changing the form of prompting: This usually involves converting explicit prompts to more implicit forms, such as replacing a physical prompt with pointing or replacing an explicit verbal prompt with a vague prompt (e.g., usually a question or other imperative such as, “What should you be doing?”).
  • Replacing personal prompting with environmentally embedded prompts: This is where static visual references usually come in.  Things like timers, TEACCH boxes, rigid schedules, counters and the like are examples of replacing personal prompts given by people (e.g., “It’s time for…” “Do this next…”  “Put it here…”  Here again, these kinds of compensations can be beneficial and absolutely necessary, but when remediation for deficient mental processes that have led to unnatural reliance on these non-social references is available – remediation is the better long-term strategy.
  • Replacing prompts with natural cues: This is usually a laudable goal for everyone.  Parents of neurotypical children certainly see a problem with a child that does not recognize a messy room or dirty dishes in the sink as a ‘natural cue’ to clean up, or to recognize the signs of other peoples’ hurt feelings as a natural cue to stop teasing.

Again, prompt fading strategies are necessary when prompting is included as part of the teaching method.

Think of how inefficient the use of prompting can be if over-used or done carelessly.  A teaching strategy that includes prompting will require extra steps and extra effort and time to reduce the prompting.  This is one of the reasons some therapies require many more hours of instruction to work than newer methods.  The use of more natural and social interactive techniques instead of the prompts listed above, at least in our experience, has drastically reduced the time it takes to teach skills, whether they be functional and instrumental skills, or social/emotional skills.

Least-to-Most Forms of Prompting and Fading

Least-to-Most prompting starts with child attempts at performing a skill, and the Guide provides as little help as possible so that the child can do more of the thinking and trying.  This approach is much like the scaffolding techniques used in Guided Participation.

[1]     This depends on providing sufficient framework (control for distractions and a reasonable assumption of the child’s potential and experience that would enable the child to remember or think of what to do independently).

[2]     “Intrusiveness” has to do with how much the prompt interferes with the child’s ongoing activity.  Examples of maximum intrusiveness might be when the adult uses hand-over-hand guidance or any kind of physical guidance to do something, or when the adult rearranges the environment to a degree where it no longer resembles a natural environment for the demonstration of the skill.