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PROMPT Evaluation and Treatment

PROMPT Evaluation 


PROMPT evaluations usually take 1-2 hours. PROMPT-trained speech language pathologists (SLP) will have a conversation to discuss evaluation results and recommendations. Following this discussion a written evaluation report is typically provided.  


If a therapist recommends treatment, the client is typically scheduled for 30-60 minutes sessions, 1-2 times per week. Frequency varies based on the setting therapy is provided in and client needs.



Preparing for my PROMPT Evaluation 


In preparation for your first visit, click here to view a list of questions to think about as food for thought.


Most clinicians have their own forms and intake processes, but forethought on these issues will pave the way to starting off on the right foot.


What to Expect from PROMPT Therapy - A Caregiver’s Guide:


At PROMPT we recognize the vital role caregivers play in the treatment of a client’s speech. This checklist will give you an overview of what to expect from the process and how you can contribute to the success of the client. Our goal is for everyone to feel comfortable and familiar with the process to maximize success. 


Step One: Expect an Honest Discussion 

The first thing you can expect when you sit down with a PROMPT-trained SLP is an honest discussion of the client’s communication strengths and weaknesses. Your feedback here is essential.


Step Two: Receiving and Discussing Assessment Forms

Caregivers should expect to receive a copy of two sets of assessment forms called the “Systems Analysis Observation (SAO)” and the “Motor Speech Hierarchy (MSH)” that your SLP uses to analyze how the client’s jaw, lips, and tongue move together to create words. Information regarding the client’s performance on the SAO and MSH may also be included in the evaluation report.

Your PROMPT-trained SLP will go over the client's treatment plans and goals. As the client progresses, you should receive updated versions of these forms tracking his/her improvements.


Step Three: Receive and Practice Home Programming 

Communication attempts need to be supported and guided by caregivers at home. Please remember applying PROMPTs is meant to be done by your PROMPT-trained SLP. Your clinician will provide you with home programming (homework) such as practicing certain words and phrases, following directions, and/or turn taking. The work done in sessions is invaluable, but it’s imperative for the work to continue at home - repetition is key.



What Happens in a PROMPT Session


After the client is assessed by a PROMPT-trained SLP, the next step is developing a treatment plan. Based on the assessment tools, clinicians will identify the client’s “attractor state” - this term refers to the way the client prefers to move when attempting to speak. This step helps the SLP understand where the client is “stuck” when trying to communicate, so that PROMPT can help him/her get “unstuck.”


PROMPT-trained SLPs will pinpoint the most important aspects of the client’s communication that need attention across the three domains. Within the Physical-Sensory domain - we determine the client’s Motor Speech Priorities. In PROMPT treatment, clinicians will choose to focus on the movements that fit these priorities and will help the client accurately produce functional words, phrases, and sentences. Priorities need to be relevant to the client/family and useful in daily life. The first motor speech priority should address the client’s attractor state. Be sure to ask your SLP about that!


Clinicians use a motor phoneme warm-up to help the client focus his/her attention on moving the jaw, lips, and tongue (articulators) accurately when producing words, phrases, and sentences. During this time, they provide multiple practice opportunities to help the client achieve accurate motor movements when producing that speech. The client might be asked to repeat each target three to five times during which time the SLP will provide specific verbal feedback about the client’s movement, saying things like “I like how you rounded your lips when you said go” or “Your jaw was too big when you said ball.” All of these steps help the client to focus on correctly producing speech.


Mapping is when a PROMPT-trained SLP uses his/her hands to shape the articulators which links motor movements to the understanding and use of words. A clinician may PROMPT the client but does not expect them to say the concepts out loud.



Reciprocal turn-taking is another crucial part of PROMPT treatment. Throughout a session, the SLP is doing the same thing as the client - saying the same words, following the same rules, and doing the same activities. 


“On-line” shaping is a clinical term to describe the process of helping the client move their jaw, lips, and tongue correctly when speaking. PROMPT-trained SLPs will watch the client say a word or phrase, and determine if his/her physical movement was correct. The clinician will then use his or her hands to correct or reinforce that movement. This occurs throughout the session, ensuring that the client is successful and is constantly improving his or her motor movements.


The process of evaluating the client’s movement is very complex and relies on extensive training in the PROMPT technique. Because of this, PROMPT is meant to be applied only by a PROMPT-trained clinician. Inaccurate PROMPTing could interfere with a client’s treatment and set back the progress s/he has already made. 


PROMPT also implements a number of support strategies during treatment sessions to provide the client with the best conditions for learning. These strategies can be physical, like PROMPTing to help the client move accurately when producing a word, or taking a break to do some physical activity. There are also important Cognitive-Linguistic strategies, like matching the therapy exercises to the client’s age and level of understanding, and providing clear and consistent instructions. Lastly, PROMPT also uses strategies for supporting the Social-Emotional aspects of treatment, like providing positive reinforcement. These support strategies are evident throughout the videos shown above.



The PROMPT Institute is a non-profit organization dedicated to making PROMPT available to anyone, in any country, that can benefit from it. 

Your donation will help us to continue: 

  • vital research that determines the best treatment to help your family member achieve his/her highest level of communication possible
  • to expand PROMPT therapy training to ensure your SLP has the best PROMPT skills available to your family member
  • to continue to provide family education (like this page) to help you understand the best treatment approaches for your family member

If PROMPT has made a positive impact in your life, please consider making a monetary donation at the following link:


Thank you for your support!

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