Speech Delay: Some Kids Just Need a Little PROMPT


I used to be a little jealous of physical and occupational therapists.

If you can’t get a patient to move her arm, you can move it for her. If you can’t get a patient to hold a pencil correctly, you can move her fingers into the correct grasp. Even if a patient is unable (or unwilling) to cooperate, you can physically manipulate him into position. He may resist you the entire way, but it can be done. By creating the movement – even if the therapist is the one doing most of the work – she can create muscle memory with the aim of having the patient do it on their own one day in the future.

But how do you physically manipulate the action of speech?

I used to think that I had to wait for a patient to “crack under the pressure” of speech therapy and decide on his own that he was ready to talk before speech would occur. I can also tell you from experience that the wait for some patients to (finally!) comply felt endless.

Then I found PROMPT, and my view changed.

PROMPT is an acronym for “Prompts for Restructuring Oral Muscular Phonetic Targets” – a fancy way of saying that a speech therapist can physically manipulate the muscles of the mouth into the correct positioning for producing sounds, words, and even full sentences. I knew instinctively that PROMPT would be great for my patients with childhood apraxia of speech, a motor disorder in which the brain has problems coordinating the muscle movements needed for speech.

What I didn’t realize is how helpful (more like amazing!) PROMPT could be for my kiddos who simply refuse to talk. Although I can’t force a child to start talking, using PROMPT I can work with my patients to create muscle memory, and when they do (eventually!) crack under the pressure, they will be able to say the sound or word correctly.

Most kids enjoy PROMPT once they realize it’s helping them.

Some of my kiddos who refused to talk really just needed help, but after using PROMPT they now try to talk more and come to me to PROMPT words on them. They appreciate the help and are happier during their speech sessions. Before, they simply didn’t know how or where to start. PROMPT gives them all of the information they need to say the word so they are more willing to try.

Of course, I still have kiddos that are stubborn and refuse to talk. At least, I think they’re stubborn, but maybe I just haven’t figured out the right tool for them yet. 😉

Jessie Nelson Willis, M.Ed., CCC-SLP

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