Prompting: Part 2

Prompting Appropriately and Prompt Fading

How do I know when to prompt?

When teaching a new skill, keep in mind that many children may have difficulties completing the task or skill independently. This is where prompts come in, as we use them to assist the client and guide them to choosing the correct response, or complete the task successfully. If a stimulus is presented and there is either no response, or an incorrect response from the client, this is our signal to incorporate a prompt into the next trial. We may start out with a small prompt, and increase the level of intrusiveness if the learner is still giving incorrect responses. On the other hand, we may start out with the most intrusive prompt if we are teaching a brand new skill. Regardless, we always have to be cautious about how we use prompts and if we are using them appropriately. All in all, the goal is to eventually fade all prompts out, and the learner can choose the correct response independently.

Prompt Hierarchy 

A prompt hierarchy helps us decide what prompt to begin with, and which prompts to use to either increase or decrease the level of assistance the learner may need. The prompt hierarchy begins with the prompt that is the most intrusive, or provides the most amount of assistance to complete a task or select the correct response. As the prompt hierarchy continues, the prompts become less and less intrusive, allowing the learner to have more independence. The prompt hierarchy can also start from the bottom, with the least intrusive prompt, and work its way up if the learner requires more assistance. The prompt hierarchy looks like so, starting with the most intrusive prompt:

• Full Physical 

• Partial Physical

• Proximity

• Modeling

• Gestural

• Visual 

• Full Verbal

• Partial Verbal

For more information about what each of these prompts look like, visit this blog.

Least to Most

The least-to-most prompt approach is used when the learner already shows similar skills to the new skill being introduced. These similar skills are called “component skills”, meaning they are the base or foundation skills needed to learn new things. Least-to-most prompting is usually preferred, unless component skills are not exhibited by the learner. As behaviour therapists, we want to use the least intrusive prompt first, as this will help promote independence. Once the stimulus or signal is delivered to the learner, the therapist will use a prompt towards the bottom of the prompt hierarchy, such as an eye gaze, and continue to use a more intrusive prompt if necessary. A more intrusive prompt, such as moving the correct response closer, will be used if the correct response was not selected on the previous trial. A least to most prompt technique may look something like this:

Eye gaze → hand gesture → move correct response closer → taking learners hand and placing it on the correct response 

Most to Least

We use most-to-least prompting when a learner is just beginning to learn a new skill. This approach is used for a technique called “errorless learning”, which ensures there is no chance the learner will choose the incorrect response. In errorless learning, prompts are delivered very quickly and swiftly, typically less than 3 seconds after the stimulus is delivered. This allows the learner to choose the correct response, and the prompts can quickly be faded out. A most to least prompt technique may look something like this:

Hand over hand → move correct response closer → point to correct response → no prompt needed 

Prompt fading: Avoiding Prompt Dependency 

While prompts are a great way to encourage our clients, we want to ensure they do not start relying on the prompts to make a correct response. In other words, we do not want them to become prompt dependent, rather we want them to be making independent choices. Prompt fading can occur in two different ways; it can be data driven or client led. When prompts are data driven, we specifically plan out which prompt will be used at what time. We can plan to use gestural prompts today, and use visual prompts tomorrow. This gives us a clear timeline of which prompts were used and when they were used. On the other hand, prompt fading can also be client led. When prompt fading is client led, we gradually fade the prompts when the client has mastered the skill at the current prompt level. For example, if we are teaching a child how to brush their teeth using a hand over hand prompt, once they have mastered how to hold and maneuver their toothbrush, we can now fade the prompt to a less intrusive, say a gestural prompt of pointing to the toothbrush, and eventually no prompt at all. Prompt fading promotes independence in our learners, and once they have mastered the skill, there is no need for prompts at all!

Prompting

Prompting: What is it?

In ABA, we always want our clients to succeed in everything they do. We want clients to feel empowered, supported, and know that they have the ability to do anything they set their mind to. A very common aspect of ABA includes something called prompting. Prompting is simply encouraging or assisting an individual to do something. In the case of ABA, we are assisting the client to respond appropriately. Essentially, we are adding or modifying a stimulus to evoke a correct response or behaviour. There are several different types of prompts, so let’s break it down with descriptions and examples of each.

• Partial Verbal: Saying the beginning of the correct response, so the learner can say the rest 

Ex: Asking the learner, “What is your name?” and providing part of the correct answer, “My name is … “ 

• Full Verbal: Telling the learner what to do, or saying the correct response 

Ex: Asking the learner, “What is your name” and also providing the complete answer, “my name is Bobby”

• Visual: Providing pictures or textual cue to evoke the correct response 

Ex: Asking, “What is your name?”, and providing a card that says “Bobby” on it

• Gestural: Gesturing or pointing to the correct response 

Ex: Asking for the toy cow, and then pointing to toy cow 

• Modeling: Showing the learner what to do before they do it

Ex: Showing the learner how to put toys into a box for clean up, and the learner follows by putting toys into the box 

• Proximity: Increasing the closeness of the correct response

Ex: Asking for the picture of the pig, and pushing the picture of the pig closer to the learner 

• Partial Physical: A small and quick physical touch to direct the learner in the right direction

Ex: Gently tapping or guiding the client’s arm in the right direction to grab the correct item you asked for

• Full Physical: Also known as ‘hand over hand’, we provide full physical guidance for the learner 

Ex: Using ‘hand over hand’ guidance to learn how to hold a pencil

These are all examples of how we use prompts in ABA. The ultimate goal of prompting is to encourage the learner to respond correctly, and praising them for that response.

Visual Supports and Why They Are Important

Visual supports are pictures used in ABA to help those who might have difficulty in understanding language. Visual supports can be a range of visuals including drawings, written words or photographs.

We use visual supports everyday in our life. A shopping list for groceries, road signs when driving, or signage on stores saying whether they are open or closed. Visual supports are useful in many ways. For individuals with autism, they can help in many ways. They can teach social skills and help with understanding social situations. Visual supports can also be used as a social story in order to understand the appropriate behaviour in a given social situation. Visual supports make it easier for people with ASD to understand language and instructions. Many parents and teachers will take advantage of visual supports while making a choice board. A choice board is a visual where the person has several choices in order to communicate their needs. A small choice board can be used as a quick reference for simple actions like, “stop”, “go”, and “help”. Visual supports are also helpful for a daily schedule. It can be divided up into sections during the day and have a picture representing each activity.

Visuals are important because they tend to make more sense for people with autism who might struggle with the complexities of verbal communication. Remember, if it’s a new strategy you will have to teach them how to use it. Let’s go over a few examples of methods to use visual supports.

 1.     Choice boards

A choice board is designed to have multiple pictures and is useful for those who have limited language. The idea is to have the person make a choose between items. This can also be done with objects in combination with the choice board so they can see the items they are choosing.

 2.     Visual Schedule

A visual schedule can be useful when communicating expectations. Often a first/then visual will be used. For example, you can have a picture of table work (first) and after it is finished a picture of an ipad (then). They can also become useful in visually representing the structure of your day. It can serve as a visual reminder making transitions easier and gives the child and idea of what to expect throughout the day.

 3.     Visual Quick Reference

These are often on a necklace or keychain and are laminated flash cards for quick access in order to redirect behaviour or facilitate transitions/requests. An example would be showing a picture of a stop sign with the word stop on the card, or showing the child a picture of the washroom.