Welcome to the Module on Prompting

Prompting

Welcome to the module on prompting.

My name is Jennifer Neitzel and I am a content specialist on the National Professional Development Center on Autism Spectrum Disorders at the Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill.

This module is important because teachers and other practitioners who work with children and youth with autism spectrum disorders (ASD) can use prompting to teach new skills by systematically providing and removing prompts. This process helps learners with ASD perform target skills independently.

Prompting procedures include any help given to learners that assist them in using a specific skill. Prompts are generally given by an adult or peer before or as a learner attempts to use a skill. Prompting can be used to teach a variety of skills, including seeking information, pointing to objects, identifying numbers/objects, and remaining "on task." The use of prompting procedures increases the probability that learners with ASD use target skills correctly.

There are different sections to this module that provide (a) an overview of prompting, (b) descriptions of who can implement prompting and the types of learners with which it can be used, (c) detailed guidelines for implementing prompting with children and youth with ASD, and (d) answers to frequently asked questions regarding prompting.

As part of this module, we also provide you relevant documents that will support your implementation of prompting, a reference list of evidence-based research articles, and a list of additional resources that may be beneficial as you implement prompting. Also, please check out the informal assessment materials that have been developed as part of this module. These materials are designed to help you make more informed decisions about the implementation of the practice with individual learners with ASD and to evaluate learner progress. Buttons located below the advanced organizer provide links to these additional resources, as well as discussion questions and activities designed for use in professional development, in parent meetings, or in a face-to-face training or course.

Throughout the module, we provide information across the age range so that you can find relevant information for your specific learners. If at any time you need help, please click on the HELP icon. Also, please complete the online survey that asks you to rate the usefulness of this module.

It's time to begin. Please proceed to the module preassessment.

Pre-Assessment

Top of Form

Pre-Assessment

All prompting procedures contain:

Select an answer for question 335 Select your answer A consequence The target skill An antecedent All of the above

With least-to-most prompting, teachers/practitioners provide learners with minimal support to use target skills correctly before providing additional assistance.

Select an answer for question 336 Select your answer True False

Which of the following is NOT a prompting procedure used with learners with ASD?

Select an answer for question 337 Select your answer Simultaneous prompting Least-to-most prompting Graduated prompting Most-to-least prompting

When using simultaneous prompting, teachers/practitioners use probe sessions to teach target skills to learners with ASD.

Select an answer for question 338 Select your answer True False

Which of the following is NOT an example of a cue?

Select an answer for question 339

A controlling prompt is the prompt that ensures that a learner with ASD uses the target skill correctly.

Select an answer for question 340 Select your answer True False

Overview

Prompting procedures include any help given to learners with autism spectrum disorders (ASD) that assist them in using a specific skill. Prompts are generally given by an adult or peer before or as a learner attempts to use a skill. Prompting can be used to teach a variety of skills, including seeking information, pointing to objects, identifying numbers/objects, and remaining "on task." The use of prompting procedures increases the probability that learners with ASD use target skills correctly. All of the prompting procedures outlined in this module contain three main components:

• the antecedent (i.e., target stimulus and cue/task direction) that tells the learner to use the target skill,
• the target skill (i.e., learner response), and
• theconsequence (i.e., feedback/reinforcement provided by teachers/practitioners).

These three components are critical to implementing prompting procedures effectively. When teachers use all three components during a teaching activity, it is called a trial.

Target Stimulus (Antecedent)

The target stimulus is the "thing" or "situation" to which we want the learner to respond by performing the target skill.

EXAMPLES

If a learner's hands are dirty from finger painting, messy hands should be the target stimulus to wash hands.

If the child wants a toy a peer has, the target stimulus is the toy and the peer. The target skill is asking for the toy.

If the goal is for the learner to name a picture, the picture is the target stimulus.

Cue (Antecedent)

A cue or task direction/question tells learners the skills or behaviors they should be using. For example, a teacher might give a learner a picture card to go wash hands, saying, "Time to wash your hands." The target stimulus is the dirty hands; the cue or task direction is the picture and verbal command. When using prompting procedures, the cue should be consistent so that learners know exactly when they are supposed to do something. The target stimulus also is important because it helps learners recognize that they should be using a particular skill even when teachers/practitioners are not present and providing a cue or task direction.

Learner Response (Target Skill)

Learner response is essentially the target skill teachers/practitioners want the learner to acquire. Learners are more likely to use the target skill accurately when the cue and target stimulus are clear and consistent. However, learner responses and use of target skills are not always successful. Therefore, learner responses are classified as either correct or incorrect.

Feedback (Consequence)

The reinforcement and feedback provided after a learner's response are critical for teaching the target skill. When learners use skills successfully or respond accurately, feedback should be highly positive and descriptive so that learners know exactly what they did that was correct. Positive feedback (i.e., reinforcement) increases the likelihood that the target skill will be used correctly in the future. With prompting procedures, correct responding should be reinforced even when it is prompted. Feedback for incorrect responding (i.e., incorrect use of target skill) is delivered either by ignoring the incorrect response or by applying a correction procedure. The latter type of feedback generally consists of either interrupting learners when they begin to respond incorrectly or repeating or stopping the trial.

A variety of prompting procedures support the learning and development of children and youth with ASD. They include (a) least-to-most prompting, (b) graduated guidance, and (c) simultaneous prompting. An overview of each of these procedures is provided in the following section.

Prompting Procedures

All of the prompting procedures outlined in this module help learners acquire skills by systematically providing and removing prompts so that learners begin to perform skills independently. These procedures rely on reinforcing all correct responses - both those that are prompted and those that are not. The required steps for each prompting procedure (i.e., least-to-most, simultaneous prompting, graduated guidance) are described throughout the module. Implementation checklists also have been developed to guide and improve instruction. Once teachers/practitioners determine which prompting procedure is most appropriate for an individual learner with ASD, they should use the steps for implementation for that particular procedure.

Least-to-Most Prompting

The least-to-most prompting procedure is also referred to as the system of least prompts and sometimes as increasing assistance. With this procedure, a prompt hierarchy is used to teach new skills. The hierarchy is comprised of at least three levels. The first level provides learners with opportunities to respond without prompts. The remaining levels include prompts that proceed from least to most amounts of assistance. The last level should be a controlling prompt - a prompt that ensures that the learner responds correctly. This procedure can be used with both discrete skills (e.g., single skills of a short duration such as naming pictures, reading words, greeting peers) and chained skills (include a number of steps such as dressing and undressing, making a sandwich, and washing hands) (Godby, Gast, & Wolery, 1987; West & Billingsley, 2005).

Graduated Guidance

With graduated guidance, teachers/practitioners provide a controlling prompt (i.e., a prompt that ensures the learner will do the skill correctly) and then gradually remove the prompt during a teaching activity. This procedure differs from other prompting procedures because teachers/practitioners make judgments during the teaching activity based upon the learner's response. As learners start to use the skills, the prompts are withdrawn, but quickly reinstated if learners regress, or stop using the skills. This procedure should only be used with chained skills that include a physical component (e.g., putting on a coat, washing hands). With these types of skills, numerous steps comprise one complete task. For example, when individuals wash their hands, they get soap, turn on the water, rub their hands together, turn off the water, and dry their hands. This is in contrast to discrete tasks such as saying your name or identifying letters, which require only one response (Alberto & Troutman, 1999).

Simultaneous Prompting

With the simultaneous prompting procedure, two types of sessions are needed: instructional and probe. In the instructional sessions, the task direction or cue (i.e., a signal to the learner to use target skill) and controlling prompt (i.e., prompt that ensures that the learner will do the target skill successfully) are delivered simultaneously. In the probe sessions, the cue or task direction is delivered without the prompts. The probe sessions are used to determine whether learning is actually occurring. Simultaneous prompting has been found to be one of the most effective near-errorless teaching procedures and is relatively easy to implement. Researchers also have indicated that simultaneous prompting can be used while working 1:1 with learners with ASD as well as during small-group instruction (Akmanoglu, UludagBatu, 2004, 2005; Colozzi, Ward, & Crotty, 2008; Gursel, Tekin-Iftar, & Bozkurt, 2006; Kurt & Tekin-Iftar, 2008).

Types of Prompts

Within the prompting procedures described in the previous section, different types of prompts are used in a variety of ways to help learners with ASD acquire target skills. For example, with least-to-most prompting, one teacher might use gestural, model, and physical prompts. Another teacher might use only physical prompts when implementing graduated guidance. Prompt types include the following:

• gestural
• verbal
• visual
• model
• physical

The various prompt types that can be used with all prompting procedures are described below.

Gestural prompts give learners with ASD information about how to complete target skills or tasks by using gestures. Teacher/practitioner makes some kind of gesture to prompt the learner to use the target skill.

Example

When teaching a learner how to write his name, the teacher mimics hand-writing, or points to the faucet when teaching the child to turn on the water to wash his hands.

Verbal prompts range in intensity level from least to most restrictive and include any verbal assistance given learners to help them use target skills correctly. For example, providing instructions (e.g., "Write your name," "Wash hands") is more restrictive than providing a hint about how to complete a task (e.g., "This animal says, Meow'," "What do you need?"). Teacher/practitioner verbally gives a hint, a clue, or a direction.

Example

When teaching a child to read the word "dog," the teacher might give a hint (e.g., "It says bow wow") or some other clue (e.g., "It starts with d'").

Courtesy of Division TEACCH

Visual prompts are often incorporated into teaching activities to help learners with ASD acquire target skills. For example, teachers/practitioners may give learners examples of correctly completed assignments. Visual prompts can be used to teach a wide variety of skills, including academics, daily living, and vocational tasks. Visual prompts may include checklists, pictures/photographs, classroom schedules, or written instructions (Alberto & Troutman, 1999). When using visual prompts, it is important to identify supports that are developmentally and age appropriate for individual learners with ASD. For example, it may not be appropriate to use written words with a preschooler with ASD. Similarly, teachers/practitioners would not want to use pictures without accompanying text of objects with a middle school student who receives services within a general education setting.

Example

Task analysis checklist, transition picture card, photographs, pictures/line drawings

Model prompts are used when verbal or visual prompts are not sufficient in helping learners with ASD use target skills correctly. When using model prompts, teachers/practitioners demonstrate, or model, the target skill. Modeling may be used to prompt discrete and chained skills (Alberto & Troutman, 1999).

• Full Model Prompts: The teacher/practitioner models the target skill for the learner with ASD. Full model prompts can be verbal if the skill being taught is verbal, or they can be motor responses if the skill being taught involves moving a body part.
• Partial Model Prompts: The teacher/practitioner models only part of the target skill - either verbal or motor.

Example: Full Model

• When teaching a learner how to raise his hand during class, the teacher raises her hand while saying, "Raise hand."
• When teaching a learner how to request more, the teacher says, "More, please. Say, More, please'."

Example: Partial Model

When teaching a learner how to raise his hand during class, the teacher raises her hand part of the way

Physical prompts are used when learners with ASD do not respond to less restrictive prompts (e.g., modeling, verbal, visual). Physical prompting is useful when teaching motor behaviors (Alberto & Troutman, 1999).

• Full Physical Prompt: The teacher/practitioner leads a learner through the task by providing full physical assistance (e.g., hand-over-hand) to ensure correct use of the target skill.
• Partial Physical Prompt: The teacher/practitioner provides minimal physical assistance to help the learner use the target skill correctly. Taps, nudges, and light pushes are used.

Example: Full Physical

The teacher/practitioner leads a learner through the task by providing full physical assistance (e.g., hand-over-hand) to ensure correct use of the target skill.

Example: Partial Physical

The teacher/practitioner provides minimal physical assistance to help the learner use the target skill correctly. Taps, nudges, and light pushes are used.

It is important to keep in mind that teachers/practitioners should select prompt types based upon the needs and characteristics of individual learners with ASD. That is, prompt selection should be individualized to meet learner needs since learners may respond differently to the same prompt (Bryan & Gast, 2000).

Why Use Prompting?

Prompting, sometimes referred to as an errorless learning method, includes a set of procedures designed to reduce incorrect responding as learners acquire new skills. The prompting procedures outlined in this module help learners with ASD use target skills correctly and minimize the negative effects that they may experience when target skills are not used successfully (Kurt & Tekin-Iftar, 2008; Mueller, Palkovic, & Maynard, 2007; West & Billingsley, 2005). This is particularly important for learners with ASD because they often have difficulty learning new skills through imitation and by extracting meaning from tasks (e.g., understanding the most important or relevant details of a task). Therefore, learners with ASD often require direct instruction to learn key social, communication, adaptive, and cognitive skills, which can limit their ability to generalize the use of newly acquired skills to a variety of environments and individuals (National Research Council, 2001). Prompting is an efficient and effective way to provide instruction to learners with ASD that maximizes their success and increases their generalized use of target skills

Who Can Use Prompting and Where Can It Be Used?

Prompting procedures can be used by a variety of professionals, including teachers, special educators, therapists, and classroom assistants, in different educational and community-based environments. Evidence-based studies have been conducted mainly in clinic-based settings or in one-to-one teaching sessions with learners with ASD. The research did not demonstrate the use of prompting in more naturalistic settings such as during ongoing classroom routines and activities, in the home, or in community-based settings; however, each of the prompting procedures may be adapted for use in these settings as well.