PROMPT Therapy
PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) is a specialist, hands-on approach to treating motor speech disorders in children. I am trained in PROMPT assessment and intervention and use it as part of my practice with children who have difficulty coordinating the movements needed for clear speech.
What is PROMPT Therapy?
Most speech therapy relies on a child listening to sounds and trying to imitate them. For children with motor speech disorders, this approach on its own is often not enough — the difficulty is not that they cannot hear the sounds, but that their brain has trouble sending the right signals to the muscles of the mouth, lips, jaw and tongue to produce them. PROMPT takes a different approach. Rather than working through hearing alone, PROMPT uses gentle physical touch on the face, jaw and neck to guide the muscles involved in speech. The therapist's hands give the child a physical map of where to place their articulators, how much movement to use and how to sequence the movements together. Over time, the child internalises these patterns and becomes able to produce speech more independently.
PROMPT was developed by Deborah Hayden in the 1970s and has since been refined into a comprehensive framework for assessing and treating motor speech disorders. It is used with children across a wide range of diagnoses, including childhood apraxia of speech, dysarthria, autism spectrum disorder and cerebral palsy, where the underlying difficulty is motor rather than linguistic.
Who is PROMPT For?
Childhood Apraxia of Speech (CAS)
CAS is a motor speech disorder in which the brain has difficulty planning and coordinating the precise movements needed for speech. Children with CAS often know what they want to say but cannot reliably get the sounds out. PROMPT is widely regarded as one of the most effective approaches for CAS because it directly addresses the motor planning difficulty.
Dysarthria
Dysarthria is caused by weakness or reduced control of the muscles used for speech, often as a result of conditions such as cerebral palsy. PROMPT can help children with dysarthria by providing external support for muscle movement and gradually building strength, coordination and intelligibility.
Autism Spectrum Disorder
Some autistic children have a motor speech component to their communication difficulties, which can make it harder to develop spoken language even when other forms of communication are developing well. PROMPT can be a useful part of a broader intervention plan for autistic children with motor speech difficulties.
Unclear Speech with a Motor Basis
Not all children have a formal diagnosis. If your child's speech is significantly difficult to understand and other approaches have not led to the progress you hoped for, a PROMPT assessment can help identify whether a motor speech difficulty is contributing and whether PROMPT would be a helpful part of their therapy.
What to Expect
Exploratory Phone Call
Not sure if PROMPT is the right approach for your child? I offer a free 15-minute phone call where you can tell me about your child's speech and any previous therapy they have had. I can help you think through whether a PROMPT assessment makes sense as a next step, or whether something else might be more appropriate first. To book a call, use the contact form below.
Assessment
Before PROMPT therapy begins, I carry out a thorough assessment of your child's speech. This includes a PROMPT-specific motor speech assessment alongside broader standardised assessments to build a full picture of their strengths and difficulties. Assessment takes around 90 minutes. You will be present throughout, and afterwards I will share my findings with you, explain what I think is driving the speech difficulty and outline a therapy plan. A written report is provided.
Therapy Sessions
PROMPT therapy sessions are 60 minutes. I will use gentle touch cues on your child's face and jaw during activities to guide the movements needed for speech — children generally find this comfortable and are often surprised by how much easier it feels to produce sounds with the physical support in place. Sessions are play-based and tailored to your child's interests and goals. Parents are involved throughout: I explain what I am doing and why, and I will give you practical ways to support your child's speech at home between sessions. PROMPT therapy tends to work best when sessions are frequent, particularly in the early stages, and we will discuss together what is realistic for your family.
What Does the Research Show?
PROMPT has a growing evidence base, particularly for childhood apraxia of speech. Below is a summary of what the research tells us, written in plain language.
Strong evidence for childhood apraxia of speech
A randomised controlled trial by Strand and colleagues found that PROMPT was significantly more effective than a comparison intervention for children with CAS, with children making greater gains in speech accuracy and motor planning. CAS is notoriously difficult to treat, and having a well-designed RCT showing clear benefit makes PROMPT one of the most robustly evidenced approaches for this population.
Broader benefits beyond speech sounds
Research by Hayden and colleagues found that children receiving PROMPT made improvements not just in their speech accuracy but also in their overall communication, including language use and social interaction. This reflects the holistic nature of the PROMPT framework, which considers the whole child rather than targeting individual sounds in isolation.
Effective across a range of diagnoses
While much of the strongest evidence is for CAS, studies and case series have also reported positive outcomes for children with dysarthria, autism spectrum disorder and other complex communication profiles where motor speech is a contributing factor. PROMPT is listed as a recommended approach for CAS by ASHA (the American Speech-Language-Hearing Association) and is widely used by specialist therapists internationally.
A note on suitability:PROMPT is not the right approach for every child with unclear speech. Many speech difficulties have a phonological rather than motor basis, and in those cases a different approach will be more effective. Part of my assessment process is working out what is actually driving your child's speech difficulty, so that the therapy we choose is the right fit.
Fees
| Service | Duration | Fee |
|---|---|---|
| Exploratory phone call | 15 minutes | Free |
| Assessment | 90 minutes | £150 |
| Therapy session | 60 minutes | £80 |
| Report writing | Per hour | £80 |
| Travel | Per mile | 45p |
To enquire about availability or fees, please get in touch using the form below.
Get in Touch
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