PROMPT

PROMPT is a technique used to treat motor speech disorders, mostly heard when it comes to childhood apraxia of speech, which does not always qualify for services under biling codes, therefore you simply bill it under 'apraxia.' Anyhow, I observe that many more children that I see under age 3 are showing signs of apraxia (to begin with, they aren't vocal...so it takes a while to get them to vocalize, be spontaneous in vocalizations and words, and then figure, oh, now that I see your mouth moving, something's amiss...or rather, extraneous). The other biggie I'm seeing is grading of the articulators...it's kinda wondrous actually...why is almost every child I see having some grading difficulty? What causes it? Low tone? What low tone, if everything else in typical? That is the question I can't answer now and am itching to get an answer.
But PROMPT--from an academic standpoint (meaning the 'talk' in grad school and below), PROMPT is not viewed as very happily...of course there is not prefect method, and PROMPT is always referred to as 'having it's own place, which tends to be very narrow and specific.' And they don't tell you beyond, 'it's one method used to treat apraxia.' True...in a way. But now that I'm getting to know the theory and principles of PROMPT better, things are clicking and making a lot more sense...the different way speech movements are viewed by PROMPT is refreshing and to me, creates a clearer way of observation and systematic treatment, an explanation why errors happen in certain patterns. And especially when the child is not cognitively ready for verbal cues and attending long enough for visual cues consistently. It's also a way to be able to diagnose...haha...ok, I mean, screen...diagnose is such a D-word I am finding out.
In the speech as a job world, PROMPT seems to be either loved or rejected. One reason why not all like it is because the carryover, and dependence on prompts is difficult to eliminate over time. This is something I have yet to take a closer look at simply because 1)I am not PROMPT-certified (yet), and 2)I've only started working a few months, and those children that have been PROMPTed have not shown significant dependence on tactile cues over time, I do see the 'weaning off.' But then again, I'm working with really great clinicians. And although they use PROMPT, they also use best practice...whatever works best for the child. There's a beginning point where PROMPT would be most effective, and then an ending point, which is always gradual in the majority of cases.

The deal with all these techniques is, in grad school, you hear opinion, professional opinion of why they aren't best practice, and then you get out into the 'real world' and people are using these techniques (depending on setting I guess)...and you wonder if what you learnt in grad school is any good...sigh...I like school...you get to debate all these ideas and concepts and come up with crazy new ideas and people are willing to talk about them...and at work, it's just plain crazy, why would you want to think of that when it's not helpful to any specific kid?

Another biggie in grad school that I learnt concerned oral motor exercises...they are for strengthening purposes...therefore, the problem has to be weakness...and never never never use oral motor in Tom, Dick or Harry case...in the case of dysarthria, only flaccid dysarthria would qualify. And no doubt, O-M exercises are a hot topic now and generally, viewed as overdone. And now (please don't look at me with disappointment, prof) but I am doing them to children who are not vocal and think can benefit from tactile input (oral motor) to create awareness or articulators...the touchpoints for speech. And these kiddos have a general low to no body awareness or environmental awareness...like children with autistic tendencies, and those who keep crashing into walls and don't feel pain at normal thresholds. And it seems to work, or maybe not...they get PT and OT and all this other good input from peers and whatnot around them. So...but they's better communicators!