Prompting and AAC

Prompting and cueing are very similar in that they both are used to lead a person to a certain response. Prompts are direct support that lead to a correct response. This differs from cues, which are an indirect hint. Both are useful tools for teaching new skills for AAC when used appropriately.

The terms prompting and cueing will be used interchangeably in this post in reference to leading to a correct response. Prompting and cueing have varying degrees of support and range from gestural, such as pointing to a device, to physical, such as hand-over-hand prompting. When it comes to teaching skills for AAC, it is essential that prompting is kept to a minimum. This means that we want children to be as independent as possible while using AAC.

One reason to limit prompts, especially physical prompts, is prompt dependency. When prompts are used and not faded appropriately, children may become dependent on the prompt to communicate. This may look like a communication partner always needing to ask “What do you want?” in order for the child to select what he/she wants via AAC instead of spontaneously telling a communication partner what he/she wants. Another example is that the child may always need a physical prompt in order to select words via AAC. This is not how we want children to communicate. We want children to be able to spontaneously tell us they got hurt, how their day was at school, their likes and dislikes, and share information about a variety of topics.

Not only should we limit prompts, but physical prompts should be avoided as much as possible or even completely eliminated. There may be certain circumstances in which a physical prompt is needed, such as for individuals with physical disabilities, but the times that we use them should be rare. If a physical prompt is needed, it should be hand-under-hand or a brief tap rather than hand-over-hand. There are many reasons for eliminating hand-over-hand prompting including that the child isn’t actually communicating anything. The communication partner is the one communicating. Children should not be forced to say something another person wants them to say. Additionally, we need to give the child control over their own body. Hand-over-hand prompting sends the message that it is okay for adults to touch children and control them. In a population that is more susceptible to sexual assault, it is important that they are able to refuse unwanted touch.

Overall, aided language stimulation, or modeling, is the most effective method for teaching new skills for AAC. This method gives children the freedom to express what they want to and protects their dignity as a human person. Any other prompting that is used should be limited and faded as quickly as possible.