May is Better Speech and Hearing Month! What are Cues and Prompts?
Happy May 2021 and Happy Better Speech and Hearing Month! This month is dedicated to raising awareness about communication disorders, shining a light on treatment options that can improve the quality of life for those experiencing speech and hearing difficulties, and learning some strategies that speech-language pathologists (SLPs) employ in therapy-- that you can also use at home-- to support communication goals!
Cues and prompts, prompts and cues. Almost synonymous, but also quite different. Picture this: you’re heading into the grocery store in search of a new ingredient. You’ve never shopped for this mystery ingredient before, so you ask a store associate about it. They kindly tell you to “check the spices in aisle 7.” You use the signs in the store to get to aisle 7, and then look for the shelf that has the sign, “spices” beside it. After a few moments of scanning the shelves, you find it! You happily grab one, pay for it, and make your way home so that you can use it.
We use prompts in our everyday lives even when we don’t realize it. In the scenario above, there were a few verbal and visual prompts that supported you in your shopping endeavor (i.e., the store associate telling you where to go, and the store signs that directed you). Eventually, you will no longer need all of those prompts to help you find that ingredient; you will have learned how to independently navigate the store in order to find it.
Although oftentimes interchangeable, the terms prompt and cue are not entirely the same. Let’s pretend that you’re back in high school and you have a part in the school play. The lead character is on stage reciting her monologue and the next scene is your entrance. Instead of the lead saying, “Ok Dorothy, put your red shoes on now and come on stage”, you must listen carefully for the sentence that cues you to begin walking on stage. This was a subtle, almost indirect way to signal you of what to do.
In speech and language therapy, many of our children are learning a specific communication skill. It’s helpful to keep in mind that the main goal that we are typically working toward is independence, or as close to independence as possible with that skill. Depending on a child’s current skill level, prompts and cues are incorporated into therapy activities in order to provide opportunities for the child to practice the skill (at varying levels) so that ultimately, the child understands when to use it and then becomes independent with it. Perhaps the child is working on understanding the concept of in. A verbal prompt might be, “Put the block in the bucket.” A verbal (indirect) cue might be, “Where should we put the block?”
In essence, prompting and cueing are like “strategic scaffolds” that get the child to their end goal. Prompting tends to be more direct and invasive, whereas cues are like indirect hints that signal the child to use the skill. Further, there is a prompting hierarchy that we use when targeting a specific skill, depending on how much support the child needs. When using prompts, we want to begin with the least “invasive” support (i.e., allow the child as much independence as they’re capable of), and offer prompts at the next level if they require more support. Detailing the hierarchy is an article in and of itself! But here’s the general road map:
VISUAL → VERBAL → GESTURAL → MODELING → PARTIAL PHYSICAL → FULL PHYSICAL
All in all, prompts and cues support a child with skill development and skill mastery. As the child makes progress with the skill, the prompts and cues are faded out to allow for greater independence on their part, and less “intrusion” on ours! I challenge you to think of what the next level of prompting or cueing might be with a child you know who is working on a new skill!