Rapid Prompting Method - Any users?

[*Michelle*]

Last night, I began reading Ido in Autismland: Climbing Out of Autism's Silent Prison. I was immediately struck by something his mother wrote in the introduction to the book. She talks about how, at a very young age, Ido was fascinated by things like alphabet charts, license plates, signs, and (what really struck a chord) the credits at the end of movies and shows. It was like she was talking about my own son.

 

Naturally, I stayed up way too late last night trying to find information on rapid prompting method, the technique taught to Ido by Soma Mukhopadhyay. I am completely intrigued by this and have already ordered Developing Communication for Autism Using Rapid Prompting Method: Guide for Effective Language.

 

Does anyone here have any experience with this method?

 

 

 

Edited to correct video link.

[Χά�ων]

Not what you are looking for but I did something similair for sight word reconition with DS and I plan to do it with math facts.

[*Michelle*]

I'm looking for any info. What procedure did you use?

[PeterPan]

Ooo, I read Understanding Autism through Rapid … also by Soma, and it's AWESOME. Have you seen the videos on her website? I learned about it through a mom at the parent workshop I was attending for PROMPT speech therapy. So PROMPT speech therapy is for verbal apraxia (common in autism), and Rapid Prompting is a method of teaching. Both are awesome.

 

Is your dc non-verbal? Have you looked into PROMPT? You may need both. The mom I met was pursuing PROMPT. She had used Rapid Prompting successfully for years to teach her non-verbal at that point teen with autism, but he wanted to learn to talk. So for her, PROMPT was the next step. Obviously there's no need to wait on PROMPT.

[*Michelle*]

I have looked in to Prompt, but the closest certified therapist is about an 8 hour drive away. However, we will be moving to VA in the fall and there are two certified therapists in the same area we'll be in. I plan on contacting them once we're there. We're already in touch with the doctor who will be our developmental pediatrician there (he's actually our former pediatrician from down here!).

 

Our son turned 4 in March. He's nonverbal, although he makes a variety of sounds. He currently attends center-based ABA therapy three days a week. His therapists there all think that he's very bright. Over the past 9 months of therapy, he's picked up multiple mands and has worked his way though many skill levels.

 

At home, I work with him a lot on things like shapes, colors, letters and numbers. We do a lot of tactile things like bean bags, but he also reacts very well to Starfall and to apps like Tracing ABCs. On Starfall, he'll point to each section he wants to go to and then points where he'd like me to click. He even plays the matching and sorting games on there in this way, so I think it wouldn't be out of his reach to do the same with the stencils used for RPM.

 

I've been looking for something that I can use to do more academic instruction with him, but there seems to be a dearth of instructional material for nonverbal kids. Stumbling across RPM has raised my hopes considerably, especially since Soma has provided instructional texts for parents to use within the home.

[PeterPan]

I'm looking for any info. What procedure did you use?

 

 

You know it's fading in my mind now what I know from talking with that mom, what was from that other book, and what was from the videos on their site. Have you seen their videos yet? The way it was explained to me, you're looking for open channels. Soma explains it in the book. So you look for open channels and up your ante to get a connection with them that way.

 

Apparently there's training for it available. If that's seriously your situation, then it's worth pursuing. And if there's severe apraxia (non-verbal due to motor control), then it's also worth moving or doing what it takes to get PROMPT. People move to Cincinnati to work with our therapist. I think that's also where this mom got the Rapid Prompting training.

[PeterPan]

You could go ahead and talk with the PROMPT therapists and get on their list to get in. There can be a wait. The other thing to consider is going for a week of intensive therapy. He may make dramatic gains. Our therapist has had 5 yo's come in non-verbal and leave speaking at the end of the week. They teach you how to carry it over at home. So you could do that now if the 8 hour away therapist is any good. Then for the follow-up you go to the therapists in VA. That way at least you're getting started.

 

The PROMPT therapy will change how you work with him. Right now as you work, he's pointing. That's lost therapy practice. The PROMPT therapist is going to have specific tasks and targets for you, and the first thing she'll say is to require speech for EVERYTHING. NO MORE pointing. If he has ANY sound, no more pointing. So I like Rapid Prompting, but you need to be putting your energy into getting PROMPT. To me the value of Rapid Prompting is being in tune with your child. But at this age, the better speech therapy is where it's at.

 

I'm getting ready to go down for a week of intensive btw, so it's something we're doing ourselves. I've done the trips weekly, bi-weekly, etc. Now we're going to try a week of intensive, where we'll do 2 sessions a day for a week. He has a number of sounds that are formative that we're trying to get automatic, and the PROMPTs are too hard for me to do at home.

 

So if you can go to that therapist for *1 week* it could literally change everything. I don't know how severe your apraxia is. Yes there has to be communicative intent. You're saying he's bright though. That therapist might be able to get some breakthroughs with a week of intensive. Then the next therapists would pick up with it in a few months. If you do that, videotape it.

[*Michelle*]

I have ordered the book; it should be here Friday. According to the HALO site, I can also become a member and have access to training videos online, so that's always an option. We will be moving to the same city as a certified PROMPT therapist in the fall. Due to our life circumstances, we wouldn't be able to move sooner or accommodate that kind of travel at this time.

[PeterPan]

Should be interesting! I didn't realize there were 3+ books about it. The one I read was Understanding Autism through R.P. and it was definitely interesting. You should write back and tell us about what you learn and what strikes you or what you want to try to implement.

 

And yeah, the week thing was just an idea. It's exciting that you'll be moving to an area with not one but *two* certified therapists, wow. I drive a long way to ours...

 

Did you find the free videos on the Halo website? I think they were on there. I know I've watched some. They weren't so much training as just demonstrations. The mom I talked with who had been using it for years got GREAT success. It's definitely a good method. Her boy had bright or gifted (I forget which) IQ and was basically at or above grade level at age 12, in spite of being non-verbal. So it definitely can work. She just seemed very TIRED, honestly.

[*Michelle*]

I will. I'll be reading it over the weekend and taking notes. If it clicks, I'll be getting the lesson plan book also.

 

I would love to get a week away with him for therapy, but it just wouldn't happen right now. I am very grateful that the Navy is insisting we move to a place with so many autism resources though. :)

 

I did find the free videos on Halo and I think they are very interesting. In my bleary-eyed research late last night, I ran into a couple of sites that are very anti-RPM, stating that it's the instructor doing the answering, but I really don't see that. Considering that Soma has openly published her methods, it doesn't have that typical "secrets under lock and key" vibe.

 

Ido's book is heartbreaking and encouraging at the same time. It's an amazing read so far.

[PeterPan]

Wow, I'm just blown away that someone would criticize it that way. I guess somebody always has to have an opinion. For the woman I talked with, who had been using it for years with her non-verbal boy (who is now getting PROMPT, yay!), the thing she emphasized was how it informed her on how to CONNECT with him. And that's what really stood out to me as I read the book, the idea of channels and that if they're having a very whatever moment, you use that as your channel into their world rather than thinking they have to come over to yours. My ds is not on the spectrum, but to me it was this big challenge to step up your game, put in more energy, meet them right where they are. It was the first book on education I've read in the last 10+ years that I actually REALLY AGREED with and found myself going YES, YES over and over.

 

The heartbreaking part (well, among many things), is the thought that things might not improve for your kid. I know you don't want empty hopes, but PROMPT is AMAZING. Hopefully they're going to get breakthroughs for you. It's a technique that is only about 10 years old, so Soma's boy was not able to be taught with it. Don't lock yourself into thinking it's hopeless or that the level Soma's boy got is all that's possible. You have two good therapists with the best technique currently available, and you're right on the cusp of starting that. He might make MUCH more amazing progress than you ever dreamed.

 

That's great that the Navy is moving you btw. My dad was in the Navy. We were in VA for years while he was overseas, on shore duty, etc. We lived way out in a tiny town called Courtland. :D

[*Michelle*]

We're looking at Chesapeake. :) Apparently, the PROMPT therapist is there, our developmental pediatrician will be at Portsmouth and the ABA center we're looking at is in west Virginia Beach. I'm triangulating rentals based on those three points, LOL.

[*Michelle*]

The book arrived on Friday and I read through the whole thing, which isn't as impressive as it sounds since a large portion of the book is lesson plans. My honest take on it is that there's a lot of psych-speak just kind of thrown out there in an attempt to make what is a pretty simple process sound more, I don't know, scientific? Which is not to say that the process is bad at all because I think it's truly wonderful.

 

My motivators for trying this were 1) wanting to communicate better with my son and 2) try to provide more academic instruction. My roadblock is that he's nonverbal and has limited signs, so it's hard to understand what he really wants when he can't even give a simple yes or no.

 

And now, he can. :crying: I'm utterly amazed. I'm not doing the exact same method. We've adapted it to his level and ability and it's working. Already.

 

The paper method was not clicking. The ripping prompt didn't seem to do anything. What I'm doing instead is using his MagnaDoodle board. I'm taking it slow and using for things that I know he wants already so I can be sure that he's really understanding.

 

For example, he took me to the fridge and opened it up, which is his usual cue for me to get him a cup of milk. Instead of just getting it out, I closed the fridge, grabbed the MagnaDoodle and said, "Oliver, would you like some M-I-L-K, milk?," writing out "milk" at the top, then wrote and said "Y-E-S, yes" on one side at the bottom and "N-O, no" on the other side, then handed him the stylus. He instantly drew a line through "YES." "Ok, sweetie, I'll get your milk for you." Big smiles.

 

We've been doing this all morning. He took me to the cupboard where we keep his snacks. The options were pretzels or crackers. Took out the MagnaDoodle. "Oliver, would you like P-R-E-T-Z-E-L-S, pretzels or C-R-A-C-K-E-R-S, crackers?" Handed him the stylus. He immediately drew a line through "PRETZELS." "I'll get you a little bowl of pretzels then." Big smiles. I'll tell you also that he is not shy at all about letting us know when we're not giving him what he wants. If I get out the wrong snack, he'll do a little shriek and push the bag away.

 

So, I'm walking around with a MagnaDoodle now. On a side note, I'm doing the same thing with my NT toddler. She wants to learn how to read so badly and she's loving watching me write out questions and having her spell, point, and say her answers.

 

This is getting really interesting. I feel like I have a way to teach now.

[PeterPan]

Sounds like the book you got is the application part. The red book (Understanding...) is the theory. You ought to go back and read it as well. It sounds like you're adapting the method very well, love the magnadoodle idea. Remember though, if he has ANY speech, ANY sound, PLEASE use it. When we started ST with my boy, for the first few months a lot of his response was something simple like /a/. When we started he had two sounds (/m/ and /a/), neither of which he ever used. Your most foundational motor control skill is the ability to pick the jaw up and down. So we spent MONTHS, probably 6 months, picking his jaw up. Apraxia kids usually get stuck one way or the other, either unable to get it down or unable to get it back up. So when you offer him the two choices, he can respond with a sound he has, which in my ds' case was /a/. At that point his jaw was down (try it, you'll see your jaw drop), and we would pick his jaw up. Boom, communication, speech therapy, improvement, all in one. So you can show the two choices, but have him use whatever sound he has when he does it.

 

Well that's awesome to hear your progress. Sounds like you're on the right track! She explains the channels in the other book, and that's helpful if you have a dc who is stimming or on the spectrum. I can't remember. Did you say he is on the spectrum or not? Not every dc with apraxia is, and sometimes a dc will lose their spectrum diagnosis when the speech comes in with therapy. Anyways, that's fabulous that you're getting communication going. It unlocks what's in them and should help with the frustration.

[*Michelle*]

He is on the spectrum, although his behaviors there are pretty mild. It's mainly his speech. He has a lot of sounds. Lots. Just no words. He used to mimic me when I strung all the long-vowel sounds together. He'd even push my mouth around to get me started then say it back to me, although he's dropped that particular game now. I've heard him say all the short vowels and plenty of buh, cah, duh, dah, guh, hah, juh, la, mmmm, neh, ess, and tuh. He's said words a very few times. Twice, it was echoic. He repeated "Halloween" and "brothers." Once, he said "thank you" and that was in context. He'd just signed for "chip" to my husband and received one. He makes a lot of noises when he plays, like a variation of "vroom" when he's driving his little cars around or flying a toy plane in the air or something that sounds like "choo choo" when he plays with his trains. Sometimes, he'll mimic noises when I try to get him to use them for requests. Things like "mmmmm" for milk and "cah" for car and so forth, but most of the time, he'll just kind of giggle and continue using his nonverbal methods to request things. I will try to increase my demands for sounds, though.

 

He really doesn't have too much stimming behavior. A little bit of hand motions now and then, but not flapping. He likes to hold his hand out in front of him, then he'll do this thing where he squints one eye and kind of cocks his head to the side while he changes the angle of his hand. I think it's why it took so long for us to really think there was anything going on. He just doesn't do a lot of the "typical" behaviors (if there are even such things).

[PeterPan]

That's the problem with regular speech therapy for apraxia. :( They get sounds, but sounds aren't WORDS. PROMPT will have him build the sounds into words. They're going to evaluate his motor control and go through the hierarchy. You'll see. So anyways, take his sounds and build them into words. If he can say /u/, does he pick up his jaw? If not, pick it up. So every time he responds with /u/, what he's really doing is practicing picking his jaw up, motor control. Once he can do that, you add /p/. Now he has a WORD: up! And that's how you build words.

 

PROMPT is very particular about getting sounds into words as quickly as possible. They'll have to build them like that. That's why I was saying make your focus getting into the PROMPT therapy as soon as you can, because it's going to be amazing what they can do for him and how they can make it build. He has pieces, but they're going to bring those pieces together. What vowels does he have? It's ok to simplify words to things he can hit. He can say moo for milk. You said he has /m/ and he says choo choo in some fashion. If he can say /oo/, that's good rounding, awesome motor control practice. So now take every consonant he has (d, t, m, whatever) and put it in front of /oo/ to make words. Slow him down and help him hit them. If he can't, it's ok. I'm just showing you how it will build. Do, moo, to/two, they are all good little combos to shoot for. But start with his jaw. /a/ and his jaw coming up. /a/ or /u/ will be simpler vowels that /oo/ obviously.

 

They aren't doing it totally correctly in this video, but it will give you a start. I'll see if I can find something better. What they're *trying* to do in this video is demonstrate what the PROMPT looks like. They're not stabilizing the head and neck (which the child won't naturally have in the correct position), and they didn't follow through, picking up the jaw. At least those their cupping of the chin is correct and will give you a view of what I'm talking about. You place your hands on the jaw, and when he goes down for the vowel you physically pick it up. If he does it on his own, you're awesome. If he doesn't, that's a foundational skill, jaw stability, picking the jaw up and down. Here's that link. Like I said, it's not very good, so I'll look for something better.

 

Oh man, I'm trying to watch the lady at this link, but she's just vomitous. Our therapist works WAY harder than that. Sigh. Gotta love the cross-legged, pretty therapists. This is supposed to be hands-on work!

 

Ok, this site has MUCH better videos. Check this lady out in videos 1-3. Wow is she working hard, like patience of Job hard! (13 months and he can finally say "me" with assistance.) Prompt Therapy Training | Prompt Speech Therapy | PROMPT Courses That's how therapy should look. Hands-on, the therapist giving themselves constantly to it. In video #4 you see a therapist stabilizing the neck correctly. Man she's negative. Yeah, that lady in #4 is totally bugging me. The child misses the word because doesn't give the PROMPT well, so she tells him no he did a bad job. :cursing: #5 is that same lady and yucky too. She's just too slow on the PROMPTs. #6 though is what your therapy might look like. It's that lady again with the fast fingers, and you see a really good view of some basic PROMPTs. That's what our therapy looks like.

 

Well that's a tangent for you! :) Anyways, the idea is one sound that works on a motor control goal building ASAP into two sounds that make words. That way all his sounds go into words. But Fall is coming and you'll be in PROMPT. Then they'll help you implement all this! :) I'm just explaining why I was saying what I was suggesting. I agree with you that isolated sounds alone aren't worth much. PROMPT always wants to build them into words ASAP, because words are where it's at.

[*Michelle*]

I did some more research and the PROMPT therapist is part of a children's therapy office in VA. They contract with Tricare, so that will be nice. I'm looking forward to getting up there. Our former pediatrician down here will be our developmental pediatrician up there and he's just amazing. I can't wait to get our son in his office and get his input.

 

I've mixed things up with the MagnaDoodle today, switching the sides of the board for yes and no to make sure he's not just picking the same side each time, giving him a choice of three things to pick from and so forth. He's still choosing definitively and is very happy with my responses to his choices.

[PeterPan]

Well I hope when you get situated you'll keep us posted! :)

[*Michelle*]

I will.Thank you for your input!

[Lecka]

http://www.autismone.org/content/full-life-autism

 

I just read a book by this woman and my understanding is her son learned from Soma when he was a teenager.