Using Prompt Hierarchies to Support Independence in Kids with Disabilities

We all want to see kids grow and become as independent as possible. For kids with disabilities, achieving independence often involves a carefully structured approach to support, and that's where the prompt hierarchy comes in. 

A prompt hierarchy is a systematic way of providing assistance, gradually reducing the level of support as the child learns a new skill. This method not only helps children acquire new abilities but also significantly boosts their autonomy and self-confidence.

Let's take a look at the different levels of a prompt hierarchy, moving from the highest level of support to complete independence, along with examples for each:

1. Full Physical Prompt: This is the most intensive level of support, where an adult physically guides the child's entire movement. It's often used when a child is first learning a new, complex motor skill.

• Example: A therapist or teacher might use full physical prompting to help a child with significant motor delays learn to bring a spoon to their mouth or a Math counter from the bin to the table. The adult's hand would be fully guiding the child's hand and arm through the entire motion with hand under hand support. More on the “under” later…

2. Partial Physical Prompt: As the child starts to grasp the concept, the physical support is reduced. The adult might only guide a portion of the movement.

• Example: For the same Math counter task, the adult might now only place their hand on the child's wrist to gently guide the direction, allowing the child to complete more of the motion independently. 

3. Modeling: At this stage, the adult demonstrates the desired action, and the child imitates it. This requires the child to have observational learning skills.

• Example: The adult might say, "Watch me," and then demonstrate how to stack Math cubes. The child then tries to imitate the action.

4. Gestural Prompt: A gestural prompt involves using a non-verbal cue, such as pointing or nodding, to direct the child's attention or signal the next step.

• Example: To encourage a child to put away Math counters when they’re finished with them, the adult might point to the storage bin after the child is done with Math.

5. Visual Prompt: Visual prompts use pictures, symbols, or written words to provide cues or sequences for tasks. These are incredibly helpful for children who are visual learners.

• Example: A visual schedule showing pictures of "brush teeth," "wash face," and "get dressed" can help a child follow their morning routine independently.

6. Verbal Prompt: This involves using spoken words, phrases, or instructions to guide the child. These can range from direct commands to subtle hints.

• Example: When a child is getting ready for Writing, the adult might say, "What do you need next?" or "Don’t forget your pencil."

7. Independent: The ultimate goal! At this level, the child can perform the skill or task consistently without any prompts or assistance.

• Example: The child can now independently gather learning materials, get ready to go home, and pack their backpack.

Get a pdf printable copy of the Prompt Hierarchy HERE!

Hand Under Hand vs. Hand Over Hand: This is important!

When providing physical prompts, the method of interaction can significantly impact a child's sense of autonomy and true independence.

Hand Over Hand: This is when the adult's hand is placed over the child's hand to guide the movement. While sometimes necessary for safety or initial learning, it can make the child feel as though they are not in control and can foster dependence rather than independence.

Hand Under Hand: This approach involves the adult placing their hand underneath or beside the child's hand, subtly guiding rather than controlling. This allows the child to still feel their own movements and experience a greater sense of agency and participation. It encourages exploration and builds confidence.

• Example: Instead of guiding a child's hand to hold a crayon by covering it with your own (hand over hand), you might place your hand gently under their wrist or elbow, allowing them to feel the sensation of holding and moving the crayon (hand under hand). This small shift can make a huge difference in the child's willingness to engage and learn.

What Do We Ultimately Want for Kids? Increased Independence and Autonomy that Leads to Learning and Growth!

The beauty of the prompt hierarchy lies in its systematic fading of support. As kids need less assistance, they gain confidence in their own abilities. This gradual increase in independence leads directly to greater autonomy, allowing them to make choices, participate more actively in their daily lives, and feel a stronger sense of accomplishment. 

It’s that what we want for all kids? The answer is an emphatic YES 💙

Grab a FREE consult HERE to chat more about what learning supports you might need for your students or your kid: