What is Prompt Dependency?

What is Prompt Dependency?

It is well established that children on the autism spectrum frequently experience difficulties that result in a lack of independent task initiation skills and inhibit their capacity to stay actively engaged in academic tasks  (Hume, Loftin, & Lantz, 2009; Milley & Machalicek, 2012).  One strategy to address these difficulties and facilitate learning, has been the use of prompting (Cooper, Heron, & Heward, 2007). Prompting is defined as antecedent stimuli (e.g., instructions, explanations, gestures, and illustrations), designed to produce a target behaviour that otherwise would not occur without the prompt (MacDuff, Krantz, & McClannahan, 2001; Shabani et al., 2002). Prompting has been successfully used with children on the autism spectrum to compensate for their challenges.

Within teaching situations, a prompt is usually offered after a cue has proved to be unsuccessful. Although the terms cues and prompts are often thought of as interchangeable, in most cases a cue is given as a “first step” which is not expected to lead the student to a direct answer and/or behaviour. A prompt, on the other hand, is considered to be more explicit and designed to lead to task completion. According to National Professional Resources (2009), a cue is an “action intended to encourage a student to initiate or continue a task that he or she has previously performed” whereas a prompt is an “action taken to directly assist a student with the completion of a task” (p. 111). Simply put, a prompt is a temporary learning aid used when precise instruction is required. It is designed to help children respond correctly during the acquisition phase of learning when they require additional help.

Prompt Dependency

For many children with ASC however, the cues and prompting strategies aimed at managing their difficulties frequently result in an over-reliance on adult support and development of prompt dependency (Bryan & Gast, 2000; Milley & Machalicek, 2012). MacDuff et al. (2001) explain that “prompt dependence means that a person responds to the prompts instead of responding to the cues that are expected to evoke the target behaviour” (p. 43). In other words, an ongoing and explicit step-by-step instruction is required in order to produce the target behaviour, each time it is required. In the case of prompt dependency, self-initiated behaviour does not develop. Over time, prompt dependency not only inhibits the learning of new skills, but also reduces the ability to function without adult help (Mesibov, Shea, & Schopler, 2004). Subsequently, learned helplessness; the belief that one’s own behaviour does not control outcomes, can develop (Sternberg & Williams, 2010). Similar to the prompt dependent characteristics children with ASC display in school, it was found that adults ASC can also display prompt dependent characteristics within their close relationships (Wilson et al., 2014; 2017).

What Prompt Dependency Means for Adult Relationships

Within typical relationships, the giving and receiving of prompts is an ordinary aspect of life. From reminding someone of that appointment with the doctor, to encouraging a call to a family member for a special occasion, prompts are a necessary strategy to jog another’s memory or to organise life’s events. We all need prompting from time to time. However, since “affectionate communication is a key interpersonal tool to fulfill the basic human need for close, successful relationships” (Hesse & Tian, 2019, p. 2), requiring prompts to give affectionate types of communication is considered atypical. Becoming dependent on these prompts could be deemed all the more unusual.

Findings from the Masters and PhD studies, however, suggested that prompt dependency can be a significant component of the communication differences and resulting difficulties between those involved in neurodiverse relationships. The NT participants in both studies reported that they were required to prompt their partners/family members by triggering responses in order to activate reciprocal interaction. Prompts took the form of reminders, instructions and explanations, and were expected to resolve their partners’ and/or family members’ lack of responsiveness, and improve personal and affectionate interaction. The belief was that, the necessity to prompt would ultimately cease. However, it was found that this strategy, while only partially successful in the attainment of the intended outcomes, continued to be a requirement, rather than coming to an end. Whereas the prompts were intended to sustain personal and affectionate interaction, and at the same time increase unprompted responses, the NT participants reported that the desired outcomes were often thwarted by a chain of behaviours exhibited by their partners/family members that prevented communication. These behaviours also negated further interaction.

Thus, when not able to avoid unwanted interaction, adults with ASC became dependent on the prompts that facilitated their responses. Unprompted responding only occasionally improved. The intermittent success of prompting, especially in regard to personal and affectionate interaction, tended to intensify the concentration of prompting from the NT participants, as it became the main way that any personal or affectionate interaction occurred. Accordingly, rather than using “declarative language”, that is language defined as a statement or comment, it became necessary to use mostly “instrumental language” with their partner/family members with ASC.

Instrumental language is speech that requires a particular response, whether that is an answer to a question or following a direction. The aim of instrumental language usage is to influence the listener for certain purposes intended by the speaker. As a result, the data suggested that repeated guidance, supervision, and explicit step-by-step instruction, became necessary practically every time interaction was desired, especially emotional interaction. Prompting by means of extensive explaining, instructing, teaching, training, guiding, or advising, in attempts to solve the issue as best they could, was reported by NT participants as their only option. At the same time, the failure of their partner/family members with ASC to independently commence the actions that were sought meant that, unfortunately, dependency on the prompting became the custom. At other times, avoidance of the prompted actions was the preference. This avoidance of, and/or dependence on, prompted actions appeared to become a pattern in the majority of conversations seeking connectedness.

Further, it was found that the need to impart prompts on the part of the NT participants coupled with the dependency that adults with ASC developed on these prompts, formed a cycle within the interaction of these couples. The need for reciprocal interaction on the part of the NT participants and the opposing need to avoid reciprocal interaction on the part of the AS participants resulted in prompt dependency cycling between them. Predominately, the prompt dependency cycle had negative impacts on both partners although lower degrees of prompt dependency contributed to better outcomes within the relationship (Wilson et al., 2014; 2017).

Dr. Bronwyn Wilson

Bryan, L. C., & Gast, D. L. (2000). Teaching on-task and on-schedule behaviours to high-functioning children with autism via picture activity schedules. Journal of Autism and Developmental Disorders, 30(6), 553-567. doi:0162-3257/00/1200-0553$18.00/0

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (Second ed.). New Jersey: Pearson Education Inc.

Hesse, C., & Tian, X. (2019). Affection deprivation in marital relationships: An actor-partner interdependence mediation analysis. Journal of Social and Personal Relationships, 026540751988369. doi:10.1177/0265407519883697

Hume, K., Loftin, R., & Lantz, J. (2009). Increasing independence in autism spectrum disorders: A review of three focused interventions. Journal of Autism and Developmental Disorders, 39(9), 1329-1338. doi:10.1007/s10803-009-0751-2

MacDuff, G. S., Krantz, P. J., & McClannahan, L. E. (2001). Prompts and prompt-fading strategies for people with autism. In Making a difference: Behavioral intervention for autism (pp. 37-50).

Mesibov, G. B., Shea, V., & Schopler, E. (2004). The TEACCH approach to autism spectrum disorders. New York: Springer Science+Business Media Inc.

Milley, A., & Machalicek, W. (2012). Decreasing students’ reliance on adults: A strategic guide for teachers of students with Autism Spectrum Disorders. Intervention in School and Clinic, 48(2), 67-75. doi:10.1177/1053451212449739

National Professional Resources. (2009). Hierarchy of Cueing and Prompting. In RTI-Paraed-p111 (Ed.), NPR. Inc: Dude Publishing.

Shabani, D. B., Katz, R. C., Wilder, D. A., Beauchamp, K., Taylor, C. R., & Fischer, K. J. (2002). Increasing social initiations in children with autism: Effects of a tactile prompt. Journal of Applied Behaviour Analysis, 35(1), 79-83.

Sternberg, R. J., & Williams, W. M. (2010). Educational psychology (Second ed.). New Jersey: Pearson Education, Inc.

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