Cues vs. Prompts

Understanding Prompts, Cues, and the Prompting Hierarchy in Therapy and IEPs

Have you ever been handed a document or treatment plan and felt overwhelmed by the terminology? For many parents navigating an Individualized Education Plan (IEP), the technical language can feel confusing, frustrating, and difficult to interpret. You’re not alone—many families experience this when reading reports from special education teachers, speech therapists, occupational therapists, and physical therapists.

As providers, it’s important to remember that not everyone is familiar with the terminology we learned in graduate school. Clear communication matters. We must take time to explain concepts, reword complex terms, and ensure families fully understand what is being discussed during meetings, evaluations, and therapy sessions.

One common source of confusion is the difference between cues and prompts. These words are often used interchangeably, but they serve different purposes.

• Cues help a child recall information or skills they have already learned.

• Prompts help a child learn new skills by providing additional support.

• 
  

If your child receives speech therapy, you may have heard about the prompting hierarchy, a structured way of teaching new skills by gradually reducing support. This hierarchy is used across many fields—including special education, occupational therapy, and physical therapy—to help children build independence.

Below is a clear breakdown of the prompting hierarchy commonly used in therapy:

Physical Prompt

The most supportive level. The therapist physically guides the child’s movements to complete a task. Example: guiding a child’s hand to produce a specific sound.

Tactile Prompt

Uses touch or pressure to guide movement. Example: gently touching the child’s jaw to support correct tongue placement.

Model Prompt

The therapist demonstrates the skill or behavior. Example: modeling correct pronunciation for the child to imitate.

Gestural Prompt

Uses nonverbal cues such as pointing or signaling. Example: pointing to the mouth to encourage attention to articulatory movements.

Verbal Prompt

Provides spoken hints or reminders. Example: “Use your lips” to support correct placement.

Visual Prompt

Uses pictures, charts, or visual aids to guide learning. Example: showing a visual cue for vocabulary, sequencing, or articulation.

Independent

The ultimate goal. The child performs the skill without any support.

It’s important to remember that the prompting hierarchy may vary depending on the skill being taught. Your child’s therapist uses clinical judgment to determine which prompt to use and when to fade support to build independence. Practicing skills at home and reinforcing strategies used in therapy can help your child progress more quickly.

As providers, our goal is always to help children succeed. We break down complex skills into manageable steps, provide repeated practice, and collaborate with families to ensure learning carries over into daily routines. If you ever feel overwhelmed by the terminology in your child’s treatment plan, please ask for clarification. And truly—send me an email anytime. I’m always happy to help.