Rapid Prompting Method (RPM): Autism’s Newest Trend or Bogus at Best?

Annie Tanasugarn, PhDc, BCBA CEO/AUTHOR, The Autism Analyst
"Autism Awareness simply means to acknowledge that Autism exists; Acceptance is to acknowledge its value."

Hey everyone! I hope you’re all having a great week! I would like to begin this blog with a little background for you.

As most of you should know, I have been in the field of ASD and behavior management for 14+ years and have worked with a wide array of children, teens and young adults. My clients have included both neurotypical children (without developmental disabilities) and children/teens with Autism. No two days are ever the same with my clients and each day brings new promise, new challenges and continued progress towards independence.

A huge part of what I do involves using statistics, graphs, and validated empirically-supported treatments (or, basically stuff that’s been proven to work for kids with Autism). As of today, there’s dozens of ‘’treatments’’ out there for Autism, but only ONE that has scientific evidence supporting it is: ABA therapy, which helps increase the good behaviors and reduce the not-so-good behaviors common with ASD. While I am not a speech therapist, I have worked with many of them over the years and it is quite common for kiddos in ABA therapy to also work with speech therapists and occupational therapists. We collaborate in helping your kiddo reach their goals.

Here’s the skinny: As a parent myself, I know the pain we experience when our children are not meeting their developmental goals as they should, which includes speech. We’re often willing to try anything – and I’ve heard so many heartfelt stories that many of my clients have tried over the years – to help their children. While browsing online today, I came across another article that caught my attention: Rapid Prompting Method (RPM) for use with children with ASD and severe speech delays. This tool was created by a mother with a child with ASD who is nonverbal. To this day, it was reported that the boy will not ‘speak’ unless this machine is used by his mother or other therapist to assist him. At first glance, this tool sounds amazing (and very promising) for helping kids with Autism learn to speak. Basically,  RPM supposedly works by a therapist using stencils, keyboarding, handwriting, and letter boards along with verbal questions (What are you sitting on? Chair. C-H-A-I-R) while using one of the letter options to point, gesture and eventually spell out, the correct answer. So, I had to put my researcher hat on and check out the info on this thing for myself.

The results?….

Parents: I want to help you weed out the quacks while providing you support for treatments that have scientific validation. While Rapid Prompting Method (RPM) showed success with very limited preliminary trials, here’s what parents need to consider:

PROS:

Used for individuals with nonverbal Autism or with severe speech delay

Easy to use

Anecdotal results based on small clinical trials

Some marginal support for decrease in repetitive (stim) behaviors

 

CONS:

Only one study has been conducted validating its usefulness

Initial cases have used very small participant samples with often mixed results

No ‘control’ or ‘experimental’ group studies have been conducted

No validated or empirical support for its utility

No validated or empirical support for its safety —are you kidding me?!

No consistency or structured teaching in its methodologies

Mixed evidence supporting direct gaze (joint attention)

Can create prompt dependency in children (child relies on the prompts as their cue to “speak”)

Mixed results in supporting claims of increased attention or focus in children

 

The point to take from this information is that research on this tool is still in its infancy and any findings have been preliminary, at best. At worst, the safety and efficacy of this tool are not yet fully established or validated – yikes. There’s way too many questions posed from the scant research that has been conducted, thus, suggesting that this tool is marginal at best in helping control repetitive (stim) behaviors, with little-to-no supporting evidence for improvements in speech – which is the reason the tool was created in the first place! To further complicate things, research that has been done often has mixed results.

The bottom line? As with any controversial subject that is brought to my attention, I advise parents to do research. As of today, Applied Behavior Analysis (ABA therapy) is the only scientifically validated treatment for Autism. Speech pathologists who specialize in children with ASD or developmental disabilities often collaborate with Behavior Analysts as part of a comprehensive ABA program and are the preferred choice in helping your child reach their goals.

 

 

References

Chen, G.M., et al. (2012). Harnessing repetitive behaviors to engage attention and learning in a novel therapy for autism: an exploratory analysis. Frontiers in Psychology, https://doi.org/10.3389/fpsyg.2012.00012

Lang, R., Tostanski, A.H., Travers, J., & Todd, J. (2014). The only study investigating the rapid prompting method has serious methodological flaws but data suggest the most likely outcome is prompt dependency. Evidence-Based Communication Assessment & Intervention, 8(1), 40-48.

Toskanoski, A., Lang, R., Raulston, T., & Davis, T. (2014). Voices from the past: Comparing the rapid prompting method and facilitated communication. Developmental Neurorehabilitation, 17(4), 219-223.

Contribute to

[give_form id="1284"]