Least prompts assistance aka hand-under-hand

Happy Tuesday! This week I want to share something that one of my favorite preschool TVIs, Yvonne Locke, compiled into one amazing handout! This handout  is to help teams and families understand least prompts assistance.  (We call this hand-under-hand.) Yvonne took the information from the Developmental Guidelines for Infants with Visual Impairments, (Lueck, A., Chen D., et al (2008) page 15-16) and tweaked it.  It is only one page, so it’s easy to use as a reference tool.  

LEAST PROMPTS ASSISTANCE

Least prompts assistance is a child centered approach for instruction, which has been proven to be effective when teaching children with a range of disabilities.  The belief is that instruction should begin with the prompt that provides the least amount of assistance whenever possible.  If the most assistance is needed, the goal is to fade to the least amount of assistance for the child to participate in the activity.  The intention of this sequence is to encourage a child’s active participation and to minimize dependence on prompts (dependent/passive learning). Below you will find a list of prompts that move from least to most intrusive, which has been adapted for children who are visually impaired with and without additional disabilities. 

Hierarchy of Prompts

Natural Cue

The offer of an object for the child to see or feel elicits the desired reaction.

Gestural Cue

Movement or gesture, such as a point or a wave, indicates the desired action to the child and elicits the desired response.

Direct Verbal Cue

Verbal request for the action elicits desired response by the child.

Modeling

Demonstration of the action to the child elicits the desired response.  Completely blind children should be encouraged to place both hands on the modeler’s hands to feel the movement (tactile modeling).

Physical Prompt

Physical contact is provided that can range from a touch of the child’s hand to placement of a hand under the child’s hand (hand-under-hand assistance) to guide him/her through part of the action to elicit the desired response.

Physical Guidance

The interventionist’s hand is placed of the child’s hand in full physical contact to complete the desired action.  This is known as hand-over-hand assistance.  Some children may dislike this kind of physical assistance and find it intrusive.  To encourage a child’s active participation, hand-over-hand assistance should be used only when absolutely necessary.