Prompting Hierarchy: Building Independence
- Julian Vilsten
- 6 days ago
- 4 min read
In support settings, phrases like “needs prompting” are used daily. It sounds efficient. It ticks a box. But in practice, this shorthand often lacks the clarity needed to deliver consistent, person-centred support.
Does “prompting” mean a gentle reminder? Does it mean guiding their hand? Does it mean asking them what comes next? Without clarity, three different support workers might use three different approaches. The result is confusion for the participant and a lack of measurable progress.
At Outcomes Lab, we believe that clear, shared language is essential. When we are specific about how prompting is used, we improve communication across teams and deliver support that genuinely empowers the person at the centre.
Why Clarity Matters
Without specificity, prompting instructions are open to interpretation. One person may give a gentle verbal reminder, while another may physically guide someone through a task, both thinking they’re following the same plan.
Vague language leads to confusion, over- or under-support, and missed opportunities to build skills. To be effective, we must ensure that our support builds capability, not dependency.
The Prompting Hierarchy: A Framework for Independence
The prompting hierarchy provides a structured way to think about levels of support, from the least intrusive (most independent) to the most intrusive.
Here is how these levels look in the real world:
1. Natural Cue Prompting
This is the goal. Natural cues come from the environment or routine and don’t involve another person prompting.
The Nuance: Even natural cues range from subtle to explicit. A lunchbox on the table might be enough for one person, while another needs a visual schedule with images showing each step.
The Goal: We want to set up the environment so the person initiates the action themselves.
2. Gesture Prompting
Non-verbal prompts such as pointing, nodding, or miming an action to guide behaviour.
The Nuance: Gestures rely heavily on context. Pointing to a labelled drawer is clear; a vague nod toward the bathroom might be confusing.
Key Point: This respects the person’s space by reducing verbal clutter.
3. Verbal Prompting
Spoken words used to initiate or guide a behaviour.
The Nuance: Are you giving a vague prompt (”What do you need to do now?”) or a specific one (”It’s time to get your bag”)?
Repetition: Some individuals need the same prompt repeated due to processing differences. It is important to note if they become dependent on this repetition.
4. Model Prompting
Demonstrating a task so the individual can observe and imitate the behaviour.
The Nuance: This is “I do, then you do.” You might model the full task (using a checkout machine) or just step-by-step.
Key Point: Essential for teaching new skills, but must be tailored to the person’s learning style.
5. Partial Physical Prompting
A light touch or partial physical guidance to initiate an action.
The Nuance: This might be a light touch on the shoulder to encourage movement, or guiding a hand halfway to a lunchbox.
Key Point: This helps start the momentum without completing the whole action for them.
6. Full Physical Prompting
Hand-over-hand assistance provided specifically to guide a person through a task they cannot perform independently.
The Nuance: This is not the same as doing it for them. It involves supporting the person through the action to engage them in the process.
The Goal: Even here, the aim is to build the motor pattern and gradually reduce support.
Using the Right Level (Least-to-Most)
An important principle in effective support is to use the lowest level of support necessary to build skills and foster independence.
Providing more help than needed can reduce opportunities for independence and unintentionally foster dependency. If a person can zip their jacket with a gesture prompt, but we use full physical prompting because we are in a rush, we are taking a step backward.
Deciding the right level often requires collaboration. Input from Behaviour Support Practitioners or Occupational Therapists can help assess the individual’s needs and create a plan to “fade” support over time.
Describing Prompts Clearly
To make your support notes count, swap vague generalisations for specific descriptions.
Instead of: “Needs prompting to make lunch.”
Try: “Responds to a verbal prompt to begin making a sandwich. Needs one verbal reminder to collect ingredients, then completes task independently.”
Instead of: “Needs help with swimming gear.”
Try: “Uses a visual checklist (natural cue) for packing swim gear. Requires verbal prompts to check off each item.”
Using detailed language helps create a clear picture of the person’s abilities. It ensures that support is respectful, goal-oriented, and aligned with the individual’s capacity for growth.
Final Thoughts
Prompting is not just a tool to get things done; it’s a strategy to build capability, confidence, and independence.
By moving beyond generalisations and using the structured language of the Prompting Hierarchy, support staff and families can provide more consistent, person-centred care. When we describe prompting well, we honour the individuality of the person we’re supporting and set the stage for real, measurable progress.
Struggling to move from support to independence? Our mobile team in helps families turn daily routines into skill-building opportunities. Reach out to Outcomes Lab today.
About the Author
Julian Vilsten
Founder, Outcomes Lab | Clinical Neuropsychologist | Advanced Behaviour Support Practitioner. MClinNeuro, BBNSc (Hons)
With over a decade of clinical experience, Julian combines neuropsychology with practical behaviour support. He is dedicated to neuroaffirming practice and building support systems that champion autonomy and genuine well-being.
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