Presuming competence of someone with autism is an important step in the movement from awareness to acceptance. A method that acts as both a therapy and educational support is gaining traction as a means to express learning, understanding, reasoning, thought and communication.
Rapid Prompting Method (RPM) is viewed primarily as an educational method for individuals with autism, traditionally considered more severe on the spectrum and are verbally unreliable speakers. It was created by Soma Mukhopadhyay to teach her son, Tito, who was diagnosed with severe autism and who has used RPM to thrive into a published poet and author.
Angie Paquin of Portland learned of RPM through online groups, blogs and books. However, because her 13-year-old son, Liam, was verbal, she initially dismissed RPM as a therapy option that would benefit her son. However, a local workshop with Virginia-based RPM provider Elizabeth Vosseller proved otherwise.
“I quickly discovered that my son had a whole lot more going on intellectually and with language processing than I ever realized,” Paquin says. “I heard my son’s true voice for the first time ever, including his thoughts on having autism, which we didn’t even know he realized. After a workshop, RPM became the number one priority for my son. It has been a life-changing experience for our whole family!” According to the Mukhopadhyay’s website (halo-soma.org), “RPM uses a ‘Teach-Ask’ paradigm for eliciting responses through intensive verbal, auditory, visual and/or tactile prompts. RPM presumes competence to increase students’ interest, confidence and self-esteem.”
Prompting competes with each student’s self-stimulatory behavior, and is designed to help students initiate a response. Student responses evolve from picking up answers, to pointing, to typing and writing which reveal students’ comprehension, academic abilities and eventually, conversational skills.
RPM is a low-tech approach in that is requires only an instructor, student, paper and pencil. But the science behind how and why it works for some individuals is much more complex.
RPM differs from other autism therapies such as Picture Exchange Communication System (PECS), Applied Behavior Analysis (ABA) and the often-criticized Facilitated Communication (FC) by using prompting to elicit a student’s independent response.
RPM doesn’t use physical touch, as is done in facilitated communication—in which a facilitator places a hand over the user’s hand or arm to guide to letters, pictures or a board for communication. Some physicians and therapists feel more research and scientific studies are needed to conclude the efficacy of RPM. And critics of FC and the American Psychological Association issued a position paper against the method, arguing that it is a “controversial and unproven communicative procedure with no scientifically demonstrated support for its efficacy.”
While each person with autism responds differently to therapy options, RPM is a relatively new type of therapy and there are very little studies that have been conducted on its efficacy. As with any therapy, discuss treatment options with a physician, therapist or clinician to see if it’s the right fit for the individual.
However, those using RPM argue that it is foundationally different from FC.
“There is no physical support,” says Dana Woodhouse-Nagy, a Portland mom using RPM with her 13-year-old son, Ethan. “In fact, a child’s stims are not addressed and are ignored. As far as the argument that it is not supported by evidence-based practices, I would counter that ABA was considered experimental by insurance companies until recently, despite a variety of studies and the fact it has been used for decades.”
Woodhouse-Nagy adds that every methodology had to start somewhere.
“It’s very easy to allow ourselves to become stuck in one mindset and unwilling to consider anything new,” she says.
Loreta Boskovic was managing a home-based ABA program for her 13-year-old son, Niko, when she borrowed a book on RPM. The method has proven to be invaluable in learning about her son, his intelligence and his capabilities. She agrees that RPM does differ from FC and has no physical touch during the sessions.
“My involvement is holding the letter board, naming the letters as he touches them, and writing down his responses,” Boskovic says. “But I am not touching him in any way. My goal is to eventually move him to a wireless keyboard so that Niko will be typing on his own.”
RPM is primarily academic-based with sessions typically lasting 30 minutes. Lessons are pre-planned and in-depth, but kept to a concise length to keep the child’s attention. After a dialogue begins or specific questions are asked, the student uses a letter board to point to individual letters that spell out responses. Depending on abilities, those using RPM can eventually use keyboards and computers to communicate.
Pre-planning for lessons is important and sessions generally start with short bouts of about five to 10 minutes. Boskovic says her and Niko have daily RPM sessions to complement the ABA program he attends. Their sessions last 35 minutes during the week and close to an hour on the weekends. The pair begin with Niko sharing how his day has been and dive into eighth-grade academics, such as history and chemistry, using a combination of books, handouts and videos.
It doesn’t take long for both children and RPM administrators to learn a lot. “Ethan is very kinesthetic and has a long of motor planning challenges, so we try not to overwhelm him,” Woodhouse-Nagy says. “He works very hard during the session. You would be amazed how much information you can teach in 20 minutes.”