Interview between Speaker 1 (Meg) and Speaker 2 (Alexandria Zachos)
Episode 40: Delayed Echolalia & Gestalt Language Processors
[Introductory music]
Welcome to the Two Sides of the Spectrum Podcast. A place where we explore research, amplify autistic voices, and change the way we think about autism in life, and in our professional therapy practices. I’m Meg Proctor from learnplaythrive.com.
Meg: Before we get started, a quick note on language. On this podcast, you’ll hear me and many of my guests use identity-affirming language. That means we say, ‘autistic person,’ rather than, ‘person with autism’. What we’re hearing from the majority of autistic adults is that autism is a part of their identity that they don’t need to be separated from. Autism is not a disease, it’s a different way of thinking and learning. Join me in embracing the word ‘autistic’ to help reduce the stigma.
Welcome to Episode 40 with Alexandria Zachos. This episode is all about kids who communicate using echolalia or scripts. They’re called gestalt language processors, and their communication is often so misunderstood by the neurotypicals in their lives, including — or perhaps especially — their speech language pathologists and their occupational therapists. The truth is, we were only trained to understand how traditional language processors learn and use language. You’ll hear Alex refer to these kids as analytical language processors. And this is the way that most neurotypicals learn language. So, it’s another area where most of us really don’t have the information yet to practice shifting our perspective and imagining the experience and learning needs of our autistic clients, many of whom are gestalt language processors. If this already sounds like a lot of new information, I totally get it. And don’t worry, Alex is going to walk us through this in the most practical and in depth step-by-step way in this podcast episode. I’ll tell you a little bit about her. Alexandria Zachos is a speech-language pathologist who has presented at ASHA and trained therapists all over the world on delayed echolalia and gestalt language processing. She owns a private practice in Illinois called Social Butterfly Speech Therapy and she runs Meaningful Speech, where she teaches an online course on gestalt language processing and shares tons of absolutely transformative content on social media. Alex’s online course — oh, my gosh, it is absolutely jam packed with strategies and videos of her working with kids that completely change how you will work with your gestalt language processors. You can check it out at bit.ly/gestaltcourse, and I’ll also link to it in the show notes. Here is the interview.
Hi, Alex! Welcome to the podcast.
Alex: Hi, Meg. Great to be here.
Meg: Yeah, I’m really excited to have you here. I’ve been wanting to have this conversation with you for so long. So, I, like many others, know you from Instagram where you post as @meaningfulspeech. And your content is all about gestalt language processing, which is a term that’s becoming increasingly familiar, but it’s still new to a lot of us. So, I just want to start there. Can you tell us what gestalt language processing means? And how do we know if that is the way someone processes language?
Alex: Absolutely, yes. So, gestalt language development is language development. Unfortunately, it is not something that is being taught in a lot of speech language pathology graduate programs. However, the research from Dr. Anne Peters and Dr. Barry Prizant has been around since the 70s. There’s a whole lot of history I won’t get into about how our field swung in another direction. But I do have an interview with Marge Blanc on my course that gives a lot of insight into this. And so anyway, I just wanted to give that background to kind of let the audience know why this may not be something that they’ve heard about. There are two ways to develop language. Really, the only way people think that kids develop language is analytic language development. And you know, that’s starting out with one word. So, kids start out with babbling, and then they’ll say their first word, and then they do two-word combinations. So, analytic language development might go like this: Milk, more milk, Mama more milk. And they’re building sentences. And so, traditional speech therapy focuses a lot on, “Oh, this kid doesn’t have any words. Let’s get them words, let’s get them combining words.” Gestalt language development is also a normal way to develop language. A lot of neurotypical kids develop language in this fashion but they go through the stages so quickly that we don’t even know they’re gestalt language processors. A lot of our kids that I say in quotes ‘get stuck’ in the early stages need our assistance, needs speech language therapy to move through the stages.
There are four stages in gestalt language development. The first one is echolalia. And what echolalia is, is repeating something that you have heard, so it can be immediate echolalia, or delayed echolalia. I talk a lot about delayed echolalia, because that is scripting. So, taking a long chunk of language, or a shorter chunk of language that you have heard maybe a day ago, a minute ago, a month ago, a year ago, and it carries meaning for you and you use it to communicate. Stage two is when you start taking that and breaking it apart, and mixing and matching. And stage three is, I call it the magic stage where kids start to understand words as units. So, that chunk of language is no longer a unit, but the word is a unit. And they then can start doing what our analytic language processors started doing from the beginning and taking single words and combining them. And so, stage four is original, flexible, self-generated language. Both ways of developing language gets you to the same point. They both get you to original self-generated language. It’s just a different pathway of getting there. And I took it to social media about a year ago, because I feel like a lot of the therapy that’s being done out there is not appropriate for gestalt language processors, and I needed to spread the word in a way that was going to reach a lot of people.
Meg: Okay, I could talk to you for the whole episode about any one piece of that.
Alex: I have a lot of info.
Meg: Yes, I will link to your podcast episode on the history about this in the show notes. And I feel like I’ve maybe always said this word wrong, because I hear you saying gesh-talt?
Alex: Yes, it’s fine. I feel like it’s kind of like those to-may-to, to-mah-to words. Like, you can kind of say it both ways. So, ges-talt, people also say it like that.
Meg: Okay.
Alex: And what that means is, it’s just a whole, it’s a term that was coined by Anne Peters back in the 70s.
Meg: Yeah, I remember this word from other contexts. And it’s been interesting to apply it to language learners. And I think this is just another case of how hard it is to wrap your mind around people thinking and learning differently from you, right? It ties back in just like almost everything else to the double empathy problem, that I didn’t learn language that way, so it’s hard for me to imagine unless I really do my work around it, that someone is learning language in a different way.
Alex: Mm-hmm.
Meg: And when we kind of start with our assumption that our experience can be imposed on others, we make a lot of mistakes. Like, you’re saying that we’re approaching our gestalt language learners in a way that’s not appropriate for their learning needs.
Alex: Mm-hmm. I think the biggest issue is that as far as the field of Speech Pathology, that this is just something that most speech pathologists were never educated in. And so, they are looking at things only through one lens of language development.
Meg: Absolutely. Okay. I want to parse this out a lot more with you and get you to help us apply it. But I am curious, before we go even deeper about your personal journey. How did you get here and how did this become an area of interest for you?
Alex: Yeah, thanks for asking. I will be brief because it’s a little bit of a longer story. But I have been a speech language pathologist for almost 19 years. I have pretty much worked in every setting. Hospitals, schools, early intervention, private practice. About 10 years ago, when I had my first daughter, I took a year maternity leave from my school job and decided to go into private practice. So, I do own a private practice in the suburbs of Chicago. It’s called Social Butterfly Incorporated. And my original focus was social language and running pragmatic groups. That really led me to a lot of phone calls where parents were calling because they wanted their kids to be more quote-unquote ‘social’ and they felt like language was getting in the way. So, they thought, let’s put this kid in a group. And I’m like, whoa, whoa, whoa, whoa. We don’t need a group here.
So, I got a lot of children on my caseload that were echolalic, and what I had been taught in graduate school and in my placements after that was ignore it, redirect it, tell them ‘No movie talk’. And that’s what I was doing. And it never felt right. And I always felt like I was spinning my wheels. I remember coming home and telling my husband one day, “I don’t feel like I’m making any difference. I feel like my job is pointless.” And I did not know what to do for these kids. And so, I started joining all these Facebook groups for different people in our field, different speech groups, and someone had posted Marge Blanc’s book, ‘Natural Language Acquisition’. And I remember — I can visualize it in my mind — seeing that post and like immediately clicking to buy it. So I’m like, maybe this is my answer! And as soon as that book came in and I read it cover to cover, my mind was blown.
And every speech language pathologist that I have spoken to has said the exact same thing to me about, you know, Marge’s work and reading her book. And so, after I read her book, I joined her NLA study group on Facebook and I reached out to her. And basically, Marge Blanc has been my mentor since 2016 and we have presented together at ASHA, we’ve collaborated, we’ve done an ASHA webinar that’s available on Learning Pass. She has helped me with so many things and given me her blessing to start Meaningful Speech. And basically, it’s been a grassroots effort. We have just been trying to educate people on this ever since I think when Marge’s book first came out in 2012. I don’t want to say it wasn’t well received. But I don’t think it had a big audience and I don’t know that there was a lot of awareness around it.
Meg: I am just going to venture that your story resonates so much with a lot of listeners of feeling ineffective, feeling maybe even harmful, feeling like we’re just going through the motions and not doing something that’s really adding to the lives of our clients, and then finding something that helps you pivots and trying to dive into it. What I love about your story is you found this thing. And then you said, “How can I share this? And how can I change my profession and impact more kids and more lives?” And I’ve seen your social media page grow even over the last year, and I would venture that you’re doing that. And that’s really exciting. And I think even selfishly, it can reinvigorate us professionally to feel like we have something to do that feels good and aligned with our values and respects and supports our clients.
Alex: Absolutely. Yeah, I completely agree with everything you just said. It completely reinvigorated my practice, my life as a speech pathologist, and I write about that a lot in my posts. It basically changed my work life 100%.
Meg: Yeah, I relate to that story with going from trying to be an OT, doing the things that I was taught that were so behaviorally based, and then feeling wrong but not knowing what else to do to really starting to listen to autistic voices and not feeling stuck, right. Not saying, “Oh, I’m not supposed to do any of these things I was doing before, but I don’t know what else to do.”
Alex: Right.
Meg: And I what I see you doing is offering that, “Here’s what else to do, not just stop treating them like analytical language processors.” Not just that, which leaves us feeling stuck, but also, here’s a different path. And we’ll get to that in this interview. But I want to revisit those four phases that you mentioned to make sure that we’re wrapping our minds around them. Phase one is echolalia. And the kid who came to mind for me was a kid when I worked in the schools who often use really specific phrases around her interests, and I didn’t really understand what she was telling me or asking me. And the school psychologist said — and this is, I don’t know, for autistic listeners, I feel like what I’m about to say could be triggering because it’s so dehumanizing. She said, “She’s treating you like a cause-and-effect way. Just ignore her.” Which is such a gross misunderstanding of the way that child was communicating with me with asking the same question in a lot of different contexts. So, like, give us some more context and framework around echolalia.
Alex: Absolutely. Absolutely. So, the thing that can get really tricky about stage one, and Marge Blanc is the one who developed and wrote all these stages in her book. And so, what we’re talking about here is the natural language acquisition framework. And she coined that term ‘natural language acquisition’ because she felt like, and we know this, it’s a natural process. But I keep using that word ‘stuck’ in quotes, because some kids aren’t naturally moving through the stages on their own. So, a lot of our kids, especially our autistic individuals that we work with, because about 75% to 85% are gestalt language processors, according to Dr. Barry Prizant’s research.
Meg: Okay, wait. So, 75% to 85% of autistic kids are gestalt language processors.
Alex: Yep, correct.
Meg: Okay.
Alex: I actually think that number is probably higher, and his research is a bit dated. So, I keep saying we need more research in this field. And I hope now that this is becoming a household term, that some people pursuing research in their PhD may start looking into this area more. But so going back, echolalia can look like a lot of different things. And I have several posts on this if we can link to them in the show notes and that people can go back and look on Instagram. There’s one that I share very often with four circles. Because a child can have long unintelligible strings, it can sound like jargon. But the key is they have rich intonation. So, they may have heard the line, let’s say from a movie, but they’re not processing words as units. They’re only picking up on the intonation. So, it might sound like ju-ju-JU-ju-ju-ju. But then, we know that that was somebody saying, “Do you want pizza, or ice cream?” or something like that. But they picked up that line and they just picked up on the intonation. And a lot of our younger kids have not motorically caught up to say these long gestalts so they sound unintelligible.
The other thing that we see very often, especially in our kids that have been through either traditional speech therapy or behavior-based approaches like ABA is a lot of single words. And we call these stuck single words. So, they’re not going anywhere. They’re not being combined with anything. We’re not building sentences. They’re just standalone single words, because they’re processing them as unit. That single word is almost like a long gestalt to them. And why do they have these? Well through a lot of drill, or whatever the approach was that people were using with them. And then the other thing that we see, probably the most commonly known type of scripting or echolalia, is a full chunk or a line from a movie, a show, a YouTube clip, something mom said, something the teacher said. One that I use very often that one of my clients had is, “Don’t worry, I’ll help you find your Mama.” And that was from Dora the Explorer. And she always said that whole thing. And what it meant to her was, “I’ll help you find that game,” or, “It’s somewhere in here,” like it’s not lost. And that script sat with her because of the Dora episode.
And the last piece I’ll say about stage one is it’s always tied to an emotional experience. So, I know you’ve probably talked about episodic memory in the past, probably on your podcast with some people, Rachel Dorsey. And I talk about it a lot. And she has a recorded module coming out in my course on February 2nd about episodic memory and gestalt cognitive processing. But basically, what that means is there was an episode or an event in the child’s life that is tied to this gestalt or saying. So, it carries a ton of meaning for them. So, let’s say I was out on a walk with a kid and we saw a Great Dane and I said, “Wow, what a big dog!” And then that stuck with them because maybe that was the first time they ever saw a dog like that. And now every time they see anything huge or exciting, they might say, “Wow, what a big dog!” So, we have to make sure we don’t take a lot of these scripts literally, because they are tied to that first emotional experience.
Meg: That is so interesting. I’m sort of taking a moment to take all of that in and reflect on the ways that I have misunderstood echolalia, and how much reflection and work it takes to really do that piece differently. And I imagine listeners are having the same experience right now.
Alex: Yes. And I think the mind-blowing piece for a lot of people is, “Wait a minute. All these things I tried to ignore because they sounded out of context aren’t? Like, they all mean something?”
Meg: Yeah. And it really hits home that you’re saying they’re tied to big emotions. And we’re taught to ignore them and treat them not as communicative. And that really ties in to the way we’re treating autistic kids as not full humans, right? Like ignoring meaningful, emotionally driven communication is at minimum, unkind.
Alex: Yeah, I think so, Meg, that a lot of people, going back to what we said like a few minutes ago, feel stuck and just don’t know what to do. And I mean, I was one of those people. I wasn’t trying to be unkind, but I literally had no tools in my toolbox. I had no idea what to do. And I’ve gone into quite a few schools and done consultations with staff. And this one student just popped into my mind and I’d like to share with your audience. I went into a therapeutic day school, and it was a high school student. And they brought me in because every time before he had what they called a major meltdown, he would say, “I have a canker sore.” And the staff was trying to be so kind. And so, they were taking his script literally. And the teacher would come up to him and like kind of pat his back and say, “I’m sorry, you’re not feeling well,” or, “I’m sorry, your mouth hurts.” And he kept getting more and more agitated. And eventually, it went into what they call the huge meltdown.
And I bring up this case, because I think when people are not educated about echolalia, they do one of two things. Either they do ignore it, or they take it literally. And then they’re stumped as to why a child is dysregulated or not handling what they say well. And a lot of times, it’s because we don’t understand what that script means. And so, the biggest takeaway that I’d like to give your audience or piece of advice is just acknowledge the script, even if you have no clue what it means. The way that I encourage people to acknowledge is to head nod, or smile, say, “Yeah,” or, “Okay,” or, “Repeat it.” So, in this boy’s case, what we started with is just saying, “Oh, okay, I have a canker sore,” or, “Oh. Oh, yeah. Okay.” And I didn’t try to force my idea of what I think the canker sore script was about, because I had no clue. But now, after a lot of work with the family and the school, we realize that he uses that script because it’s a way for him to get any kind of attention, because maybe one time he had a canker sore and somebody gave him a whole lot of love, because he wasn’t feeling well. So, I wanted to bring that up. Because I feel like that story hits upon a lot of points that I want your audience to take away from this interview.
Meg: I love that you’re describing the way to get a lot of attention, not in this behaviorist way of like, “Oh, this is attention-seeking, we should ignore it,” but this is a way that he can state his needs and say, “I’m needing connection, I’m needing attention,” and that we can hear that I also appreciate this idea that it’s not going to be easy for us to know the meaning of the scripts. And so, we approach them with acceptance and curiosity, and see if over time, we can learn without — you know, I imagine sometimes that’s asking questions from people and in the child’s life, and sometimes that’s just watching and learning and seeing if we can get some clues.
Alex: Yes, exactly. And I think a lot of SLP’s and probably OT’s feel very uncomfortable with the watching and listening and being silent. But that’s something that I very much encourage on my social media posts. Sometimes, especially with our older kids that have been treated like analytic processors for so long, we do need to step back and be quiet and listen for their spontaneous language, and look at their signs, and try to figure out what something means. And a lot of times we get answers that way. The family is also a great resource. Many families, especially if you’re working at a school are just not contacted. And so, I think getting them to record some language at home or show home videos or tell you what they think certain scripts mean.
Meg: This goes back to a very basic need for us as therapists to take off our expert hats and put on our detective or curious person hat and be ready and willing to learn from an about our clients, which I’ll acknowledge is especially hard for new therapists and therapists who have, you know, all the like self-doubt. “Do I know what I’m doing? I need to do strategies, I need to teach things, I need to help the kid meet goals, I need to have answers.” And over time, hopefully that settles into, “I’m curious about this. I want to learn about this. I don’t know what this means. So, I’m going to listen more.”
Alex: Mm-hmm. Absolutely.
Meg: Yeah, that’s such a good emotional shift for us to prepare for and to do intentionally. Okay, let’s look at the next stage where a kid start breaking apart words and mixing and matching. Can you talk to me a little bit more about what that looks like, and also what we traditionally do with it, and what we can try instead?
Alex: Yeah, so I do want to say before I get into that, that a lot of kids are using a combination of these different stages. So, I do teach people how to assess through language samples in Module Three of my course. And I encourage the gathering of a lot of different spontaneous language samples, because what we want to try to figure out is what the main stage of communication is. And that’s where we kind of start working. But that doesn’t mean that the child doesn’t have some communication in the other stages. So, stage two is mitigation, so that means they have broken apart pieces of that chunk of language that they had in stage one. So, I’m going to go back to the example I shared with my client, “Don’t worry, I’ll help you find your Mama.” So, stage two, when she first kind of started moving that gestalt a little bit was, “Don’t worry, I’ll help you find grandma.” And her mom came in and said, “Oh, my goodness, she said this when grandma was visiting in the basement, and she told her brother that.” And so, that was awesome for me to hear, because I’m like, okay, she took a unit and a unit, and she put them together. So, I call it mix and match. And it can look different for different kids, because how much they’re able to break down. So, let’s take another gestalt that maybe a child has. So, “Let’s go to the gym.” So, we might hear something like, “Let’s go play now.” So, ‘play now’ might be a chunk from another gestalt, which was, “We need to play now,” or something. So, they take two different gestalt chunks, and they’re able to combine them together. And that’s stage two. Really, it’s a great indicator that they are starting to move toward processing words as units, which is stage three, because keep in mind at the very beginning, our gestalt language processors are all about intonation. They’re not processing words as units.
Meg: I’m curious about what the therapist or the other adult listeners in the child’s life have done in between the echolalia stage and the breaking apart and mixing and matching stage knowing that like all developmental models, it’s not this linear process. Because I imagine what it’s tempting for us to infer from this is, oh, okay, so we need to model that during the echolalia stage, but it’s really based on our assumptions of what they’re trying to say?
Alex: Yes, thank you for asking that. And there’s so much information here. I feel like I do not want to overload your audience. So, I’m going to keep saying I go into all of this in a very manageable way but in-depth in my course, so you will know exactly what to do. But briefly, in stage one, what we want to do is give kids more scripts. We want to give them more gestalts. So, we are modelling new, easy to mitigate gestalts that are appropriate for the child. How do we pick those? A lot of times through detective work. Oh, what do I think he wants to say here? Okay, let me model a gestalt for him. And a lot of times you’re going to hear the kid repeat it back. That means bingo! You got it. You gave them the language they wanted. Or, I talk about that bingo eye contact; they’re going to give you some natural, great eye contact because you got it. Or, they might say, “Yeah,” or they might move on in acceptance. And so, we’re looking for those signs, oh, yeah, we’ve matched their communicative intent. And I guess the other piece I want to emphasize is analytic processors in their first stage need more words, but gestalt language processors in their first stage need more scripts.
Meg: That is so interesting. And I do appreciate your point that this isn’t a framework that we can master in a one hour or less podcast episode, right. And I’ve heard such great things about your course. And it’s full of these practical ways to support our autistic learners. And I’m just realizing, because I don’t actually know a lot about this, how easy it is to keep imposing our worldview even as we’re trying to change it. Because this process is so distinct and so different from how we’re used to teaching language.
Alex: It is.
Meg: Okay, so words as units.
Alex: Yeah, that’s stage three. And that’s a really exciting stage, it’s a lightbulb moment for a lot of kids. It’s very different from those stuck single words in stage one. A child has actually pulled the word out from a script or partially mitigated script. And so, it stands alone for them. And then also, they might start combining it with another noun or an adjective, so maybe it’s ‘truck’, and then they’re able to do ‘blue truck’ or ‘truck car’. And I emphasize in stage three, we’re not worried at all about grammar. I feel like speech language pathologists and parents are way too hooked on grammar. And I tell people, we are not at all even going to touch that until stage four when a child is self-generating language. So, the point of stage three, and especially in therapy, is to really get them to pull down those words from all their scripts and have them stand alone and have them play around with different combinations with nouns and adjectives. And then in stage four, we’re going to start to hear things like, “I fall down.” Bad grammar. The hallmark of stage four is that bad grammar. Why do I want to hear that? Because then I know a child is self-generating. That is not a script; they put all those words together and they’re starting to formulate sentences on their own.
Meg: That is so interesting. And I appreciate how you’re bringing us back even in stage three and four that, no, we can’t at this point use our analytic language strategies. It is still different. We’re not just teaching discrete words, we’re pulling from scripts.
Alex: Right. Thank you for bringing that up. Because something that I wanted to mention that I talk also a lot about in my posts is these strategies and techniques we have for analytic language processors do not work for our gestalt language processors. I see a lot of speech pathologists on social media that are posting about things like expanding utterances. And I do see in the comments section, especially a lot of parents of autistic individuals, that are frustrated because that’s a technique that the SLP has been working on with their kid for four years, and their child is still stuck.
Meg: And is there harm in it, do you think?
Alex: I would say the harm is that we’re really just spinning our wheels. We’re wasting the child’s time and the parents time, and I know that that’s a really bold statement. But if a child is in the beginning stages of echolalia, using those techniques is not going to move the needle forward for them.
Meg: Can you name some of the other techniques? I hear you saying teaching discrete words, goals to expand utterances. Are there any other common —?
Alex: Yeah, so labelling or just, “Oh, we need to get more words and we need to get more nouns in. Let’s point and look around the room; truck, car, book, ball.” What is that going to do for a stage one gestalt processor? Stuck single words. So, and this is a really common strategy and technique used when we feel like a child doesn’t have words. We want to give them words. So, we really have to look at it through a different lens. Another thing is incessant questioning. This kills me. These ‘Wh—’ questions. We do not want to ask kids WH questions when they’re in stages one to three. Why? They are not self-generating language. We are going to get a script. Speech pathologists are going to mark it wrong on their assessment sheet, because it seems out of context or, you know, out of the blue, even though, like we said earlier, it means something to the child, because we’re looking at it through that analytic lens. I start working on ‘Wh—’ questions when kids are at stage four. They’re ready for it then because they’re actually communicating with their own words in their original sentences.
Meg: What about the strategy that those of us who are trained in child-led play-based therapy often use of just narrating?
Alex: I love that. I talk a lot about declarative language. And that is definitely a huge thing when you’re doing play-based therapy and I think an invitation for more communication. I think the one issue sometimes that that can bring up is the therapist is talking way too much, and not allowing the child to have that spontaneous communication. So, I think that’s great as long as we’re, we have those natural pauses in there, and we are listening for their language.
Meg: Yeah, there’s so many reasons. I hear you saying that we need to be talking less in our sessions and not filling up all of the space with our own voices and our own experiences.
Alex: Yeah.
Meg: Yeah, that’s a great reminder. Okay, I want to kind of tie this together with a case study. Your case study, you can walk us through of a gestalt language processor and speech goals. Let’s try it as what would it look like with a traditional lens compared with one attuned to how gestalt processors learn language?
Alex: Yeah, I’m actually going to bring up one of my current clients. I won’t mention him by name. He’s definitely been featured in some of my videos on my social media page. But he was referred to me from his pre-school speech pathologist at the school and I have a great working relationship with her. So, she understands gestalt processing, and identified that this is how he was developing language. But she had just gotten him on her caseload. So, the year prior, he had been working with someone else and had a lot of those stuck single words. So, let’s talk about that SLP. She was probably looking at things through an analytic lens. Here comes this kid, and he is unintelligible. It sounds like he’s jargony all day long. He reported to have no words. And he also is not making eye contact with her and is really interested in his vehicles that are, you know, with him from home, and he’s not sharing them with her, and he’s on the ground really interested in his vehicles, jargony. So, for many analytic ones, she’s like, “Oh, whoa. I got to get joint attention. I got to get into play. I need to give him words.” So, she immediately starts working on labelling. And I am not here to judge or shame anyone because I was that person. So, this person is looking at things through that lens, because that’s all they know.
Year two, he gets a new speech pathologist who understands gestalt development in his school, and she immediately recognizes the jargon as unintelligible strings of language with rich intonation. So, she’s like, “Oh, this is a sign he could be a gestalt language processor.” And then she realizes all those words he got last year are now stuck single words, yet another clue that he is a gestalt processor. And by the way, those words are clear. Because these kids that haven’t motorically caught up, and it sounds unintelligible or jargony, it’s because they’re trying to say these long gestalts. And so, that’s another huge clue to her. When we’re looking at things through an analytic lens and we hear all this jargon and unintelligible language, a lot of times we’re thinking, “Oh, oh no. Artic apraxia, what’s going on here?” But a lot of times, it’s not motor planning. It’s just long gestalts are trying to be communicated and a three-year-old is often ready to say a 16-word sentence, or whatever this long gestalt is he picked up from this movie.
Another clue with this kid, and I talked about this also is a lot of our gestalt processors are musical. So, a lot of his gestalts are songs. And she does the detective work and starts to realize this. Talks with his mom, figures this out. So, what goals are we going to write for our child like this? Our main goal is going to be to give him more gestalts, because a kid in stage one needs more gestalts. And I have a whole kind of checklist check-in that I have people go through in my course where we look at different categories. Things like surprise, things like sensory-motor experiences, transitions, help. And we look to see, do they have gestalts in all of these categories? Because sometimes the dish salts that kids have are not serving them well. They’ve picked some up and they’re emotionally connected to them but they’re not serving them to communicate, help, or communicate transitions. So, we want to model easily mitigable gestalts in those categories. So, that’s going to be our goal with him. While we’re working on that goal, what is naturally happening is we’re doing child-led play-therapy. So actually, the day of this recording, I posted a reel on Instagram where I’m kind of showing how I do this, and how I’m getting a lot of natural eye contact from a child that fits a similar profile, because I am following his lead and doing special interests play in his area of interest. So, that stuff is happening naturally. I don’t always write a goal for something like that. My big focus is to give him the amount of gestalts he needs and then when he’s ready, I’m going to start helping him mitigate those.
Meg: That is so interesting. So, the traditional model would be labelling, trying to give him more words, not really recognizing the ways in which he is communicating. And, you know, I’m picturing so much tabletop speech therapy, structured activities, or flashcards. And I know even a lot of traditional speech therapy is much more child-led than that, but still without the understanding of the meaning of this child’s communication. And then the different model that you gave us is being able to recognize and try to understand where the child is, and it gives new meaning to this like, join in with the child, right, not just copying the way they’re playing. But if I got this right, trying to see what areas they have scripts, what areas they might need scripts, what kind of scripts land for them, and then modelling and giving them natural opportunities during meaningful experiences to acquire new scripts. Did I describe that?
Alex: Yeah, that’s a really nice summary.
Meg: Are there any other insights or strategies that people should keep in mind when working with gestalt language processors?
Alex: I think the biggest thing is everyone is an individual. So, we really need to get to know that child and their own special interests, their likes and dislikes, and what scripts mean to them. I think a lot of times in our field, people are looking for like a blanket approach. And it’s way too hard to individualize things I think a lot of speech pathologists have fallen into, “I’m just gonna buy this program on TPT and I’m going to use it for everyone!” And again, not shaming anyone, because we’ve all been there. I’m just trying to open people’s eyes up to we really do need to individualize but it doesn’t have to be stressful or hard on us. I don’t plan out my sessions. I keep in mind what the child is into and then that’s some of the stuff that I pull and I let the session lead itself; I follow the child’s lead. So, I don’t need to stress myself out by printing and laminating and making everything a theme because that’s not what the child needs.
Meg: Absolutely. Thank you for that. Tell me, what feedback have you gotten from the autistic community about your work?
Alex: Yeah, so I have formed some really great relationships with like Courtney Johnson from Just Keep Stimming on Instagram, Rachel Dorsey, Autistic SLP. I’ve communicated with lots of other accounts run by autistic individuals. I feel that everyone feels this is a neurodiversity-affirming approach and a really gentle, natural way to get kids to where they need to be.
Meg: Wonderful. I have heard the same because I’ve checked with some of my autistic consultants like Rachel Dorsey and said, “Can you give me feedback? I’m about to talk about this. And I just want to check this,” and it’s been really positive and really affirming and you’re obviously doing your work and working alongside of and being guided by autistic adults.
Alex: Definitely. I have a couple great Lunch & Learn episodes, I do monthly live Zooms that I then record and post on our YouTube channel with autistic individuals and we can link to that below.
Meg: I will definitely put those in the show notes too. Okay, one question I want to touch on really briefly before we wrap up, is about gestalt language processing and AAC. And I know this isn’t an area we have a lot of clear answers on. But can you tell us about working with AAC users who are also gestalt language processors?
Alex: Yeah, so this question has come up a ton. And actually, a group has been formed on Facebook now. For those people that are interested, it’s called I think ‘AAC and GLP’, something along those lines. And a lot of speech pathologists that specialize in AAC are in there offering up ideas. Kate McLaughlin, who I know has a course on your site, Meg, has kind of been my AAC consultant. And she actually recorded a module for me on AAC and gestalt language processing that will come out when my course re-launches on February 2nd. We also wrote a post about this together. And basically, the answer is we don’t have any answers right now. It’s a lot of trial and error. But one thing that’s become clear is the device that the child has started on, we want them to grow with it. And so, a lot of SLP’s are just playing around with finding ways to program gestalts into those devices. And then those partially mitigated gestalts; obviously, when they get to stage three, it’s much, much easier because most AAC systems are set up for — well, all of them, actually, are set up for analytic language processors. So, they’re all starting out at that word level. I just had a great Lunch & Learn that’s on my YouTube with Jen Schonger. She is an autistic advocate and parent of a gestalt language processor who uses AAC and she gave parents a lot of ideas on things that they had done with her daughter and her device. Like, she has a lot of YouTube clips programmed in there and she often picks favorite scripts from shows that she’s taken that communicate something for her. And Jen shares a lot of clips of her doing this during our interview. I think she’s also been on your show, right, Meg?
Meg: Yeah, she was on Episode 10. And usually, I have to look up episode numbers, but it was one of my favorites. So, she’s not autistic and she’s a great advocate for her daughter and has such an intuitive — or hard earned, I don’t know — understanding of her daughter. And I love learning from Jen and I will definitely link to all of those resources.
Alex: She’s wonderful.
Meg: Yeah, okay, if everyone who’s listening today has one big takeaway — and this is hard, because I think I personally have had a lot of very big takeaways — but if people come away with just one overarching message, what do you hope that would be?
Alex: I think just please acknowledge any communication attempt or script that you hear. No ignoring. Don’t take it literally. Just acknowledge it. Smile, head nod, repeat it, “Okay”, “Yeah”. I think that’s the building block step for our kids. We need to build that trust, that rapport, and how do we do that? We let them know that they’ve been heard.
Meg: Thank you so much, Alex. Tell us what you’re working on now and where we can find you online.
Alex: Yeah, thank you. So, I’ve mentioned it quite a few times. But my course launches again on February 2nd. It will stay open, it will not close again. I have included six bonus modules that are taught by experts in our field, including Kate and Rachel who have also done courses for Meg. I’m really excited about those bonus modules. You also get access to our member forum where there’s a lot of discussion and questions being asked and answered. There are over 18 hours of continuing education in gestalt language processing in the course. And I’m happy to say I have kind of a Parent track and an SLP track. So, there’s different pricing for that. And I really want my course to be for anyone who wants to learn not just for professionals. And you can find all that information at meaningfulspeech.com. You can follow me and see all these posts I’ve been talking about on Instagram at @meaningful speech. The very last thing I want to mention is new this week. We have an MLA-trained clinician registry, so if you are a parent or caregiver or guardian looking for services for your child, and you want a speech pathologist that is focused on child-led and understands gestalt language processing, go to this list, and you can look up your area. It is updated daily. So, speech pathologists are daily taking our exam, passing it, and uploading their profile info, so check back frequently, and you can find that on the Meaningful Speech site or on its own site at meaningfulspeechregistry.com.
Meg: Thank you so much, Alex. I will link to all of that in the show notes. And thank you so much for sharing with us today.
Alex: Thank you for having me, Meg.
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Thanks for listening to the Two Sides of the Spectrum podcast. Visit learnplaythrive.com/podcast for show notes, a transcript of the episode, and more. And if you learned something today, please share the episode with a friend or post it on your social media pages. Join me next time, where we will keep diving deep into autism.
