If you’re not following us on TikTok, @TurnAutismAround, we’ve been doing videos on scripting and echolalia. With that have come questions and comments related to Gestalt Language Processing. I was unfamiliar with this and have invited SLP-BCBA, Sari Risen on the podcast to discuss it.
What is Gestalt Language Processing?
Dr. Marge Blanc is an SLP who has most recently begun discussing and studying Gestalt Language Processing, as an intervention program. In her research, she cites earlier studies by Dr. Anne Peters and Dr. Barry Prizant. This term is best described by separating the two ways children learn a language. One, analytically, by learning single words eventually piecing them together creates longer utterances. Two, “Gestalt”, by learning language in chunks. This can be scripting or echoing phrases or “chunks” of language and eventually creating longer and longer utterances and piecing different “chunks” to create different utterances.
Is Scripting or Echolalia communicating?
Scripting and Echolalia phrases are not to be considered accurate snapshots of your child’s language. If they are only using those words in the specific phrase or often out of context, they should not be counted in the number of words your child uses or considered as a length of utterance. However, scripts can be considered clues for what motivates your child, or even a way to communicate based on the original context of the script. I share an example of my son Lucas and a common script of his as a child, “Arthur’s Tooth” and the way it helped him communicate pain.
Many say we should, “Presume Competence” based on the level of language or articulation coming from a script or echo, but Sari argues this can be harmful to the progress and intervention of a child if we aren’t starting at the necessary level. Her colleagues, Nikia Dower and Tracie Lindblad coined the philosophy, “Presume potential, teach competence.” This is great because it’s believing the child has the potential to reach language goals but starting at the level they’re at and not above.
In this episode, Sari references a webinar from Marge Blanc when sharing information about research and case studies. If you have questions about Gestalt Language Processing be sure to listen to this full episode and view the linked, referenced webinar for more information. Also, please read the 16-page critical appraisal of NLA written by Sari Risen (the link is the first in the references below).
Sari Risen on the Turn Autism Around Podcast
Sari Risen is a speech-language pathologist as well as a Board Certified Behaviour Analyst (i.e., a practitioner of applied behavior analysis). She has had extensive experience working with individuals with complex communication needs, including individuals with Autism Spectrum Disorders and individuals with intellectual disabilities. Having conducted her Master’s thesis in the area of augmentative and alternative communication (AAC), Sari has always had a strong interest in this area and continues to have a strong focus on serving individuals with AAC needs within her practice. Sari’s training and experience in the area of communication disorders also include a focus on improving speech clarity by addressing motor speech disorders and helping non-speaking children develop the use of spoken language. In the area of language development, Sari focuses on helping learners develop the language skills they need to thrive in the environments that are important to them and their families with applied behavior analysis guiding her selection of strategies. Sari also has experience in addressing feeding concerns in children with food selectivity and oral motor concerns. She also conducts assessment and treatment to address maladaptive behavior,
Early in her career, Sari worked as a speech-language pathologist at the Geneva Centre for Autism in Toronto, Canada, serving as a member of a team that provided consultation and training to parents and professionals regarding communication and maladaptive behavior for preschool children. In 2012, she opened her own private practice, Action Potential Services, in which she and her team provide speech-language pathology and applied behavior analysis services, focusing primarily on serving individuals with neurodevelopmental disorders as well as toddlers with severe language delays and children with feeding difficulties.
Sari is a mom to her almost 2-and-a-half-year-old daughter. Along with her clients, her daughter serves as a wonderful teacher for Sari, helping her to learn about the complex and fascinating area of language and social development.
- What is Gestalt Language Processing?
- How does Gestalt Language Processing relate to Scripting and Echolalia?
- What is Natural Language Acquisition (NLA)?
- Can Scripting, Echolalia, and Imitation be communication clues?
- Is Scripting communicating?
- Echolalia in Intraverbals and answering questions.
- Is there evidence and research to support Gestalt Language Processing?
- What is Presumed Competence, and can it be harmful?
- Marge Blanc: Making Sense of Echolalia: It’s All About Language Development!
- Apraxia and Autism: What is Apraxia with Tamara Kasper
- Speech Development | Interview with Rosemarie Griffin, SLP & BCBA
- Mistakes to Avoid when Increasing Language Skills in Children with Autism
- Hyperlexia in Children – Autism Mom, ABA Help for Professionals and Parents
- Assessment App
- Delayed Echolalia and Scripting in Children with Autism
- Is Your 2-year-old not Talking? How Katty Turned her Son’s Speech Delay Around
- Acting Antics: A Theatrical Approach to Teaching Social Understanding to Kids and Teens with Asperger Syndrome
- Mary Barbera
- Mary Barbera on TikTok
- Mary Barbera on Instagram
Sari Risen – Turn Autism Around Podcast Transcript
Transcript for Podcast Episode: 209
Gestalt Language Processing: What Is It and How Does It Relate to Scripting and Echolalia in Autism?
Hosted by: Mary Barbera
Guest: Sari Risen
Mary: You're listening to the Turn Autism Around podcast episode number 209. We are airing the first week of January 2023. So Happy New Year. I'm glad you're with us today. Today we are talking about a brand new topic called Gestalt Language Processing with Sari Risen. And she is both a speech and language pathologist as well as a board certified behavior analyst. She has done some training on the topic and has some suggestions for how to think about Gestalt language processing. So let's get to this really important episode with Sari Risen.
Intro: Welcome to the Turn Autism Around podcast. For both parents and professionals in the autism world who want to turn things around, be less stressed and lead happier lives. And now your host, autism mom, behavior analyst and bestselling author Dr. Mary Barbera.
Mary: All right. Sari Risin is with us. And I'm so excited that you are joining us today. Thanks so much for your time.
Sari: Thanks so much for having me.
Mary: Yeah. So we are going to talk all about a topic called Gestalt Language Processing and how it relates to Echolalia and scripting and all the things. But before we dive into that very new topic for us, I'd like to start with your fall into the autism world and fall into the speech therapy world and behavior analysis world.
Sari Risin on the Turn Autism Around Podcast
Sari: Okay, great. So I had my first interaction or my first sort of client when I was in high school. I was interested in health care and interested in working with kids. And so the idea of working with someone with special needs was really exciting to me and I got to support this child with at the time there was a term PDD NOS and loved it. And then in university my major was human biology, but I also took minors in linguistics and psychology with a thought that maybe speech language pathology would be what I would pursue. And I really enjoyed the linguistics classes and the psychology classes and you know, it all combined kind of into being a good foundation for speech language pathology. So I started that. But in, you know, my last year of undergrad and early in my graduate work, I also worked part time in a job where I got to learn ABA. So I kind of got to tip my toe into ABA and loved it and I loved that it gave us a very logical and systematic way to do what I was learning to do in speech language pathology. So I thought at that point, at some point I want to become BCBA, but there were not a lot of us back then.
Mary: What year? So what year did you become an SLP?
Sari: So I finished grad school for SLP in 2007 and then worked for a while on a team at a center for children or for people with autism, and on a team that had ABA professionals but we didn't have any BCBAs in the agency when I started. So it was the ABA professionals were people that had some undergrad training in psychology or, you know, related fields, and I was the speech language pathologist and they would work together. So I got to use ABA there and in 2012 started BCBA course work and finished the whole process in 2013.
Mary: Okay. So, so you're both an SLP and a BCBA and according to my friend Rose Griffin, who's been on the podcast a few times, we can link her in the show notes. This is episode 209. There's about 500 of you.
Sari: Nikia Dower would know she's got a list so you know maybe four something. I'm not sure if we have 500 yet.
What is Gestalt Language Processing?
Mary: Yeah. So it's a unique combination of an SLP, and a BCBA and and is a really great combination like I cannot think of an SLP-BCBA that I do not like or agree with. So it's really unique, they call themselves unicorns. And it really is a great combination because, you know, using Skinner's analysis of verbal behavior is like, I can't think of any BCBA SLPs that aren't in favor of that. And it's just it, it's just a really great combo. I'm a nurse and a behavior analyst and I know a few other nurses that are behavior analysts, but I can't name them. We don't have a group. Yeah. And there's of course, tons of parents who have become behavioral. And I did start like a Yahoo group way before Facebook, and I did write an article I can link in the show notes the experiences of autism moms who become behavior analysts, a qualitative study and and that was actually in journal like of speech therapy ABA it's no longer in press, but it's a, it's a great article and I got a lot of ideas from this combination group. But anyway, that's a great segway into this Gestalt Language Processing. And I told you I actually got your name and information as being, you know, somebody that would be willing to talk. On the top topic from Nikia Dower, because we are getting we're doing a lot of Tiktoks and Instagram. And if you're not following me there and you're there, it's @turnautismaround. But we're doing some things on scripting and stimming and echolalia and delayed echolalia And so now we're getting messages about Gestalt Language Processing and my son said, Gestalt Language Processor or Yeah, I'm looking for somebody who has expertise in this. And I'm like, I don't even know what that is. So can you tell me and our listeners what it is, why all of a sudden we're hearing more about it and then, you know, is it really a thing? Is it something different? Is it just what we're doing with a different name?
Sari: So yeah, when it first got popular, I don't know what, maybe two years ago or about a year and a half ago, I was like, Well, okay, are they just talking about kids who use scripts, kids who use chunks? So sequence of the words that they've memorized because okay, I've seen that. But why is it controversial? And also, why are people so excited about it? So I decided to watch Dr. Marge Blanc (NOTE: During the podcast interview, Sari erroneously referred to her as Dr. but upon checking, Mrs. Blanc does not have a PhD.), she's the founder of this method of approach.
Mary: And how do you spell Blanc?
Sari: B L A N C? I could be saying you're wrong. It might be my Canadian heritage. Just getting me to say blanc and maybe it's blank, I don't know!
Mary: So Dr. Marge Blanc. And I'm assuming she's an SLP?
Mary: She coined this or started talking more about it and started studying it.
Sari: She's the one who started talking about it as an intervention approach, and she cites previous authors from the seventies and eighties who in her approach or kind of her thinking they got the idea of these gestalt language processors starting. I can go into a bit of that as well. Okay. So I watched a webinar by her and there's a free webinar through New Jersey AC. I'm not sure what AC stands for. I think it's a parent organization in New Jersey for people with autism.
Mary: We can try to find that and link and link that in the show notes.
Sari: So that's the first thing I watched. And when I watched it, I realized, okay, it's not just that we're using these scripts sometimes we're trying to encourage kids, use them more, there's more to it. And at that point, I became a little bit concerned about some of the aspects of it. So there's some great aspects to it. There's the idea that we really want to figure out what our kids love and what makes what they're interested in and be a detective and learn all about them. That's amazing. And we want to make our interactions with them super fun and motivating, and we share that idea as BCBAs. But as I said, there's some concerning points. So first, the idea that there are some people who are Gestalt Language Processors in that they learn differently than other people. This idea was started, Dr. Blanc talks about how it was first talked about by Dr. Anne Peters. I believe she was a linguist or maybe a psycho linguist. And so she wrote about how there is a continuum between people who use mostly analytical processing. So what we usually think of most kids who learn a single word and then they start putting together short utterances and move from there versus people who use mostly Gestalt what she called to use that word. I don't think she had coined the word Gestalt yet. No, no, I think she actually had. I can check that for the show notes. So on the other end, there were kids who learned chunks of language and she talked about that. It's not that you're necessarily one or the other, you use both. I don't think anyone would argue with that. Like I certainly see that with my daughter. Sure. The other day she put on her boots and said nice and warm, but she knows the word nice and she knows the word warm, but her nanny had been saying boots, they're nice and warm. And I think we've all seen that. We've certainly seen that in our children and clients with autism. But the idea that this therefore indicates some difference in learning or a difference in what type of teaching a person is going to benefit from. I don't think we have evidence of that.
Scripting and Echolalia
Mary: Right. Right. And, you know, it really does go hand in hand. That's why I'm getting a lot of messages because I am producing things about scripting and delayed echolalia. And so even when I had Tammy Kasper, who is another SLP-BCBA on the show, we can link that in the show notes. That was all about a proxy. And you know, if you have Apraxia, and autism, you know, yes, that is an additional, you know, medical diagnosis potentially or it is another challenge. But in the end, the treatment is the same. So we still have to go down to things they like and nouns. And then we build actions and then we build, you know, and we build articulation and we work with a speech and language therapist to help us. So I kind of see this and I have a son with autism, as you know, and I kind of see this as if you have a child with autism or a toddler showing signs who's also scripting. But as Sari pointed out, your daughter does not have autism and she's two. It's typical for kids to memorize songs or memorize cute little phrases or even memorize jokes from little things, and then to come out with scripts or things they like to say, you know, Buzz Lightyear to the rescue. I mean, that's not like, oh, my God, that the child might have autism. I mean, these are things little kids say and sing and memorize and come out with. Kids with autism may come out with this sooner. More so than typical language. Not like every now and again, it might be nonstop stemming and scripting my son, for instance. Before I knew any of this, before I had any inkling that there was anything going on with him. And way before I knew anything about ABA or verbal operations or anything, he would go to the park with my husband and I and there was a sign there, Please do not feed the ducks. There were actually multiple signs every ten feet. Please do not be the ducks. So my son loved to run to the sign. My husband would read, please do not feed the ducks and then he'd add quack, quack. So in the middle of the night, Lucas would wake up sometimes and say, "Please do not be the duck's quack, quack". I didn't know that was delayed echolalia, I didn't know that was a potential sign of autism. I didn't know how to get him to say it. And the other thing I did was I was like, I've got to count all those words as his bona fide words. Please do not feed the ducks, quack quack. I'm like, There's eight words. People count sentences when it's scripting. You know they like. It can it can force a parent like me into a state of denial, because when you get asked, are they talking in sentences? Oh, yeah, they're talking in sentences, but they're scripts. And so it is concerning when people message me and say, well, my son learns differently, he learns through scripting. And then, you know, I just don't know how to respond.
Sari: Yeah. So here's the thing, when it comes to language acquisition, we really don't know how languages are learned. I know I have some fellow SLP-BCBA colleagues who are like, "No, we know it's Skinner", but I don't necessarily agree with that. I think Skinner gives us an amazing way to intervene when there's a problem with learning a language, but how we learn it naturally. What I learned through my language acquisition coursework is there's so many different theories and each of them has its pros, but each of them also has its own ways to argue against them. And I think we're going to see the same thing. Or are we seeing the same thing with the idea of are there some people who learn language naturally through this NLA, natural language acquisition process, which Gestalt learned first. So who knows what happens naturally.
Natural Language Acquisition
Mary: So NLA is natural language acquisition, but is Gestalt a part of that. Or is NLA something that has been on for decades.
Sari: So NLA, Marge Blanc explains that NLA is this description of what happens with Gestalt Language Processors, okay, and maybe it's true, maybe it's not natural, I'm going to leave that to the researchers. But like what, you know, I think about the most is intervening when I need to help my clients with autism. And so I don't think we have evidence that teaches them in the way that the approach that Dr. Marge Blanc has described, we don't have evidence that it's likely to work or that it would work. And plausibly, I think plausibility is a huge thing. I think there's a lot of things in our field because we're a relatively new field that don't don't have amazing evidence behind them. They have some, but they're plausible. This approach, there's a lot of pieces that aren't. So, for example, rather than helping them to learn their first mand. So someone who's got a lot of scripts but can't tell you now that they want water rather than teaching them specific mands. The idea is you model more gestalts for them, so you model more of these sequences and you hope that they will. Dr. Mark Blanc uses the word that actually came from Anne Peters is that they will mitigate that so they will take pieces of your scripts and then initially combine them with other scripts and later on they'll parse them. So they'll pick out the specific words from them and then be able to, in stage three, really be able to put together their own two word utterances. And that's nice if that would work. But we don't have evidence that it would. One reason that it doesn't make sense to me that just modeling would work is that modeling on its own, without the expectation that a child will respond in some way, is part of what we call indirect language stimulation. And the evidence for that is mixed with the autism population. And certainly what I see with my clients is just modeling really doesn't help, if their parents have been modeling all along. So if just modeling worked, it would have worked. So that's one of my concerns.
Mary: And one of my concerns. I've done a lot of talking about how I'm actually not in favor of things like carrier phrases to bump up the length of utterance and we can link that on the show notes. And when you're talking about, you know, the two word utterances, I don't talk about this podcast a lot, but I did a solo show after I saw an online lecture at the National Autism Conference with Dr. Vince Carbone, presenting on language acquisition from a behavioral point of view. And we can link that in the show notes that that episode really goes deep into the language acquisition research. And he said, I'm kind of summarizing from memory, so I could be a little off, but you know, you really want to get one word utterances, one word utterances, then do your adjectives, adverbs, verbs, and then have the child put together naturally the two word utterances before you go messing with any real instruction on in increasing length of utterance. Because if you push in scripts or.."That's A", "I want.." or "I see.." in my two decades of experience. That is going to hurt language more than help.
Sari: I agree. You start to see that we're using it in places where it doesn't make sense because they're not quite understanding what it is. Yeah, absolutely. I follow more of what Dr. Carbone and you have described.
Mary: Yeah. So that is a concern and I don't know the exact you know, you said stages or phases of this Gestalt. But I do think that we need to use kids' scripts as evidence that they can talk, we can measure their articulation just if they talk in little sentences like "please do not be the duck, quack, quack" wasn't perfect. It was like "Pees du nah fee da duh qua quak" , you know, like that kind of thing. That's okay. For a new talker, there's no reason to work on articulation with a 18 month old, two year old who's saying it like that, that's fine. But then we need to use that as clues. Like, he's highly motivated by those signs. He's highly motivated by text. He turned out to be hyperlexic as well, which I've done some work on. We can link in the show notes like. But. Like you said, with your daughter, nice and warm. She probably doesn't even know what that means.
Mary: So then pulling out, you know, a picture of a duck for the shoe box program or for matching or getting a puzzle that has a duck and a pig. And, you know, these are words that are not only highly motivated, both motivating. In our case, it was, but they're the common first words of little kids.
Sari: Right. Right.
Mary: And then you can work on, you know, animal sounds, which are usually easy to say because they're just really sounds versus words. And knowing just a little bit about Gestalt language processing I feel like, it's like trying to put a spin on something that doesn't really need a spin.
Sari: Yeah. Yeah, I agree with that too. Yeah. I also can see the proponents of the approach talking about, well, I started to do this because I saw this child and he used a lot of scripts and that was, you know, getting in the way of his social interaction. He's got a lot of other things going on with this social interaction. Let's focus on them. Yes. There's these scripts. And like you said, these scripts tell us that he can imitate language. That's amazing, because if a child can't yet imitate language, we can help them to learn to do that. They're great approaches to do that. But that's a whole thing that we can skip that step. And just now, the child's already imitating language like we're ready to go.
Using Imitation, Scripting, and Echolalia as Communication Clues
Mary: Imitation is such a huge skill, like you said. I know another good clue and the way we used Lucas's scripts was he used to watch a lot of TV still does, and one VHS tape that he really liked was called Arthur's Tooth. And in that episode, Arthur has to get his tooth pulled or something and I guess he screams in pain from the tooth pulled. And then Lucas got his tonsils out. And he didn't have any way to say he was in pain. One of my friends said, in the middle of the night, your scabs might fall off and he might be in more pain. Don't panic. Just give him some liquid, blah, blah, blah. So, you know, day three or four after his tonsillectomy, he wakes up yelling and he's yelling "Arthur's tooth, Arthur's tooth." And that to me was saying, oh, my gosh, he's in pain.
Mary: And then after that, he would skin his knee and he would hold it and he would say, "Arthur's Tooth". So yes, we can use scripting and echolalia to provide clues even now. And now he can tell us, you know, Head Hurts or Booboo or whatever. But if he bangs his elbow, even now, he'll say, "Are you okay?" But if he says, Are you okay? People have to realize he just hurt himself. You know how when you bang your elbow, you're not like, oh, my gosh, that hurt. But, you know, so we need to continue to go like, hey, maybe we should try to replace that when he bangs his elbow, because I'm not always going to be there to go like, oh, that means he hurt himself.
Sari: Right, right and yeah. So I think your examples show that he may have been using them communicatively. And I don't think anyone argues with that like I think way back when Dr. Anne Peters and Barry Prizant were writing about this. It was thought that people had not yet thought of this as being communicative, but it certainly can be. And I think we all agree with that. But yeah, it reminds us that we also need to give these kids a way to say these things that other people will also understand.
Mary: Right. Right. So what do you do if a child is having a lot of scripting? Let's just say it's an eight year old with a ton of scripting, like as an SLP-BCBA, how would you tackle that?
Sari: So I look at what else they have in their communicative repertoire. So I might leave the scripting aside and yeah, I'd be doing, you know, like a VB MAPP assessment potentially. Like it might be that we need to look more at other things like syntax and don't get much into that, but, but probably not. Probably if most of what they're doing is scripting, they're more at the level where we're looking at their manding, which is requesting and how their ability to label with single words. Okay. Can they put together some short utterances? I also would be looking at the receptive language of their understanding of language, which in the NLA approach you don't really see a look at that receptive language.
Receptive Language and Intraverbals
Mary: That's huge, right? and we do I don't know if you know Sari, but we do have a brand new digital assessment and it only takes 10 minutes to complete and gives you scores in self-care, eating, sleeping, potty training, grooming and dressing, a score in language both expressive and receptive, as well as imitation and matching and social skills, and then a score in problem behavior. So it is a really nice tool. You can get that at freeautismassessment.com. And it's basically my one page assessment that I created like originally 18 years ago. And it's quick and easy as a real snapshot. So in that case, yeah, I think you not only have to look at the language and the intraverbal subtests. I just did episode 205 with Katty, who's a mom with a child with speech delay, who's taken my courses and her son's to the point where you really can do a lot with the intraverbal subtest, which is a VB MAPP supplement. And so I find that the kids who script it might get right to the point to do an intraverbal subtests on them and see.
Sari: Sometimes the scripting or the echolalia is because you asked the question and they don't know how to answer it. So yeah, yeah, yeah, yeah.
Mary: And that's a really good point as well. Can you explain that? I mean, I'm totally on board with that, but I don't know that we've talked about that in the podcast. So. You said sometimes the scripting is because you ask them a question that they don't know the answer to. Can you talk about that a little bit more?
Sari: Yeah, I don't know. I mean, some people might call it scripting, but yeah, but you get immediate echolalia, likely. So if a child has never been taught to answer, what's your name? And they're not a person who answers novel questions yet on their own, you say, What's your name? They're likely to say, What's your name? Because I mean, the one thing that tells us which is great is that they realize they should respond. So yay. And now we need to give them the language to be able to respond. Right.
Mary: Right. And I also have a client and a lot of experience with kids over answering yes when they don't know the answer. Yeah. And also, I was with this young man who went to Catholic school and stuff. If he didn't know the answer, he would say, God.
Sari: Wow. That's so interesting!
Mary: So that's where language comprehension is so important. And assessing quickly they're intraverbal subtests. So we'll link Katty's show in the show notes. But in her episode, in her show notes, we actually have the intraverbal subtests and where her son scored and we talk a lot about that. But I do think that it's or they just start scripting when they don't know the answer. I had a client who would throw up a ball and say, Stop throwing the ball, stop throwing the ball. You know, I couldn't interrupt him. Or if you asked him a question, you know, he would just script about something else. But it is a clue and the intraverbals are always going to be. Yeah, and answers to questions are always going to be the hardest opera. And no matter what age, ability, or what language you're speaking, it's hard.
Sari: There's an abstract answer thinking.
Mary: Yeah, and do you think that in my experience, a lot of kids script heavily from videos, from YouTube, from VHS tapes, from DVD. Has that been your experience, too?
Sari: Yeah, absolutely. Yeah. And often they really enjoy doing it. So it wouldn't be something I would ever try to stop. I've had parents ask me so because he'll say this long sentence that he's working on the video, can we do something with it? Usually not. So if they're using it, they're not trying to communicate with you about it. They're just kind of walking around the room saying it. They're enjoying it. Doesn't really tell us much about their language other than the fact that they can imitate, which is great. But yeah, so I've seen a lot of kids get a lot of enjoyment out of doing that kind of thing. I've also had one client where he and his parents were really into drama and in a good way like acting and the arts. And so they knew lots of poetry and lots of movies, and they'd memorize the movies with him. And then it was great because they could socially interact by talking to each other with scripts. So yes, you also need to learn to use language to be able to communicate with other people. But with his parents, this worked really nicely for getting sustained interactions. So that was great. And that is one of the things Dr. Marge Blanc talks about and I do agree with her on that piece.
Mary: Yeah, yeah, I like that. And there's a really good older book that hopefully is still in press. We can link it in the show notes if it. It's called Acting Antics and it's all how to teach social skills through acting and scripts. And so I do like that as well. You also, you know, some of this too is kind of trickling into that presumed competence. And like, what does presumed competence mean? And do you agree with that?
Sari: Right. Yeah. So when people say Presumed Competence, they're always assuming that our clients have more to say and more, and that their cognitive skills are higher than what they might look like. And I say like I got this term from Nikia Dower and Tracie Lindblad, they came up with it "presume potential, teach to competence." I think it's dangerous to presume competence when what we're seeing doesn't give us the evidence that the cognitive skills that we're hoping for are already there. The problem with it is that then we're not teaching at the right level. So we're missing teaching at this level. And at this level might be where mands are being large. And when the child learned to tell us what they need, we missed that and we're skipping it because we think they're already here. We're failing that. We're not giving them the quality of life that they need. And then the other problem is so this is actually a big part of the NLA approach, they say, to look for hidden meanings. So in the Gestalt for an example that Dr. Marge Blanc in the NJ AC workshop as a child said to her. Ah. Something about Jiminy Cricket in the movie. I think it's Pinocchio. He talks about that. He wants to learn about his conscience. And so he says, this child said this to Dr. Marge Blanc and then she decided that he wants to learn about it and you should talk to him about it. And so time, I think, was being wasted in her session where she was talking to him about something that he probably wasn't interested in and didn't understand what she was saying. Yeah. So I think I think that's dangerous and another I think danger of it would also be what we've seen in FC World where children will say things or people will say things with their device. But it was actually said, you know, by the person who was helping them to use the device.
Mary: Right, and FC is facilitated communication.
Sari: Oh, yeah. Sorry about that. Yeah.
Mary: No, just for our listeners who aren't familiar with all this, I agree. Like if you test, you know, Lucas's IQ, it is in the intellectual disabled category and it is what it is. I mean, it's not really fair to give him a real IQ test because of his language impairments. And I'm sure he is. He has potential and he is competent. But my three goals are he's as safe as possible, as independent as possible, and as happy as possible. I don't really put a lot of thought into his cognitive level or even his language level. Like, I want to get his words as functional as possible so everybody can understand him and that they know the meaning. But I do worry about this whole presumed competence. And like my child, you know, Lucas's level. Over all the years, there's nothing to show that he would understand consciousness or he could go to college or he could, you know, and it is kind of dangerous. And, you know, not to say that there's this Gestalt is a part of this, but this whole presuming competence and teaching to high, which we've seen over the years, can really get you in trouble. And the other thing is, if a kid is scripting a lot, what are their problem behaviors? Because I had a kid who said, are you happy? Like during instruction, like I was the consultant. And I went in and they're like, this new child is saying, are you happy, you know, 48 times in 10 minutes or 48 times in an hour? But when you didn't respond yes or no or yes, he would have a problem behavior and it could escalate to aggression. So some kids script, they want you to repeat the script. They want you to, you know, engage with them and they can get into highly problematic behavior at school, at home, the community. So it's all well and good for everybody to go like, oh, there's hidden meetings in there, but like where is their language? Where's their ability to request their wants and needs? Where is their independence? Where is their problem behavior level? Because if we're not moving and teaching in that direction, it's not really it is, like you said, like a waste of time. Yeah. So I think that is a good description. I mean, it is still a little out there. You know, it's only been a couple of years. Is there any research on this? Gestalt language processing that you know of?
Is there Evidence behind Gestalt Language Processing?
Sari: Yeah, no. I looked far and wide in preparation for this because Dr. Marge Blanc, she gives her presentations, talks about, yeah, people say there's no evidence, but there is, there is. So I looked at what she said there is. And it's what I had talked about before. Dr. Anne Peters. What she had written was an explanation or a description of these utterances. And same thing with Dr. Prizant. He gives a couple of examples in his article and he summarizes what Dr. and Peter Styles and a couple of other researchers. But again, it's not evidence that this indicates any sort of language and it's really not even a proper qualitative study. It's just anecdotes. And, you know, in terms of the intervention side of this, so does this approach as a package work? There's no empirical evidence. There's case studies, like Dr. Marge Blanc has done a lot of work in writing up her case studies but no empirical evidence.
Mary: Yeah. And I have found over the years, you know, kids just do better when there is systematic programming. I use my assessments as well as then after that the VB MAPP assessment to really look at. Raising all the, quote unquote, good behaviors we want and bringing down the barriers and raising self-care and transitions. And yeah, it's hard work.
Sari: I was going to say that it's, you know, painstaking bit by bit, block by block, but you're going to get there. I wish... I think people are looking for like, no, isn't that like a faster, more fun way to get there? And what we do, I think is fun, but like for adults, isn't there a more fun way to get there? I don't think so. I think we have to do it in a scientific way that works.
Mary: Yeah. Yeah. So you are in private practice in Ontario, Canada, you have a website ActionPotentialServices.CA you mostly do in-person kind of work and consultation so people can check out your website and contact you for information about that. I really appreciate your time. Before I let you go, part of my podcast goals are not to just help the kids, but help the parents and professionals listening have happier lives with less stress. So do you have any stress reduction tips or self-care strategies that you use to make your life happier?
Sari: That's a tough one and so important, especially for the families. I guess what I do that helps me the most is I have a group of friends and colleagues that I can vent to and get feedback from and that helps me to kind of keep things in check when I'm getting really stressed.
Mary: Yeah, yeah. I'm a talker, too, with my friends, so I appreciate that. All right. Well, thanks so much. Again, I learn some new things and I'm going to link that webinar on the show notes for you to do your own research and, you know, just keep plugging along. We know how to help kids with autism and toddlers showing signs. And let's use these scripts and echolalia to give us clues on how to better teach and motivate our kids. And I think that that's the answer.
Sari: Yeah, exactly. That's the best message. Yes. Thanks so much for having me.
Mary: If you're a parent or an autism professional and enjoy listening to this podcast, you have to come check out my online course and community where we take all of this material and we apply it. You'll learn life changing strategies to get your child or clients to reach their fullest potential. Join me for a free online workshop at MaryBarbaera.com/workshop where you can learn how to avoid common mistakes. You can see videos of me working with kids with and without autism, and you can learn more about joining my online course and community at a very special discount. Once again, go to MaryBarbera.com/workshop for all the details. I hope to see you there.
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