I had the honor of interviewing Jenna Jablonski(JJ), certified Gestalt Language Processing (GLP) therapist and lead speech therapist for Blossom.
MM. How long have you been a speech language pathologist?
JJ: I’ve been a speech therapist for five years.
MM. How did you come across Gestalt Language Processing?
JJ. When I worked as a pediatric therapist in the outpatient setting in Georgia, I always worked with kids with autism. One of my coworkers at the time completed the Meaningful Speech course through her continuing education, and introduced it to our coworkers at the clinic. We were all learning about it and working with a variety of kids on our own caseloads and seeing the children on my coworkers’ caseloads. We were such a neuroaffirming clinic and child-led, we all learned together. I saw progress so quickly with all my clients.
MM: So what is Gestalt Language Processing?
JJ: Gestalt Language Processing is a form of language processing where the child or individual processes language in chunks. A lot of times these individuals get their language from scripts, something they’ve heard from other kids. More often though, these scripts come from media: music, videos, anything that has a tune or cartoonish sound to it. A lot of our Gestalt Language Processors are able to pick up language from the intonation. When language has more of an intonation, it sticks with them a lot easier [than more monotone or “flat” language models]. A lot of Gestalt Language Processors also have episodic memory. These kids hear something once and can repeat it back immediately. Another instance is using familiar scripts when they are exposed to it a lot (such as “Twinkle Twinkle Little Star” or Ms. Rachel). They use these “scripts” and practice using it in day-to-day conversation. These are children who may be described as “echoing” all the time or “little parrots” repeating things back.
For example, right now I’m working with a child who uses “goodbye, thank you, see you later” to protest. I started looking at when she uses it (when she’s frustrated) and trying to find out where she got the “script” from. After looking at her daily routines, her mother and I discovered that mom says when she has to leave for work. It truly is playing detective. Finding the reason why someone is using a phrase that might not make sense at first glance. Every script or “chunk” has a meaning to them. Once we find the meaning, we are able to then shape the language to be functional. That’s the best way I can think of describing GLP.
MM: Does “success” look different for GLPs compared to analytic language learners? What types of goals do you set as the speech therapist on the team?
JJ: Yes, success looks different for every kiddo. GLPs basically have two extra steps [compared with analytic language learners] in how they’re learning language. There are four main levels of Gestalt language development (starting at these long, intonation rich sentences, then breaking them down into puzzle pieces to connect with other “pieces”, then single words to build back up into two-word phrases and then short sentences). It can look like they are not progressing since they are using fewer words, but it’s so important to learn that each word is a unit of meaning. And every kid is different so progress looks different in each individual case. Sometimes the echolalia isn’t a word but just the intonation of an interesting word or phrase. Overall, let’s celebrate the little wins! Every kid, no matter what type of language processor, is different. The timeline for progress can depend on some prelinguistic language skills such as imitation, initiation of play ideas and communication with others, shared attention, and spontaneous communication. Celebrating the little wins is so important.
MM: How do your speech sessions change for a GLP compared to an analytic language learner? Can you describe your approach to therapy?
JJ: It depends on a few things: what stage of GLP they’re in and how old they are. Generally, I take time to build rapport with the child, find their interests, and sometimes (most times, really!) that includes gathering information. What music do they like? What specific media do they like? What are their sensory needs? If parents and families aren’t sure, I take time to educate them on basic sensory information and refer to occupational therapy (OT) whenever possible. Other things I like to ask caregivers include finding the child’s interests. It is very important to take language samples and see “what does this child say spontaneously?”. Some of the questions I will ask myself include: “Is the child imitating me?” “Are they using echolalia?” If they’re not, how are they communicating with me? That will give me baseline information. I’m usually able to get all this information in the first month of therapy, which will help me find what stage in the process they are, and go from there.
MM: So the stages of GLP are not necessarily related to age but rather what “step” in the language learner process.
JJ: Exactly.
MM: How do you incorporate phrases into daily routines?
JJ: I start by going through daily routines with the parents. I always ask families, “What do you want your child to express? What do you want them to communicate?” Even if it’s basic, “I want more” or “all done”. By going through their daily routines, I’m able to identify and create Gestalts that would best suit their needs.
Generally, it does look the same. Every kid is going to eat. Every kid is going to take a bath. Every kid is going to get dressed. It doesn’t have to be so specific. I try to give them as many choices as one can throughout the day. Even if it’s just choosing what shirt the kiddo is going to wear. Since we typically don’t model questions directly (GLPs in earlier stages are still processing questions as whole units and therefore would be more likely to repeat instead of answer questions), I’ll narrate two sentences. “Let’s wear red” and then with a small pause…. “Let’s wear blue”. This is great for giving kids autonomy in their day, empowering them to take a part in their daily routines. You can practice any concepts or vocabulary with this idea. Even if the child doesn’t say anything, if they lean toward one, if they look at one, I say “Let’s wear blue” or “Let’s pick blue” to label the words that they could say to make that choice. And I’d recommend doing it throughout the routine. If you give your child a choice with every clothing item (shirt, pants, socks, shoes), you are giving your child multiple repetitions and opportunities to practice in their routines, in their natural environment, and promote them using communication spontaneously. Mealtime or snacktime can be some of the most meaningful opportunities to participate. I just like to think, “where can I add choices in our day”. It makes it so much easier.
MM: Love the way that you said that. You don’t have to sit on the floor necessarily and play to actively target these skills. Even if they’re not Gestalt Language Processors?
JJ: Even if they’re not GLPs. All kids can benefit from these supports!
MM: When you meet a family for the first time, what types of questions do you ask? I know we talked about getting the language sample as one of the first steps.
JJ: Even when I’m not sure what type of language processor the child is, I spend time talking with parents. I talk to them about how there are two different types of language processing. I educate parents on how I’m going to take observations and be an active listener and participant in sessions, but it might look different than they expect. It’s not always clear or quick and I typically don’t give really specific feedback until I’m completely confident where the child is at, what stage of GLP the child is at. Then I can give more specific feedback on how caregivers should model language for their child.
There’s a questionnaire from Meaningful Speech that talks about interests, media, sensory preferences and avoidances, which can help get more information on sensory preferences (especially since GLP and sensory differences go hand in hand). I’ll get that information from families and also tell them why that information is important to language development. I almost always ask questions such as “Let’s pay attention to when she’s happy. What is she saying?” or “When she doesn’t like something, how does she tell us?”. Getting to know the family and the child’s likes, dislikes, and sensory needs makes it easier to tease out language (and what the child might be saying) and make more progress by getting more into their interests.
MM: I’ve heard some other therapists use terms like “echolalia”, “scripting”, and “vocal stimming” to describe Gestalts. Is there a difference between these terms?
JJ: So there is a difference between these terms. Echolalia is more of that immediate repetition after hearing a model. These repetitions can also be used later in other activities (called “delayed echolalia”). This is repeating the phrase in its entirety minutes, hours, or even days after initially hearing it.
Scripting is the process in which kids are getting from media or parent modelings. I hear this quite a bit from GLPs. For example, when using the shape sorter and they see a “star”, they start singing “Twinkle Twinkle”. So every time they see a star, they sing “Twinkle Twinkle”. It doesn’t have to be a song, but they are “scripting” what has been said to them.
MM: Echolalia is more of that immediate imitation, and scripting is more about the context.
JJ: That’s right. Vocal stimming can be intonation-based, it can be the tune of a song. It can be a sound that they like, such as “BOOM!” from a video, which can be a script as well as vocal stim. They can also be consonant-vowel combinations. The difference is the purpose of this communication- some people say that it can physically be comforting or soothing to the throat or the mouth. There can be relaxing stims to self-soothe or comfort and there can be alerting stims, sharing excitement or heightening emotions.
MM: There have been times when the research and goals were to extinguish or minimize echolalia in place of generated speech. And while I have a feeling what you’re going to say….
JJ: All forms of communication are communication. Our goal with GLPs is to make communication functional for their daily needs. We need to use these scripts and echolalia to help support our kids. If this is of interest to them, if this is how their brain is working, we need to mix and match what their scripts are. It is our job to build on them!
We never want to stop GLPs from being echolalic or imitative, but from a SLP perspective, we have to imitate before we know how to do something. It’s great if someone is echolalic, let’s use that to our advantage. Let’s model phrases such as “Give me an apple” or “Give me crackers”. Let’s see what happens. If the children say it back, we can reinforce it by giving them their snack. If they’re scripting “Twinkle Twinkle” and we want to isolate that word, we can add a phrase like “It’s a + vocabulary word” , saying things such as “It’s a star!” while they’re singing. Use the vocabulary they’re showing us they know and make it functional.
MM: How do you stay updated on the research and best practice?
JJ: The Meaningful Speech team sends emails for parents and therapists. I follow a lot of GLP and neuro-affirming instagram accounts. I know it’s not necessarily research, but it is parent and therapist accounts on different therapy approaches, gives me ideas and how to support my data and my kiddos. Meaningful Speech is, above all else, the best. There are other resources that they share or they tag which helps me continue to learn and reflect.
MM: For our non-speaking or minimally speaking kiddos, do you lean more into the GLP approach?
JJ: I do. If they’re close to two years old or older- if they have no words at that time, I’m 80-90% confident they are GLP. I’ll try using music or sensory activities to help calm their body, help their attention and engagement. I’ll verbally model for the first few sessions but I tend to introduce augmentative and alternative communication (AAC) early. The voices on these devices can sound cartoonish (and remember our GLPs are interested in musical and intonation-rich sounds) and the added visuals can help build communication and vocabulary.
I’m always going to pick a framework that supports Gestalt Language Processing. If you model GLP, analytic language learners can still pick up those single words. If you model analytic language learning, GLPs might get “stuck” in single words that don’t fit their learning style.
– Closing Remarks –
MM. What’s one thing you wish other therapists and providers knew about GLP?
JJ: I’ve heard providers say “I think I’ve heard of that!”. I wish providers had a more general sense of how to incorporate it into their therapies. Most therapists and other disciplines know how to model language for analytic language learners- which is what we were all taught. I think it’s hard to pick one! I think it’s two-fold. I wish therapists and providers knew how to more easily identify if the child is GLP. From that, how to implement those language strategies during their sessions. For any child we’re working with, building generalization of skills (so they’re not just talking for us speech therapists!) and modeling those strategies can help with carryover and therefore faster progress.
MM: What’s one thing you wish parents knew about GLP? If your kid isn’t talking yet or your kid is quoting their favorite movie…
JJ: I would say, no matter what, get an evaluation. If you find yourself thinking, “My child is talking a lot!” or “They have a great vocabulary!”, but they can’t tell you what they want, that may be a sign your child is a Gestalt Language processor. My last takeaway question for parents to ask themselves is to think, “Is my child using language for a variety of purposes? Can they request, comment, label, greet (say hello, goodbye), and protest (such as saying “stop”, “no”, “I don’t like that”). Speech language pathologists can help build on these different functions of language to communicate more functionally. Because that’s the goal.