Gestalt Language Processing and DIR

Photo credit: Tara Winstead

This Week’s Podcast

This episode, Speech Therapist, Sabrina O’Keefe, DIR Expert & Training Leader, discusses Gestalt Language Processing within a Developmental, Individual differences, Relationship-based (DIR) framework, which listeners have been requesting for a long time!

What is Gestalt Language Processing?

Gestalt Language Processing is synonymous with the terms scripting or delayed echolalia. Sabrina says we’re learning more about it as we are privileged to hear the lived stories of autistic adults who are talking about how they developed and learned language. The term is not new, Sabrina continues, as it was talked about decades ago by Dr. Ann Peters, followed by Dr. Barry Prizant and then Marge Blanc. It’s a way of naming how someone acquires language, Sabrina explains. You can either be a Gestalt Language Processor (GLP) or an Analytic Language Processor.

Scripting is pretty self-explanatory. A child will use a script from an emotional meaningful experience, which can also be from movies or videos they’ve seen. As Dr. Barry Prizant says on his Uniquely Human podcast regularly, scripting cannot be dismissed as meaningless speech, which was kind of the norm still when my son was diagnosed over a decade ago. Scripting is meaningful communication.

Echolalia has two forms. The first is immediate echolalia where you say something, and the child says it back. Typically, Sabrina explains, when a child communicates like that, we tend to wonder about comprehension. A delayed echolalia occurs when a child pulls an echo of something they heard before into a current situation. It’s the unit of language that was important in that moment of life to represent that feeling, Sabrina says. That is a delayed script, a delayed echo, or a ‘gestalt’ that they pulled out to talk about what is happening here and now.

I wondered if there were different types of scripting, too. My son recites lines from the Super Mario movie playfully, repeating lines from the movie to connect, or to amuse himself. Other children, some who may be non speaking, will recite a movie script. If the parent attunes to that script, they will realize that it’s a line from something that happened that has the same emotional content to what’s happening in the current situation.

The ‘Gestalt’ 

Sabrina says that the idea is that you pick up these units of language, these ‘gestalts’, from your environment. The current language environment is media and media scripts, whereas in the 1970s you were typically drawing language from interactions with family, from peer play, or from observing the environment. Dr. Ann Peters would say that a ‘gestalt’ is a unit of language, Sabrina continues, which can be simply one word, or up to a 5-minute dialogue.

When a ‘gestalt’ is being used meaningfully, it’s usually a way to connect with another person, Sabrina says. We want that reaching out/engagement/connection, and we have to be good detectives to figure out where it is coming from, and what emotion is connected to that, she continues. But we do want to move those kids forward from using those long media scripts, or ‘gestalts’, because they’re tough to carry around and use as you grow, she explains. Why GLP is so exciting now is that parents and therapists are learning about how to be the best language providers for kids.

Marge Blanc’s Natural Language Acquisition (NLA) describes a way of moving a child from delayed echolalia, or the use of ‘gestalts’, to the use of spontaneous language, so we take that script and make it spontaneous, Sabrina explains.

Assessment of GLP

When Sabrina first gets a client, she puts on her DIR/Floortime glasses and waits, watches, wonders, and listens to see what Individual differences the child in front of her presents with, and one of those Individual differences is how that child is acquiring and using language. She also pays close attention to the child’s parents who might say things like their child likes nursery rhymes, that they love the intonation patterns of songs, or it sounds like they’re jabbering away to themselves. Sabrina calls GLPs ‘intonation babies’ who are drawn to the rhythmic nature of language. 

It sounds like they’re having a conversation with themself, but when you’re little, you don’t really have an understanding of language or word boundaries, so you try your best to copy what you hear, but you don’t necessarily get it all, she explains. These bits of history help Sabrina figure out what the child is responding to and what models light that child up. That bit of history guides her thoughts on figuring out if they’re a GLP, an analytic language processor, or a bit of both.

An analytic language processor is typical language development where a toddler will start referencing and will say, “Mommy” as they point, for instance, Sabrina explains. Then, as they grow, it will become, “Mommy… sock” and then as they grow again, it becomes, “Mommy… sock… me!” That sentence keeps growing, whereas the GLP won’t use single words in a referencing kind of way. They’ll tend to use intonation patterns, or longer ‘gestalts’ that can be socially completely functional. We use them all the time: “Hey! How’s it going?” or “How are you?” It’s a great chunk of language we can use, Sabrina explains. Sabrina says that she pays attention, plays, plays, and plays, and keeps listening, listening, and listening.

I asked Sabrina how we differentiate non speakers from early speakers and those who might become verbal later? She said that there is a big movement about providing GLPs with appropriate messaging on their devices such as phrases, rather than combining words to form a sentence. Instead, give them a larger amount of language which matches their learning profile. Sometimes we might try something for a long time and it’s not working, so we might try to go a different way. There’s always clues about how the child’s interacting at home, if they’re drawn to melody, etc. Maybe this is how my child is acquiring and processing language. It’s worth wondering about, Sabrina says.

The Stages of Language Development

When you have an analytic language processor starting with a single word, adding a word, then growing, this is Stage 3 in Natural Language Acquisition (NLA), Sabrina explains. The first stage of the GLP is the use of the ‘gestalts’. A client of Sabrina’s stage 1 ‘gestalt’ was, “Mama called the doctor and the doctor said“, which was his way to communicate that he wanted his Mom’s phone. The problem is that it’s pretty long, Sabrina explains. In Stage 1, we want to give children ‘mitigable gestalts‘, which means breaking them down into simpler ‘chunks’. If the ‘gestalt’ isn’t mitigable, it is really ‘Stage 0’ and we have to teach them a new one in Stage 1 that is mitigable, or break-down-able, Sabrina says.

Sabrina might say something like, “Let’s find it!” or “Let’s look!“, which is something that can be broken down so that in Stage 2, you can mix and match them. “Let’s find it!” becomes, “Let’s buy it!” or “Let’s play with it!” or “You find it!“. You get more flexible so that you can then get to Stage 3 where each word becomes meaningful and “let’s” can stand on it’s own, “find” can stand on it’s own, and “it’s” can stand on it’s own. Here, we start to see the similarity between the GLP and the NLA and can reference the “sock” in their environment, Sabrina explains.

Promoting Language Development

The tricky part is that we have GLPs who are amazing at saying things like, “I want” where rote language has been taught and memorized, Sabrina continues. They have a bevy of single words that they can’t do anything with. They can want something but it doesn’t break down to anything else, so they are stuck with their stuck language patterns. Here is where you have to go back to Stage 1 and 2 in the Natural Language Acquisition (NLA) to give them more vocabulary, so they can mix and match to then combine the single word with grammar to then become spontaneous in their language, Sabrina explains.

No two children are alike, but there are the general trends that Sabrina mentioned. There are children who chunk words together in a script, they ‘mark’ it with an emotional meaning, then match it to something in the present. We want to have them be more flexible with their language in order to help them communicate, Sabrina says–the goal of speech therapy.

Give them more vocabulary, or building blocks. Sabrina says it’s about increasing the flexibility and use of different types of language across environments, and with different people, to be understood. We always want to expand and grow so you can interact with more people in different environments, Sabrina continues. They can continue to use ‘gestalts’ as they get older, but as they move forward, they’ll start to look more like analytical language processors.

Determining Where the Child’s Language is At

There’s always going to be a mix of being both a GLP and an analytical language processor, Sabrina explains, just like if you are a Stage 2 in language development, you’re not 100% in Stage 2; you’ll be ‘primarily’ in one stage. When a client has enough ‘stuff’ in one stage, Sabrina will start to model the next stage for the client. It’s all about the partner and about the input that we’re giving with our language, she says. Also, there’s no demand for the child to repeat. It is just a matter of giving them the next type of language for their vocabulary brain to start to organize and use, so that when it’s appropriate, they can use it powerfully and spontaneously in environments that make sense, Sabrina shares.

This is not that dissimilar from DIR, where we’re not necessarily in one Functional Emotional Developmental Capacity (FEDC) or another–we’re jumping around–but, we are primarily in one as we continue to progress. When you’re older, you have the flexibility to go back and forth up and down the capacities. The onus is on us when they’re younger. We want to foster that foundation early on. We all script as adults, but we have the flexibility to use more typical language as well.

Sabrina says you have children who might be ‘stuck’ regurgitating memorized remote words or phrases that they may or may not have meaning for, along with the scripts they use. It might be harder for these children to progress versus when the child has adults around them who understand that the child scripts meaningfully when interacting and who can, accordingly, help the child build their vocabulary with ‘mitigable’ phrases so the child can communicate more as they get older.

Matching our input to the child

Sabrina says that in a DIR world, you want to provide the correct input to match the Individual differences of the child. Maybe you’ll be most regulated when you’re moving, or in a swing. It will vary for each child. We are always looking for the inputs that we can provide as a co-regulator to extend interactions, so similarly as a language user, we want to provide input that will extend the interaction as well, Sabrina explains.

If Sabrina is working with a child and they’re coming in with some ‘gestalts’, she wonders what will serve the client. She might take the girl who is scripting, “It’s raining!” to “I’m scared!” or “That’s loud!“. That’s language that the girl can then take to others to communicate, Sabrina explains. We’re looking for phrases that are fairly neutral and fairly flexible, she continues. Things that start with “We” or “Let’s” are great go-to words. “We did it!“, “Let’s go!” or “Let’s find it!” are great phrases as is language for transitions like, “How about…?“, “It’s time for…“

Sabrina says we can also talk as a child, using “I’m” in ways like, “I’m hungry” or “I’m tired“. Sabrina likes the word ‘another’ versus ‘more’ such as, “another one“, “another turn“, “another cupcake” which gives you a way to have more neutral, flexible language. “Another“, “it’s time to“, “it’s so fast“, or “it’s a car” are great types of contractions to use. You wouldn’t say “It is a car” because that’s worrying about grammar. That comes later. “It’s” and “That’s” is what we will model, Sabrina explains. “I’m gonna go!” and “Wanna play?” are other good phrases that GLPs can grab on to and use flexibly in their play and these phrases describe what the child’s longer ‘Gestalt‘ might be meaning.

Following the child’s interest

Sabrina says that it’s all about seeing what the child is interested in. Sabrina will wait, watch, and wonder, and use comments to see what the child is doing and support the interaction in this activity. It’s about attunement and providing good models in an activity or an interaction where the child’s engaged in reciprocal communication and in a position to be able to learn so you’re setting them up for success, and providing the right kind of language models that they can then mix and match later. The session looks like a big, fun play session, Sabrina says, but it’s very mindful. It has to match the child’s agenda so she can join and be welcome.

I shared that Sabrina’s sessions are indeed playful and enjoyable because she is my son’s SLP, and her and I presented at the ICDL NYC conference in 2021 showing a speech therapy session with my son from 2020, which was super playful. She makes it really fun for kids and my son always looks forward to his sessions with her!

Parent Questions

I couldn’t help but think of questions parents would ask Sabrina: How long am I going to be modelling phrases like, “Let’s do that!” before my child starts using them? I also wondered about parents who are worried about their child is using improper pronouns, since Sabrina said that grammar comes much later. Sabrina said that she is more worried when a child comes up to her and asks, “Do you want a snack?” when they really mean, “I’m hungry” because they’ve heard someone asking that question, and it’s followed by getting food. In this case, Sabrina will speak as the child, saying, “I’m so hungry!” which allows the child to navigate their way much better.

Two- and three-year-olds should not be asking questions in reverse order, Sabrina continues. They don’t speak like that. If children are mixing up their pronouns, don’t worry about that, she says. It’s a later stage. If kids are mixing up their “I“s and “You“s, it’s a sign that they’re not yet ready to figure that out yet. As for the question of how long a child will be at one stage, Sabrina says it takes as long as it takes. The goal is 50%. You can take language samples by taking down what the child says spontaneously, she explains. You then rate what stage each utterance is at. When you are spontaneously using 50% of a stage, that tells her that they’re ready to move on to the next stage, so she’ll change her language input. Sometimes a child is at a stage for a significant amount of time, and sometimes they’re through it in a few minutes. It really depends on the child.

More about GLP development

I asked Sabrina if neurotypical children are GLPs, too. She says that most autistics are GLPs, but GLPs don’t have to be autistic. There’s no harm in trying this type of approach if you’re working with an autistic child, she says. You can wonder if this is the way that they’re acquiring language. You might start using the mitigable phrases with the child, along with nursery rhymes, for instance. I also asked Sabrina what age categories she tends to see, or if there’s a developmental timeline for GLPs.

In Sabrina’s practice, what’s happening is that she’s getting a host of four- and five-year-olds who have been in ABA for a few years or other types of intervention until the parents get on Instagram and start to wonder if their child is learning and processing language in this way because when they were younger they were singing to themselves with sounds playfully. The longer you are using your current language system, Sabrina explains, it might take longer to change to something new, but it can also be very quick because finally someone is giving you something you can work with. It takes lots of observations. 

Parents usually know how their child is attuned to music, language, and tone. As children age, even teens or adults who are more analytic still rely on those ‘gestalts’, and can be living in the Stage 1 or 2 ‘gestalts’ as their primary way of using language. Once we get to grammar in Natural Language Acquisition, they do look at developmental norms, she says, but it’s less about age and more about readiness within the stage and going on a developmentally appropriate path.

Developmental Differences

It’s an important point that development, in general, tends to follow a process. It may be atypical, but follows similar patterns and has similar building blocks, but might look different. Sabrina says we know how grammar develops, typically. We know the grammar forms that come in developmental order. Same thing for play. If you’re not at FEDC 4, 5, or 6, we’re not going to play symbolically with what makes sense for that child, thinking and wondering and wanting to stay in play with us. We support them in their own path, giving them that ‘just right’ challenge. Sabrina says we have to always walk along side who you’re supporting, going at their pace, and find that edge where you can bring them something new and interesting.

Getting Parents on Board

There are still many parents who are stuck on their ideas of the way things ‘should’ be. I asked Sabrina if children of the parents who are ‘on board’ develop more quickly? Her simple answer was, “Yes“. One parent said to Sabrina, as their son was lying in her lap, “It’s all about the engagement and regulation, isn’t it?” Sabrina said yes. Unless we’re engaged and regulated, we don’t have the capacity to hear and listen to those language models, Sabrina says. Sabrina says it’s a real privilege to be a part of a family’s journey. After 22 years, she doesn’t take this for granted and feels very fortunate to be a part of this experience with families for years.

I asked Sabrina how she can get parents on board, and she said that she doesn’t pull out a norm chart! She talks about how excited she is to see them and how much she enjoys playing with their child. She will make a lot of comments about what the child is doing. You start to form relationships with humans, she says. It’s what’s shifted in her career. You need a balance because the Speech Therapist kind of has the upper hand in that relationship. Sabrina wants to even out that balance so you’re on the journey together and that the therapist is a safe person who loves that child so the parents feel more relaxed.

She lets parents know that it’s ok to feel what you feel and play with the same dinosaur for the whole time. Parents know when you meet another adult who gets your kid. It’s a weight off their shoulders, she shares. They don’t feel judged or like they’re being told what they should be doing. I shared that Mike Fields talked about that experience of being drawn to Floortime because they talked about his child’s strengths. When parents see how much fun their child is having and they’re excited to meet with Ms. Sabrina, it helps them relax.

DIR and NLA

Sabrina says that Marge Blanc speaks so much about how NLA and DIR are such good friends. As a speech therapist, Sabrina says that to have a social-emotional model match her language model, it’s so empowering. She encourages parents to get curious about their child’s language acquisition, and take good notes about what movies those scripts are coming from! Be great detectives. Sabrina loves DIR and she knew that it went together with GLP and NLA went together, but she wasn’t able to figure out how to conceptualize them together for a long time. 

She was trying to fit the language models into FEDC 3 and just couldn’t figure out where to put it within the DIR model, but once the light bulb went off and she realized that this is an Individual difference, she was able to then support the child in front of her, knowing that this is an Individual difference being presented. It wasn’t about jamming a square peg into a round hole. She can now speak with confidence and passion about GLP.

Thank you to Speech Therapist, Sabrina O’Keefe, for bringing us how DIR, Gestalt Language Processing (GLP), and Natural Language Acquisition (NLA) fit together and complement each other! We hope you found it very enlightening and will consider sharing this post on social media! 

Until next time, here’s to choosing play and experiencing joy everyday!