April 24, 2023
The first step toward supporting our clients who use Gestalt Language Processing (GLP) is, as always, identification and assessment. Use of echolalia, either immediate or delayed, is a key indicator of the presence of GLP. Identifying which stage of Gestalt Language Processing the individual predominantly uses to communicate is the most common method of both progress monitoring as well as identification of therapeutic targets. Dynamic assessment and particularly the use of language sample analysis are key components in this evaluation process.
Natural language acquisition on the Autism Spectrum: The journey from echolalia to self-generated language by Marge Blanc outlines clear steps of this evaluation process, and the bulk of the information in this post is taken from the assessment portion of this book (2012). Blanc recommends beginning with a typical case history form but adding a particular emphasis on language exposure and linguistic preferences. This will help you identify gestalts as they’re used throughout your language sample collection. It’s important to identify favorite forms of media (TV shows, YouTube videos, movies, songs, etc.). If possible, collecting a sample of language used in the home prior to the face-to-face clinical evaluation is ideal.
Once you’ve collected as much background information as possible, it’s time for the clinical evaluation. The most important step of this portion of the assessment is collecting a robust language sample – at least 50 utterances if possible. If you’re reading this – you’re likely already an SLP or on your way to becoming one, which means you already know how to elicit and collect a language sample. The overall rules remain the same: avoid modeled language, foster natural communication opportunities, engage in child-led activities/play, and write it all down (or record audio/video if available). This transcription component will be important in identifying which stage your client predominantly communicates in.
GLP is broken down into 6 stages, which we will briefly discuss below:
Stage 1: Echolalia
• Use of individual gestalts learned from either consumed media or individuals within the community (family members, caregivers, therapists, etc.)
• These gestalts are fixed, and their exact production (often including fixed intonational variations) will not change from instance to instance
EX: “Let it go!” “Give me more cookies!”
Stage 2: Mitigated gestalts
• This phrase is hallmarked by the combination of gestalts which are already established within the individual communicative repertoire
EX: “Let me go,” or “Go give more cookies.”
Stage 3: Single word use
• This phase, which is particularly exciting from a language development standpoint, occurs when the individual begins recognizing words as their own linguistic units as opposed to fixed utterances. This is the first stepping stone toward truly spontaneous and independent communication. EX: “Go,” “More,” etc.
Stages 4, 5 and 6: Emerging syntax and increased sentence complexity
• Hallmarks of these stages include inappropriate syntax use progressing toward complex and appropriate grammar and increased sentence complexity
EX: “Let’s give me more cookies,” —> “Go get the toy,” —> “Please give me the toy.”
Once you have your language sample, follow the scoring rubric located in Blanc’s book. If one stage makes up approximately 80% of the utterances collected, it’s likely that the client is operating at that developmental stage. Supporting a client who is a gestalt communicator means that this language sample and analysis should occur every 3-4 months to monitor progress and identify areas of support.
Have questions about scoring? Comment below!
Read more from this series:
References & For Further Reading
American Speech-Language-Hearing Association. (n.d.). Echolalia and its role in Gestalt language acquisition. American Speech-Language-Hearing Association. Retrieved March 7, 2023, from https://www.asha.org/practice-portal/clinical-topics/autism/echolalia-and-its-role-in-gestalt language-acquisition/
Blanc, M., & Lyon, J. G. (2012). Natural language acquisition on the Autism Spectrum: The journey from echolalia to self-generated language. Communication Development Center.
Stiegler, L. N. (2015). Examining the echolalia literature: Where do speech-language pathologists stand? American Journal of Speech-Language Pathology, 24(4), 750–762.
Zachos, A. (2022, November 16). The Stages of Gestalt Language Development. Meaningful Speech - Echolalia Education - Gestalt Language Processing. Retrieved March 27, 2023, from https://www.meaningfulspeech.com/blog/Stages-of-GLP
About the Author
Marisa Julius is a speech-language pathologist that has worked in both public and private school settings with a focus in pediatric augmentative and alternative communication therapy. She currently works for a private specialized school setting with children 5-21 with complex communication needs and a variety of disorders including Autism Spectrum Disorder, Down Syndrome, Childhood Apraxia of Speech, Language Delays, Reactive Attachment Disorder, and more. She is a Missouri native and earned two Bachelor’s degrees from Truman State University in Communication Disorders and German Studies. She received her M.A. in Communication Sciences and Disorders from Saint Louis University. She considers herself a lifelong learner, and is thrilled to be writing for SLP Toolkit, if only for an additional excuse to read more. In her free time, you can find her cooking, reading, hiking, or showing everyone unsolicited pictures of her dog.