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Integrating Gestalts into AAC Systems: Trips to Try Out

Gestalt language processing (GLP), natural language acquisition (NLA), echolalia, scripting - many SLPs are re-thinking how they are helping kids develop language. For a long time, we focused on an analytical processing style which started with one word, then grew one word at a time (e.g., 1. mama 2. mama go, where mama? 3. where mama go?). Then Marge Blanc and Meaningful Speech began to highlight another way to learn language - in big chunks first, then dissecting those chunks into words (e.g. 1. where did mama go? Let's get in the car! 2. Let's get in + the car! Where did + mama go? 3. Where did + block + go? Let's get in + mama + car). Despite mounting evidence to support many AAC users as gestalt language processors (GLP's), we are working with AAC programs that are based on analytical language learning. How do we adapt?

Wait a sec, I need you to start from the beginning

If you're new to the GLP, NLA world, you may find yourself needing a little background before you can even begin to wrap your head around where AAC fits in. You can get more info on the fundamentals of GLP and NLA here.

Note: The ideas expressed in this post can be implemented across any AAC language system, including light tech. This post is not endorsing a specific app or language organization.

GLP Stage 1 & 2 Ideas to Try

For Stage 1 and 2, the focus is on taking the known gestalts and decoding their meaning, as well as modeling new phrases that the learner can pick up and integrate as a brand new gestalt.

Let's explore an example from my own clinical work:

AJ (not his name, but what we'll call him here) had some great gestalts around advocating for his feelings: "Agent Van Cuckoo" and "skin skin skin". We started out by trying to determine the potential meaning behind AJ's gestalts. As is typical with gestalts, the exact words didn't seem to have anything to do with the feelings on the surface, but the family was able to identify where the scripts came from. "Agent Van Cuckoo" was from a Sesame Street skit where two groups are escalating a fight until the agent crash-lands into the scene, stopping the argument. "Skin skin skin" was a little more mysterious, but we hypothesized that he picked it up when he was suffering from severe eczema, so it likely had something to do with discomfort, or frustration.

AJ had some great personal gestalts for expression, but how could we help him organize this language and learn related gestalts so that less familiar folks could understand his needs? Here are some things we tried:

First, we put the gestalts alongside the analytical, pre-built vocabulary (within AJ's AAC system) in a place we thought was consistent with the meaning of the message. That way, we could help him navigate to feelings when he wanted to express himself on this topic, hopefully starting to help him connect and organize his gestalts with words pertaining to a related subject (also called semantic mapping).

Then, we tried a few different techniques to see which one would resonate with him:

  1. The "skin skin skin" folder had voice output when opened, so he could hear his typical script. Then, some preliminary gestalts appeared-for him to use, or for us to model (e.g. That’s so + frustrating, Gotta + get help, Gotta + stop it!).

  2. The second folder did not have the voice output for "Agent Van Cuckoo", but instead, directly opened to new gestalts (AJ can read well and so did not need symbols on these gestalts).

  3. We also tried to integrate some more interesting gestalts on this page. AJ is incredibly musically gifted and really took to the intonation of gestalts, using them quickly-so I put in some whole gestalts that had rich intonation in order to model some new ones. Several AAC programs now have inflected speech (e.g. Acapela expressions or vocal smileys), and most will let you record a voice (e.g. parent, sibling, even the GLP themselves!). Some will let you upload audio files so you could even use the original snippet from the script source (if it came from a video, song, etc.). Whatever will grab their attention, interest and result in increased gestalts to work with in Stage 3, is worth exploring.

We also tried one page just dedicated to existing gestalts- a mix of ones he was using with new ones, plus mitigated possibilities in line with these existing scripts. These were intended for him or his partners to try out. Remember, grammar is not super important at this stage. In this image, stems/gestalts are on the left column and mitigated “options” extend to the right.

My personal favorite page was filled with his more socially oriented gestalts. He loves the back and forth of scripting and is super motivated to engage with others to do it, so we made a whole page of gestalts and some new phrases for him to use to maintain and control the interaction. We are still in the testing phases of this, but it's fun to experiment and see what clicks for our GLPs. It's likely to be different for everyone, but the bottom line is that AAC can be great for GLPs, letting them repeatedly hear their language with controlled intonation, see and hear new gestalts, remind communication partners which gestalts are being targeted, and giving voice to those who are primarily speaking in unintelligible gestalts or not speaking at all.

I'll be honest - it does take more work (thinking, listening, planning and programming) to ready a device for a GLP. But as is always the case with communication, both partners need to share the work and the joy of the interaction. We know our GLPs are working hard to connect with us so we need to do the same.

Here are some other resources and ideas for how people are stepping up to support their GLP AAC users:

What are your ideas? Missteps? Successes? Join the conversation in the comments below-

let's do this together!

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