Something to Gestalt About

Having a child who cannot communicate effectively is challenging.

I knew this, in theory, when I was a speech pathologist working with families. I would listen to their frustrations around their child's language skills: It was so hard to know what their child wanted, it was so hard to understand them, it was so so hard to avoid the tantrums and meltdowns.

And then I had my own child.

Empathy and imagination could never have prepared me for the feelings I had around my son's communication. As someone educated on communication, I was always looking to see if my son would meet the next milestone. But then came the guilt and the shame and the burn-out as I spent so much of time as a stay-at-home mom trying to "fix" the problem.

I was confused and worried and so god-damn annoyed that nothing was working. Me -- a speech-language pathologist -- couldn't get my own child to talk.

And didn't we always say that the parent is the one who can make the most change for little ones? Speech therapists only see a child an hour or so a week. But a parent ... they see their child all the time.

So why wasn't anything working? (Hint: it has something to do with gestalts …)

Growing Up Bastian

Bastian was a COVID baby. At 8 months old, we went into quarantine, and Bastian began to have limited language opportunities beyond the home environment. We went to the park and walked outside, but his contexts were limited and so were his communication partners. It is impossible to know how much of his delay was due to Covid. I believe some of it was. But I also know he had a delay beyond just Covid.

Bastian rarely babbled as a baby. Sure, he hit the milestones -- he did babble sometimes. But not frequently. Not enough.

He would listen to music constantly, moving his body in time with the beat, bouncing his little tiny booty and swinging his arms around. His second word -- and first sign -- was music at 16 months. But while he was listening to music ...

He was silent. No babbling, no singing, no humming.

Bastian would play with toys occasionally: banging blocks, putting felt baskets on his head, reading books ...

And he was quiet. Maybe a cry or a laugh. But no babbling.

Looking back on it now, these were the signs of a delay. And they were likely NOT related to Covid. These were things that babies typically do even with limited contexts and limited communication partners.

Eventually, Bastian began to do more. He began to sing along to songs and use jargon while reading. (Note: jargon has the musical tone of real language while being made up of indecipherable sounds.) It took him longer to get there, but I began to see the signs that he was ready for more communication beyond a few single words and signs.

But still, nothing happened. No more words!

It wasn't until later –almost a year later – that I found out why.

Top Down Bottom Up

My son is a gestalt language learner.

Have you heard of gestalt language yet? In the speech language world, gestalt language is the new big thing. Except, it isn't new at all. It is a type of language acquisition that was discovered and researched in the 1970s but then got pushed to the side as the field moved in different directions. Now, SLPs are returning to this research with new research of their own -- because this way of learning language is essential for understanding autistic children and many other late talkers.

Language Acquisition

Most people think of language acquisition from the bottom-up -- sounds become words which are then used as building blocks to form phrases and later sentences. (This is called analytic language acquisition.)

However, there is another way to learn language that is top-down where a child learns language in chunks or bundles and, over time, they un-bundle these chunks, combining them into spontaneous, unique utterances. (This is called gestalt language acquisition).

BOTH analytic and gestalt language processing are part of natural language acquisition. They are valid, natural, and common ways of learning language!

But our communication milestones around word acquisition will NOT be accurate for a gestalt language learner. They don't learn language one word at a time, so it makes sense why these learners will look delayed.

IMPORTANT: Many health professionals are NOT aware of this development in the field unless they have been doing recent continuing education on the subject. Your pediatrician may not know about gestalt language processing, and even some SLPs are new to the subject. If your provider is not knowledgeable about this, send them some resources listed below to help spread the word!

Progression

Here is a comparison of how an analytic and gestalt processor may look as they build more complex language:

Echolalia

The hallmark of the gestalt language learner is echolalia, or scripting. Echolalia is when a child repeats a phrase from other people, music, books, tv shows, etc. This can happen immediately or hours, days, or even weeks after hearing the original script.

Echolalia has incorrectly become synonymous with Autism over the last twenty or so years, especially since many Autistic learners get "stuck" in their scripts, using echolalia as an older child or adult. New research shows that almost all Autistic individuals use echolalia and are gestalt language processors. (Cohn et al, 2022).

However, echolalia is a characteristic of gestalt language processing in general. Many gestalt language learners move through the stages of acquisition independently to produce spontaneous language.

NOTE: Being echolalic and using gestalts on its own is not indicative of Autism -- Autism is a neurotype that involves a constellation of differences in the areas of language, social communication, actions, and sensory profile.

What Did You Say?

The problem facing parents of gestalt language learners is that young children, especially children under 3, can be quite unintelligible. In fact, children are approximately 50% intelligible at age 2 and only 75% intelligible at age 3 with context.

So when an analytic language learner is learning new words, their parents have to understand 1-2 syllables: "mama", "baba" for baby, or "kaka" for cat. As they add language, they may have two-word phrases like "mama up" or "ma mik" for more milk.

But what do you do when your young 2-year-old child with fewer than 20 words uses a long chunk of language like "pizza-ee-meeta-see-ben"?

This chunk, one of the first gestalts I ever figured out from Bastian, means "Pizza and ice cream with Ciana and Ben". It came from a very memorable event where he went out with his aunt and uncle for a special dinner. And from that day on, he would say the full phrase "pizza-ee-meeta-see-ben" every time he was asking about his Aunt Ciana or Uncle Ben or every time we talked about pizza or ice cream.

Gestalts are long phrases of language used as a chunk of meaning. Often the context is not immediately obvious. The phrase may have been overheard from a movie or another person or a song, hours or days or even weeks beforehand. They are often phrases that have meaning to your child -- either something that was exciting or upsetting -- and your child uses that phrase to capture that same essence even if it is not literally the same meaning.

But long phrases like this are incredibly difficult to understand from a young child because their intelligibility is often low. Gestalt language learners may sound like they are jargoning -- using intonation but saying nonsense words.

Gestalt language learners are often quite musical, as well, and some of the first gestalts parents recognize are lyrics to songs that, while unintelligible, retain the melody of the song. Bastian could sing "Arabian nights" and "We don't talk about Bruno-no-no" before he could say "I see ducks" or "I want cereal".

This problem of intelligibility means that, once you know your child is a gestalt language learner, it takes some detective work to figure out what gestalts they are using and make sense of what they are trying to communicate.

But once you figure it out -- the joy of communicating with your child begins!

A Few Of My Favorite Things

We all use gestalts sometimes. Think about when you quote a movie line because it fits with the situation perfectly. Or when you say something exactly the way your mother said it growing up. You are probably using those phrases as a chunk of language rather than building it individually word by word.

Here are a few of my favorite gestalts from Bastian:

Bastian is around 3.5 now, and I still catch him learning language as a gestalt before quickly un-bundling it and using the words and parts as needed.

Check out the video below for an example recently. He quotes his Bedtime for Zoe book when he swallowed water and coughed, saying "Water and soap in my eye. I don't like that feeling". There was no soap in his eye, but he used that long script from the book to explain that he was uncomfortable and didn't like that feeling.

A few days later, he was saying "I don't like that feeling" without the first part of the gestalt. This is called mitigating a gestalt, or un-bundling.

I Need Help!

Now you may be thinking -- wait? Is my kid a gestalt language learner? Help!

Never fear -- we're going to help you out. Take a look at the bullet points below and see which one seems more like your child. Remember, gestalt learners may also have single words and analytic learners may have good intonation or some phrases early on! And lots of children are a mix of both.

Analytic Learner

"Word baby"

Moves from single words to short phrases to sentences
Word combinations are often telegraphic / agrammatical mama up, want cookie
Utterances are literal and context is often obvious
Easier to understand because shorter and less complex to articulate

Gestalt Learner

"Intonation baby"

Babbles and jargons with lots of rich intonation. Often musical.
Early language begins in longer chunks called "gestalts"
Often echolalic -- scripting from parents, songs, books, movies
Context may be metaphorical or not immediately clear
Hard to understand due to limited intelligibility at young ages

Let's Talk!

If you answered above that your child is a gestalt language learner, then here are some of our top tips for you!

Always acknowledge echolalia. If you know what they are saying, repeat it back to them or try to do some detective work to see what they are trying to script.
Model chunks of language rather than single words. For example, at mealtime, you can model "Let's eat some food" instead of "Eat. Eat food"
Help your child mitigate (unbundle) their gestalts by changing them slightly in new contexts. If your child says "Fly plane up in the sky!" when they see a plane, you can model using a similar phrase when you see a bird: Fly bird up in the sky!
Don't worry about grammar right off the bat. Just help your child grow their repertoire of gestalts!

And here are some additional recommendations:

If your child is learning language quickly and progressing from chunks of language to their own sentences independently -- you don't have to do anything special! Many gestalt language learners learn without any additional supports.
If your child is missing word milestones, that makes sense! Your child probably uses gestalts more than words so they won't align with those milestones. If your child is frustrated or getting stuck in their gestalts, they likely need additional support.Getting stuck looks like your child using the same gestalts without changing them, without using them in a new context, or without breaking them down into individual words over time.
If you are seeing a speech pathologist for therapy, talk to them about gestalt language acquisition and encourage them to include these principles in therapy.
Consider educating yourself as a parent on gestalt language acquisition and principles using the Meaningful Speech course designed for parents.

Resources

Meaningful Speech: https://www.meaningfulspeech.com/
Blanc, Marge. Natural Language Acquisition on the Autism Spectrum: The Journey from Echolalia to Self-Generated Language. 2012.
Prizant, B. M. (1983). Language Acquisition and Communicative Behavior in Autism. Journal of Speech and Hearing Disorders, 48(3), 296. doi:10.1044/jshd.4803.296

And follow these individuals on instagram for more information, especially for gestalt language learning in Autism:

@meaningfulspeech
@bohospeechie
@mrsspeechiep
@gemmajuneslp
@blancmarge