ASD and Gestalt Language: An Interview with Maya Saupe, M.S. CCC-SLP
By McKenzie Lee, M.S., CCC-SLP
Tell us about your background as a Speech-Language Pathologist. I graduated from Boston University with my master’s degree in Speech Pathology in 2020. My first clinical placement was at an early intervention center, where I did home visits with the Birth-3 population. I absolutely loved it. I’ve been with Kidspeak since graduating in 2020. Through Kidspeak, I support students with a variety of needs including articulation, receptive and expressive language, literacy, AAC and fluency. I love visiting students in the home setting and working with families directly to support their child’s language development.
How did you become passionate about language, especially with kids with echolalic language? What inspired you? During my first clinical placement, I noticed that many of my students who had the most difficulty communicating were able to sing entire songs, recite entire books, or act out whole scenes from their favorite movies. These are all forms of delayed echolalia or scripting. These students did not seem to develop language in the way that I learned about in graduate school, where children start with single words, then develop two word phrases, then end up with longer, more grammatical sentences. Some of my students had more songs and sentences than they had single words! I often felt like my students were getting stuck. I knew that my students had big vocabularies and ideas, but most of the phrases I was hearing in speech sessions were “I want” or “more.” I couldn’t figure out why my students were not imitating other word combinations or using other words that I knew that they knew.
I was once in a session where I heard a student use words for the first time ever when he was singing a song with his mother. I was so excited to hear words from him, but when I brought it up later to a coworker, they told me that even though it looked like progress, the songs were just memorized, so it wasn’t true language. In other words, it was echolalia, and did not have a meaning apart from the student liking the tune and associating it with his mother. I had a feeling that there was something more to it, and it wasn’t until a year after I graduated that I came across gestalt language processing.
Unlike traditional language development that starts with single words, gestalt language processors start bigger with songs and scripts. They then break the scripts down into smaller parts, and finally end up with basic word combinations and more flexible language. A lightbulb went on in my head, and suddenly I was understanding so much more about my students. As soon as I started using my students’ scripts in therapy and tried to figure out what the scripts meant to them, I noticed a huge change in my sessions. My students were more engaged, they were imitating me more, and they began to rely less on prompting to use their words. My most difficult sessions became some of my best sessions, and I have been passionate about working with students with echolalia (gestalt language processors) ever since.
What is your favorite activity to target language with Gestalt processing and echolalic language? My favorite activity to target language is child-directed play! Allowing students to lead gives me an opportunity to hear their spontaneous language and figure out where their scripts are coming from. Once I know where the script is from, I have a better idea of what it means to them and how I can help them more clearly communicate their thoughts.
I’ve had students set up stampedes of animals just like in The Lion King and throw birthday parties just like the one in their favorite TV show. I’ve seen students act out scenes and remember entire scripts that they haven’t heard for months. It is so fun to get a look into their imagination and discover the experiences that had a big impact on them through their scripts. Many students acquire new scripts during moments of joy or excitement, and I love sharing those moments with my students.
Can you share a fun memory you have while targeting language with one or some of your clients? I once had a student who loved a video he had seen educating children about emergency shelters and what to do if an earthquake happens. I had never seen the video and could never have guessed that my student would be interested in emergency shelters. During one session, he started repeating a script, then going and hiding under a blanket. Often scripts are unintelligible at first since they are so long, so it can be difficult to hear the words being said. I thought he might be tired and telling me that he wasn’t ready for speech yet that day. When his mom came in the room, I asked her if she knew what he was saying, and she knew just what it was. He was saying something like “It’s an earthquake! Go to the emergency shelter!” in his best announcer voice. As soon as I knew what it was, I started shaking things around the room and directing him to new places to hide. He had so much fun, and for his next few sessions we started with a video of some new kind of natural disaster like a volcano erupting or a tsunami. By the end of it, he could name all the natural disasters and tell me which one he wanted to look at next.
What is one piece of advice that you would give to parents whose children use echolalic language? One piece of advice I would give to parents is not to worry too much right away about your child using pronouns correctly or answering questions. Children who communicate using echolalia often repeat exactly what they hear. For example, a child with echolalia might say, “Are you okay? Do you need help?” every time they get hurt, or they might say hello to themselves every time you walk in the door because that’s what they hear you say! To help them with this, you can model for them exactly what you want them to say in those situations, even if it feels silly at first. For example, when your child falls down, you could say, “Ouch, that hurts!” or “I want momma!” Soon enough, they may start saying that, too!
Anything else you want to share about kids who are Gestalt language users? There is no “meaningless” echolalia or scripting! Even if a script sounds like gibberish or you have no idea where it’s coming from, it is still a form of communication that is meaningful to your child. A little detective work can make a huge difference, and there’s no feeling like seeing a child smile and light up when someone acknowledges one of their scripts and finally “gets it.”