70. Understanding Gestalt Language Processing: Insights from Speech Therapist Katja Piscitelli (@bohospeechie)

Written By Brittyn Coleman, MS, RDN/LD

In this informative episode of the Nourishing Autism Podcast, Brittyn welcomes Katja Piscitelli, a pediatric speech-language pathologist, to discuss Gestalt Language Processing (GLP). Katja explains how GLP differs from traditional language development and provides insight into the stages of GLP. She also shares practical tips on how parents can support their children who are Gestalt language processors.

Their conversation covers the importance of rich intonation in language models, the role of AAC devices in supporting GLP, and valuable resources for parents seeking further assistance. Listen in to learn about new ways to engage and understand your child's unique communication needs!

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TRANSCRIPT

Hi, I'm Brittyn, a Registered Dietitian and autism sibling. I have a passion for helping parents of neurodivergent kids navigate nutrition and wellness for their child, one small step at a time. Here we'll explore practical nutrition tips, learn from top autism experts, break down the newest research, and share inspirational stories that will empower you to utilize nutrition to help your child feel their best and thrive.

Listen in while picking kids up from school, sitting in a therapy waiting room, taking a quick walk or wherever you find yourself, looking for some inspiration and a friend to guide you along this journey. This is Nourishing Autism.

Hey everyone, welcome back to the Nourishing Autism Podcast. I hope you're having a good back to school season or if you're about to go back to school, I hope that it goes as smoothly as possible. If you are navigating some of the selective eating that goes along with the back to school season, with all of the change and routine differences, Be sure to check out the episode that I recorded a few episodes back.

I think it would really help you during this transitional time. But as for today's episode, we are going to be talking about Gestalt language processing, which you probably have heard of. And if you haven't yet, I can't wait to introduce this to you because it is a topic that can absolutely change your life.

Now, Gestalt language processing, I'm going to let our guest expert really explain it, but I want to give you a little bit of a sneak peek. If you have a child who communicates in phrases, or maybe they repeat [00:03:00] phrases often, whether that's a phrase from their favorite show, or from a phrase that you use often in just your daily life. Whether or not you realize they're communicating that way, or maybe they're just scripting or using echolalia, so repeating back that term, this is a really important episode for you to be listening in on because it can help you understand your child may actually be trying to communicate with you through these different phrases.

And there are three different stages to Gestalt Language Processing, or GLP, and it can really help you understand how to take this information and to help their language develop even further. Now our guest expert today, her name is Katja Piscitelli, and she is a speech language pathologist.

You may know her online as bohospeechie. She's a private practice owner. She specializes in Gestalt language processing and AAC. She prides herself on providing child centered neurodiversity affirming care and continuously [00:04:00] learning from the autistic community. She is a fantastic resource.

I can't wait for you to listen in on how she supports her clients that are GLPs and what you should be looking for as well.

Hey everyone, welcome back to the Nourishing Autism Podcast. I am super excited for today's episode because so many of you have been asking for more information on Gestalt Language Processing and I'm so excited to have someone who you probably know who

she is, she's bohospeechie on Instagram, Katja Piscitelli. I'm so excited to have you here. Thanks for being here.

Katja: Thanks for having me. I'm excited as well.

Brittyn: Yeah, well, so, how I always like to start off these episodes, tell us who you are, what you do, and who you support.

Katja: I'm Katja, I am a pediatric speech therapist and private practice owner here in Sacramento, California, and I support mainly autistic children with speech and language development,

specialties being [00:05:00] Gestalt language processing and AAC, which kind of go hand in hand with autism.

Brittyn: Yes. Yeah, that's amazing. And we were just talking right before we got on this podcast. I was asking you if you felt like there's been a big push and knowledge around this. Would you say that that's true?

Do you think there's been a big boom in GLP?

Katja: Yeah, and it's really just thanks to social media because the information and research on this topic is not new in itself, but it's been regenerated in the past

four years, thanks to social media starting with the meaningful speech account, which you may follow if you're in the Gestalt language world.

Alex, she really opened up the social media world to the idea of Gestalt language. And I was lucky enough to find her page pretty much right away when she started posting. And it was such a light bulb moment for me as it is [00:06:00] for so many parents. And I just wanted to dive in and learn everything I could about it.

And yeah, from there, I've seen my clients go from having no Gestalt language knowledge to now being sought out from parents all over that know about Gestalt language and want providers who specialize in it and it's, yeah, it's been such a huge shift.

Brittyn: It's so cool and I was just telling you, also, I'd never even heard that terminology and it was one of my clients that told me in 2021, yes, I need to go follow Meaningful Speech and Boho Speechie.

And she was like, this has just completely opened my eyes to the way that Henry communicates. And it just totally changed her life and being able to understand him. Because she was saying these random, random, phrases. And she was like, I don't know why he says these things. And finally, she was like, now that I view it as language, he's telling me in all of this situation, she was like, I was just not speaking his language.

So it was [00:07:00] really, really cool for her to have the aha moment. I know so many people have that as well. But before we dive in, tell us more about what it is and how to detect if someone is a Gestalt language processor.

Katja: Yeah. So if you're not familiar with Gestalt language processing at all, you've probably heard of echolalia, most of us know of echolalia to some degree, especially if you are a parent of an autistic child, your child probably

uses echolalia, but many of us don't know that kids who use delayed echolalia to communicate primarily scripting,

delayed echolalia, they are probably a Gestalt language processor.

So there's two ways to process language, Gestalt and analytic, and I could go into comparing the two, but basically analytic is what most of us see as typical language development. Kids learn single words and then start to combine them into two word combos, three word combos, and so on, until they can produce [00:08:00] self generated grammar.

But Gestalt processors don't do that. They start with these chunks, or scripts, or Gestalts, and these chunks of language eventually get broken down into their single word components, and then these kids can self generate grammar. But yeah, if your child uses delayed echolalia or scripts to communicate, or that was how they primarily communicated at one point, they are probably a Gestalt language processor.

And there's other signs you can look out for, scripting or using delayed echolalia is the biggest one, but you can, look for challenges with answering questions.

If your child is stuck on single words, so they have a lot of single word labels, but they're not able to put them together to create two, three, four word combos and so on, they're just kind of sticking at that single word level.

That can be a sign because these Gestalt processors don't see those [00:09:00] single words as building blocks for language at the early stages of their development. So that's a big one that I see. If your child's non speaking, if they have had limited success with typical speech therapy methods or with accessing their AAC device,

it might be because it was more tailored for analytic processing. So that can be a sign that they might be processing language differently. There's quite a few things to look out for, but you know, that's scripting or echolalia being the biggest one.

Brittyn: Yeah, I've learned so much from your account and now I'm trying to look back also on my brother's development when he was younger because he was

scripting a lot and now I'm like, I wish I could just go back and watch a video and kind of see him do it now knowing what I know now.

Because I'm sure that that was a part of it as well and we just didn't know. So it's just interesting to kind of think back on what he might have been experiencing without us [00:10:00] realizing. How common is this for autistic kids?

Katja: Yeah and that brings up the point as well that many kids are Gestalt processors, autistic or not, and many don't need support.

And some may go undetected as learning any differently because they move through from echolalia to the self generated grammar, which is kind of the final step, really

quickly, maybe in their toddler years before we're really even worried about their language development. So a lot of these kids don't need support, but typically the kids

who do need support are autistic kids who often will get kind of stuck in that echolalia stage and as far as how many, the research on it is pretty outdated.

So we need more updated research, but I would say most. I have yet to work with an autistic child who is not and of course, you know, these families are coming to me

because there's a concern, so maybe [00:11:00] there are autistic kids who are learning in an analytic way and not needing support, but every autistic

child that I've supported is a Gestalt processor.

It is super, super common for these kids.

Brittyn: Yeah, definitely. I would think that now that there's been such a huge boom around awareness, I would hope that the research would also follow, so hopefully we see that in the next few years.

Katja: Yep, it definitely is.

Brittyn: Well, so I've learned that there are different stages, and this is something that is newer to me as well, so I was hoping that you could explain to us what the stages are and what that means.

Katja: Yeah. So every child, no matter how you're learning language, there's stages to that development that go from early, early language to more complex grammar. But with Gestalt processors, it looks different than what most of us have been taught is language development. So yeah, there's four main stages for these kids and we call them the natural [00:12:00] language

acquisition stages, which was a term coined by Marge Blanc, a speech therapist who's done a lot of research in this area, but she basically saw that

all these autistic children were moving through language development in the same sort of pattern.

So she just put a name to those patterns. But there's four main stages to it. The first one being echolalia or scripting or Gestalts. We can kind of use those interchangeably, but the most correct term being Gestalts, but they're using these chunks of language to communicate. It might be movie lines, it might be phrases that they've heard from someone else, but they're using these chunks of language.

And then in stage two, they start to become a bit more flexible with those chunks. So they might interchange different words. For example, if they have a song that has served as a piece of delayed echolalia, they might change out the animal name to be relevant to the animal that they're [00:13:00] playing with.

The wheels on the bus might become the wheels on the truck if they're playing with a truck instead. Let's go outside might become let's go home. So they start to mix and match these original chunks of language and it's not totally their own grammar, but it's a lot more flexible and on topic than before.

And then they start to pull out single words in stage three. And this is the first time that these Gestalt kids are seeing single words as building blocks for language, like other kids do right away. So these kids kind of have to go through two extra stages of language development before they're seeing these single words as building blocks.

And then at this point, they're operating very similarly to any other child, sort of toddler age child where they're taking single words and experimenting with how to

combine them into two word phrases, three words, and then once they start adding verbs and [00:14:00] more and more complex grammar, they're moving into stage four.

And that's really the grammar stage. Our end goal is that they start self generating grammar and then it gets more and more complex and

eventually they're able to say whatever they want and communicate like any other child and adult have. You know, conversational turn taking and all of that.

So, yeah, it's a big journey from delayed echolalia to self generated language. And for some kids, it happens independently and really quickly and others need support for maybe many years, so.

Brittyn: I was going to say, I mean, it sounds like a very natural progression of going from stage one to stage four and not needing support.

So I could imagine that some kids will kind of progress through the stages on their own, but, as a speech therapist, how do you support them in going from each stage?

Katja: Yeah. So the support looks different in each stage, but, if they're in the early [00:15:00] language stage where they're really using a lot of scripts, there's I'd say four main

things that you can do, whether you're a speech therapist or just want to support your child at home.

The first being just to really affirm everything that you're hearing. So treating their echolalia and these scripts that they're using as meaningful, even if you're not sure what

they're communicating with them, treating them like they are meaningful language. Sometimes it is just stimming and it is just, I like to hear this thing, but oftentimes it's more communicative than you think.

And knowing that these Scripts or Gestalts often have a deeper meaning, so they might be saying something that at surface levels doesn't have a whole lot of deep meaning, but it might mean a whole lot more for the child. So just affirming what your child's hearing, and then the second step is giving them new Gestalts.

So in order to move them to stage two and then [00:16:00] eventually three and four, they need a big repertoire of Gestalts, or these, chunks of language. So you really just want to model new phrases for them and give it to them in their words. So if they imitate it, which they will since they use echolalia,

it'll make sense for them. So I use a lot of I and neutral we or let's sort of phrases. And I'm just kind of saying what I think my child would want to say in the moment and offering that to them. And if they pick it up and use it and store it in their repertoire, then you're giving them more tools to eventually be able to mix and match and break those down.

 So for example, if your child is getting ready to go outside, you might want to model: let's go outside. Where's my boots? I'm so excited! That kind of thing. So really just feeding them language and these kids are very attracted to language that is [00:17:00] rich in intonation and emotion. That's kind of why they're picking up on these chunks, because they're cued in more to the intonation and up and down rhythm of language than the individual words.

So, the more you can make your models really interesting and intonation rich and emotion filled, the more they're going to pick them up.

Brittyn: That makes a lot of sense. And I have noticed that oftentimes it does have a very particular intonation, especially if it's a script from a show that is one of their

phrases, I find that it is very particular in the way that they say it, and it makes a lot of sense that they're grouping that together, they're using, I mean, the intonation is a part of the communication that they're using.

But I hadn't ever thought of it exactly that way, but it makes a lot of sense. Yeah. Interesting. So, I heard you say also that you specialize in AAC. Now I'm

curious, I mean, would you program one of their Gestalts into their AAC device, would that be how they would utilize an AAC device? Like, [00:18:00] how do you accommodate it for them?

Katja: Yeah, if they are in stage one and two and using these chunks of language, then yes. I typically create a folder with some useful Gestalts, both, just things that we think they might pick up and use that are more general like let's open it. I need help. Let's do it again, time for bed, whatever, and then also maybe some of their favorites whether it's their favorite pieces of media, songs, things that they already do say or things that mom and dad say often that might resonate with them.

But yes, if these kids are really in stage one and two, they might use these single words on the device, but they're not going to start piecing them together to create grammar. And that's where we might see progress, slow down for these kids that are using AAC to communicate, but are a Gestalt processor.

So yes. Adding in phrases can really make a difference.

Brittyn: Well, [00:19:00] now I'm thinking too, would an AAC device just like as is, use for single words, would that be more geared toward an analytic thinker? That wouldn't be here because now I'm like putting all these pieces together and I haven't thought of it this way.

 Could that be a reason why some kids have a hard time adopting AAC in the beginning?

Katja: Absolutely.

Brittyn: Okay, interesting. That makes a lot of sense.

Katja: Yeah, but we don't want to change up the AAC device. You don't want to take those away because once these kids do get to stage 3 and 4, which is our goal, then they will start to piece those single words together.

So we can keep them there and we can model them, but giving them access to phrase level stuff as well and kind of seeing what they gravitate towards can be really helpful.

Brittyn: Yeah, that's great. So what advice would you have for parents who think that their child may be a Gestalt language processor and they're just uncovering this area about their child?

What would you say?

Katja: Yeah, it's exciting because, even two years ago, [00:20:00] I wouldn't have too many places to direct you, but now there's more and more info out there. There's quite a few really great courses for parents. There's a lot of free information. I would say if you're worried about your child's language development, try to find a speech therapist who specializes in it.

And you can look at the meaningful speech registry, and that has tons of therapists all over the world who have taken this meaningful speech course, which is designed to teach you how to support Gestalt language processors. So that's a good place to look, or just asking around for therapists who are familiar.

And then as far as getting more info. An amazing website, CommunicationDevelopmentCenter. com has tons of amazing handouts in lots of different languages. It has lists of detailed supports for each of [00:21:00] the natural language acquisition stages that I talked about. So a really, really great resource there.

Yeah and if you go to my Instagram page, BohoSpeechieResources, I have free parent courses linked there. We'll do parent webinars that are like three hours and really just dive into all of it. So, there's so many ways. It's free and paid to learn more about this stuff now and support your child.

So yeah,

Brittyn: You said you do private practice. Do you only work with clients in California or are you able to support clients outside of California as well?

Katja: I only can directly support California clients, but I offer parent coaching zoom calls throughout. So that can look like looking at a language sample of your child and

figuring out what stage they're in and then giving you some individualized supports for them or what if you just want to talk about Gestalt language or [00:22:00] whatever.

 Yeah, so I offer those as well.

Brittyn: That's great. I'll be sure to link your website and your Instagram below in the show notes so people can check it out. So, would you say to reach out to you on Instagram? Is that the best way for people to connect with you?

Katja: Yeah. I answer all my messages.

Sometimes they get a little delayed, but

Brittyn: That's awesome. Well, thank you so much for sharing about all of this. I mean, I think that this has been a huge aha moment for a lot of parents just over the past few years, and I know your account has been really important in helping parents realize that just like my client, and I have so many members inside of my membership who will be on calls and it always comes up some way or another and so it's really cool for me to learn from you as well because I also now know some good resources to point them in the right direction so thanks so much.

I love following you on instagram. It's at bohospeechie for anyone who doesn't follow her already and thanks again Katja for being with us.

Katja: Thanks for having me

[00:23:00]

Transcribed by Descript

About Brittyn Coleman, MS, RDN/LD

Brittyn Coleman, MS, RDN/LD, is a distinguished Registered Dietitian and Autism Nutrition Expert, known for her innovative, sensory-friendly feeding approach to nutrition for children on the autism spectrum. As the founder of the Nourishing Autism Collective, and as an autism sibling herself, Brittyn brings both professional expertise and personal understanding to her work. She empowers families with her expert guidance, helping children receive essential nutrients for optimal health and development. Her strategies are tailored to the unique dietary needs and sensory preferences of each child.

Brittyn's influence extends beyond her membership site through her active social media presence and her popular podcast, 'Nourishing Autism'. Her educational content on Instagram, YouTube, and other platforms has established her as a leading voice in autism nutrition, providing valuable resources, practical advice, and a supportive community for parents and professionals. 

Brittyn Coleman, MS, RDN/LD https://www.autismdietitian.com
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