Considerations for “graduating” a gestalt language processor from speech-language support

We are often asked how to know when a child is ready to graduate from speech and language support. It’s important to understand that while there are six stages of gestalt language development, not every individual we support will make it to that last stage of gestalt language development but that might not be the goal! We never know a child’s potential and it’s never too late to start using the right strategies to support gestalt language processors. Let’s look at what to consider for graduating and how you can figure out what the family’s goals are.  

First, let’s review the stages of gestalt language development (Blanc, 2012)

Stage 1: Delayed Echolalia 

Scripting whole gestalts, single word gestalts, and/or intonationally defined strings of language from people, media, or books.
Example: "There's a monster at the end of the book!" 

Stage 2: Mix and Match Stage or “Trimming down” (Partial Gestalts) 

Mitigating larger Stage 1 gestalts into smaller chunks and also mixing and matching parts/chunks of Stage 1 gestalts into semi-unique utterances. 

Examples #1 (mixing of two partial gestalts): "There's a monster + under there" = There's a monster under there. 

Example #2 (Trimming down): "There's a monster." 

Stage 3: Single Words and Two-Word Combinations 

Breaking the script down to one word unit and/or making a new noun combination. 

Example: "monster", "scary monster", "monster red" 

Stages 4-6: New Original Phrases or Sentences with Beginning Grammar, More Advanced and Complex Grammar 

Putting word units together to make novel phrases or sentences. At Stage 4, children are using beginning grammar. At stages 5-6, children begin using advanced and complex grammar.

Examples: “The monster goed under” (Stage 4) “The monster can’t get out” (Stage 5), “Shouldn’t he have come out from under the bed by now?” (Stage 6).

What is the family's ultimate goal for the child?

This is an important question to ask before you even begin supporting the child and their family. We recommend including these kinds of questions in your intake paperwork and/or interview with caregivers. That is why we’ve included several questions in our Gestalt Language Intake Forms that are available in our Marketplace. We recommend talking to parents/caregivers and educating them about the stages gestalt language development from the start if you suspect their child is a gestalt language processor so that there is a clear understanding of what the ultimate goal is for that child. 

Their goal may be that the child is happily communicating and thriving across settings such as home, school, extra curricular activities, etc. and not necessarily that they are using self-generated sentences with complex grammar (stage 6). If that’s the case, it may be time to graduate the child from services earlier on in the stages as long as they’re meeting that goal. Maybe the family’s ultimate goal is that the caregivers gain a better understanding of gestalt language development, and how to support their child across the stages so that they can support their child at home. If that is the case, you may focus more on caregiver/parent coaching. We are here to support the child and their family, not to keep them in speech-language services forever. 

What questions should I ask?

Some examples of questions you may ask to get a clear picture of what the family/child’s goals are include (but are not limited to): 

• What support would you like as the parent/caregiver? 
• What are your family and the child's primary goals for beginning therapy services? (e.g. social relationships, communication support, academic readiness, safety, motor skill development, self-advocacy, play, etc.)
• What do you envision for your child over the next X months? Next X years?

These are just some examples of questions you may include on your intake paperwork/interview. These will help you set clear expectations for parents and as the clinician. You will have a better sense of when it is time to graduate the child and the family will as well. 

What to do if the family isn’t knowledgeable about gestalt language development?

If the family doesn’t have a solid understanding of gestalt language development, you might consider writing family/caregiver goals into your therapy plan. It’s important that families understand gestalt language development so that they can set realistic goals for their child, understand that we never know a child’s potential or that it’s never too late, but that getting to that last stage (stage six) doesn’t have to be the ultimate goal. We want parents/caregivers to feel confident supporting their child and implementing these strategies since they often spend the most time with the child. 

Want to learn more in-depth information about how to support gestalt language processors?

1. There are many free podcasts, webinars and articles to get you started. A comprehensive list of resources can also be found on our website. We just released a new FREE masterclass on echolalia and child-led therapy that is perfect for anyone starting their learning journey or on the fence about purchasing our courses! 
2. Consider taking the Meaningful Speech course to learn more about how your child or client processes language, how you can help support them from echolalia to self-generated (original flexible) language, child-led therapy, and neurodiversity-affirming practices. Looking for something shorter? We have a 1-hour introductory course perfect for extended family, daycare or school staff.
3. Consider taking our AAC + Gestalt Language Processing course. It will teach you how to identify, evaluate and support gestalt language processors who use AAC or who you think might benefit from AAC.
4. Look for a speech-language pathologist (SLP) who "gets it" and can help you in supporting your child's language development. Check out our registry for SLPs who understand gestalt language processing and child-led therapy.
5. Are you a school-based or private practice clinician looking for intake forms for new clients/students or creative visual reminder posters for your space? Check out the Meaningful Speech Marketplace. 
6. Want to learn more about starting a niche private practice? Watch our 1-hour webinar on starting a niche private practice hosted by Alex Zachos and Jess Teixeira from the Meaningful Speech team HERE.