Echolalia, scripting, Gestalt language. That's what the experts call some of this. Echolalia is basically when Zach parrots a word/phrase we just said to him. When I ask Zach: "Do you want a cookie?" He will respond with "cookie" back to me. In pure echolalia, Zach would have said back to me "Do you want a cookie?", and not becuase he was curious if I had a Chips Ahoy in my future. Originally when trying to teach Zach to request (also referred to as "manding") for a cookie - we would just hold the cookie up and say "cookie". If he echoed back "cookie", we would give him the cookie, giving him a meaning to his utterance, so that hopefully he would understand that the round thing with chocolate chips in it had a word associated with it (labeling the item) and that if he said it he would get one (teaching him to mand for it). Eventually we were able to add the other words to make the phrase "Do you want a cookie?" and Zach continued to utter cookie if he wanted one, using it to mean "yes" which Zach still does not understand.
As of today, it appears that if Zach wants an item when we ask him, he will echo back the item. If he does not want it, he will say nothing. At least that is how we are treating it, and thus giving it that meaning. There is no "yes" or "no" in Zach's vocabulary. Well, most of the time. When pushed to a limit, I have heard Zach say quite clearly, appropriately, and vehemently, "NO!". LOL "Yes" and "No" seem like they would be some of the first things a child would say. Zach still struggles with making a choice, as do other kids on the spectrum.
The words Yes and No are often used to indicate preference. It can be very hard for kids with ASD to understand because preference is an abstract, social concept and it is hard for kids on the spectrum to understand that different people like different things. It can also be hard for a child with ASD to understand that he or she can also just choose one thing one time and another thing another time based upon preference. Tahirih Bushey MA-CCC,Speech Language Pathologist
Yes, No, More - SLPs (speech language pathologists) frequently try to elicit these words first from a child since they come more naturally for typical kids who may just have a speech disorder. If a child is having a hard time with these words, but yet have others, it should be a red flag that something more is going on.
Now Gestalt language is when a child uses complete phrases or sentences, with no recognition of the individual words in it. According to those who initially diagnosed Zach, his use of whole sentences and phrases ("Wake up!","Oh no, what did you do?" , "Thank You") prior to his regression, although used at appropriate times, may have been Gestalt, meaning, he didn't understand the individual meaning of the words, but got the overall concept of the phrase. Sort of like the whole is greater than the sum of its parts. Kids on the spectrum have a higher tendency to learn this way.
Gestalt language acquisition does not just develop in persons with autism. It’s not just short cut in language. Gestalt language acquisition comes from gestalt thinking or gestalt processing. One way of to describe it is the thought process is like thinking in pictures. Persons with autism think and learn differently. From BrightTotsScripting is almost like a combination of echolalia and gestalt language. Scripting is a lot like it sounds - reciting lines from movies, books, television, overheard conversations. Some people say that it is a self stimulatory behavior, used in times of high stress for a child who knows they are expected to be verbal. Some say that they have noticed the occasional child will use certain scripts to express themselves about something they are feeling or thinking that they have no other way to express. Zach has not done this to date.
What does Zach say? Well, he has a vocabulary of around 50 words, if I am to hazard a guess. However, he still is very quiet. He will speak spontaneously, just not often. I teeter on whether this is autism, or his personality. He is just not that in-your-face sort of kid (ahem, Sophie any one??), more laid back like his father. The autism just seems to emphasize this about him.
As much as he is quiet, and a possible a gestalt thinker, he is interested in more than the big picture. Lately, he has been fascinated with letters and all things Leap Frog. Using the knowledge of the way Zach may learn from the previous explanation, we have given him access to a LeapFrog video called the Letter Factory, and we have brought out an old LeapFrog toy that Uncle Mark got for Sophia a few years back called Word Launch. These products have been great in getting Zach to learn his letters! But how and why? First off and most importantly, Zach is fascinated with both of these items. We actually use the Word Launch game as a reinforcer during is in home therapy sessions. Now, Zach gets overwhelmed by choices. He has a problem scanning fields, especially with many items in the field (such as a keyboard). The Word Launch game has individual pieces, one for each letter. We can pull out a subset of the alphabet and have him have him make choices from a smaller sample space while playing a game. This does mean that someone has to be there to help him play the game. Guess what? Zach knows this. He is learning he has to rely on other people to achieve what he wants. For the first time ever, Zach loves therapy. He embraces his therapist as never before, even the newest one who started roughly a month ago. These therapists play this game with him. This game isn't just academic, teaching letters, it has also managed to teach a social lesson, too. The combination of these these two items has been a wonderful experience for us. Some would say to us, where is the ABA in all of this? No discrete trials bombarding the kid with flashcards? "Aha" you might say - "ABA isn't necessaryl. "
A note from the BCBA:
I probed receptive ("where is the ___?" And expressive "what's this?" Letter identification with capital letters. Zachary was able to receptively and expressively identify capital letters with 100% accuracy.A probe to start, continue on with what we are doing for now, rerun the probes, perhaps create a few programs to expand upon what we are figuring out works for Zach. But we have a baseline now, a mark in the sand, to say this is where he is at, and it is well documented and can be studied, altered, and regraded periodically. This is the reason I like ABA - DATA! Some progress events are so obvious that you don't need to get them written down to see the change (e.g. He is peeing on the potty and no accidents!) But some things aren't as obvious, and you may not recognize the changes being made through all the fog of what you are working on, unless you occasionally stick your head up and draw a hash mark.
Isn't a big reason for the written word in the first place just a way to remember what happened with as much detail and truth still in tact?
Zach also is doing some intraverbals - we are making use of his ability to remember phrases and have him fill in the blank. If you are to say to Zach: "A 'B' says _____" he will respond with "buh". He is learning some phonics from these games. I am not sure how useful phonics will be to Zach, but it does coincide with what a normal curriculum for a typical kid is, and will help him to meet that goal if he is tested against it. *sigh* Yes, I am thinking we have to teach to the test if we want Zach to show academic progress one day, even though it might not be the true test of his knowledge, and certainly not a test of how he learns.
So my wishes are coming true - not that Zach is becoming more verbal, literate, or just learning his ABC's. I am starting to get a feel for how Zach's mind works, so I can teach him, communicate with him, one day to maybe help him express his love to us, and respond to him in a way that lets him know that we love him.
If you know a kid with autism, than you just know that one. They all vary so much. One single thing does not work for all, so it is up to us to try and see what does. This method is helping Zach, but may be of no use to another. The mystery of autism will continue, but the mystery of Zach has had a bite taken out of it.