What is unique about the Miller Method®?  How can the Miller Method® enhance your language intervention strategies?

There are several elements of our intervention for language development that are often missing in mainstream speech and language therapies.  Two of our main strategies are emphasizing the role of body awareness in language development and our use of sign systems to elicit meaningful communication.

These strategies are particularly helpful for very young children on the spectrum and/or nonverbal or limited verbal children. If you work with these children the Miller Method® will open a whole new world of intervention possibilities.

Meaningful Talk begins with the Body

For obvious reasons there is often much emphasis on the mouth as the source of language and therefore the focus of intervention.  But at the Language and Cognitive Development Center (LCDC) we begin our focus on an even more fundamental and often overlooked basis of all language: the body itself.

Children with autism have poor awareness of their body as distinct from the environment.  Because of a variety of neurological differences – such as a frequent “disconnect” between visual, proprioceptive and auditory impressions --  the child with autism has difficulty figuring out where his/her body ends and the outside environment begins.   This leads to difficulty developing a concept of self that is defined separately from objects or other persons in his environment. In the following clip Dr. Miller describes the disorganized body experience of an autistic child.

What does this have to do with language? Without an adequate sense of the distinction between the body/self and objects, a child cannot directly initiate actions, signs or words to communicate his/her intentions. No matter how skillful the therapist is at facilitating the child’s motivation to speak, the child’s language will always be hampered by the body-object/other problem.

What to do? We elevate the child and set up situations so that words are experienced as part of relevant body action.

At LCDC we elevate children on boards 30” above ground as we perform language intervention. Elevating children makes them more aware of their bodies and consequently focuses their actions, so the words they hear and the manual gestures they see become directly related to what they are doing at the moment. Words like “pull” and “push,” are said while the child is performing that particular action. Ideally we don’t want the word to be merely background; we work to make the word specifically relevant to the child's body experience, as in the following clip taken from the early days of LCDC. 

Note how the child is placed on the elevated board and is taught the word “pull.” The situation is organized in such a way that "pull" becomes very relevant to the child--there will be nowhere for her to step if she doesn't pull. You can also see how the elevated board provides opportunity for the repetition of words and actions in a controlled way. In another example, Dr. Miller pulls back when the child hears “stop” so the child can experience the word with his/her body.

Sign as more than a substitute for spoken words:  Signs as facilitators of spoken words

Manual signs are used in all kinds of language therapies.  Most of us realize that  signs are much more concrete than words which are too fleeting for a child with processing difficulties. 

At LCDC we use signs in an even more powerful, systematic way. All children, typical or delayed, learn language when a word is repeatedly experienced during a directed action. For children who are word deaf or otherwise have difficulty processing, the use of the manual sign with the therapist’s word will often “ground” the spoken word and make it more available to the child.

 The Miller Method® uses sign + word+ action in repetitive but meaningful sequences so the child will repeatedly experience all three elements as a single, focused system.  For example, on the elevated square we pair word and manual sign as the child repeatedly acts out "Come," "Go," "Up," "Down," "Push," with its relevant action until the child experiences these words as part of the actions which accompanies them. Once this happens, the therapist can leave out the word and the child will – while performing the action -- often feel the compulsion to add that missing word component.

This “principle of inclusion” can be exploited to establish receptive and expressive language, often for the first time.  

After decades of clinical experience, this method was experimentally confirmed in Dr. Miller’s 1973 article in the Journal for Developmental and Schizophrenic Children and has since then been replicated.  Dr. Miller has taught many nonverbal children meaningful language with this method. In the following clip Dr. Miller describes how he inserts language (both sign and words) into a nonverbal child’s step-slide system. At first the words are meaningless but through repeated pairing with the child’s action system the words will stick to the specific actions they refer to. Here is a slide system that is used to develop words like “come,” “go,” “up,” “down”.