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On this episode of the All About Kids podcast our special guest host, All About Kids Founder Cathy Grossfeld, welcomes a mentor from her days at CUNY-Queens College. Dr. Sima Gerber, a specialist in early language acquisition and the treatment of children with autism spectrum disorders, is a respected professor, expert in her field and author most recently of a moving and visually beautiful new collection of four books, “To the Ones Who Love Me: Language Development.”

Sima and Cathy cover a lot of terrain in this hour-long conversation, which touches on the power of letting the children we serve lead the way. They touch on the critical importance of understanding non-verbal development – in its many forms – as a foundational precursor to speech development. The message is clear: Patience is required on what is inevitably a journey for which the child must be allowed to set the pace. You’ll learn about some of the tools to help along the way, including the use of intent and ideas as a starting point. “Language production becomes the goal with so many of these children and in my opinion prematurely,” says Sima, “because there are so many developmental capacities that must be in place before children can learn a language system.”

A veteran in her field, Sima shares how even as a seasoned speech pathologist she had much to learn from a mentor! Taking a cue from a young patient whose emotional affect took a sudden turn, she reached out to a psychotherapist who has since added an entirely different dimension to her approach. There is, says Sima, tremendous depth to be plumbed within the mental health component of this work. And that applies across the board among parents, siblings, therapists and educators. We all need ideas, support and resources to help us do the most creative, empathetic work possible. 

You’ll want to check out Sima’s new series of books, starting with “To the Ones Who Love Me: Language Development,” and including accounts of language, social-emotional, cognitive and motor development in the first year of life as rendered from a baby’s perspective. Written in collaboration with her graduate students, it’s a  deeply personal project that will without a doubt resonate! Click here to order. All proceeds will go to The Speech-Language-Learning Center at Queens College.

Episode Notes

  1. After a brief introduction, Cathy starts off her guest hosting with an explanation of the history she shares with Dr. Sima Gerber, who has influenced her work.
  2. Based on 50 years of practice, Sima shares her fundamental orientation with regard to communication and building a pre-verbal vocabulary. 
    1. (6:15) Why Sima prioritizes the dynamic between parent and child with a focus on supporting optimal interaction and communications.
    2. (8:10) The foundational building blocks Sima believes must be developed in children with autism well before talking takes center stage.
    3. (8:40) “Language production becomes the goal with so many of these children and in my opinion prematurely, because there are so many developmental capacities that must be in place before children can learn a language system.” (Sima)
    4. (10:00) It’s important to “join the child where they are,” collaborating in non-directive ways that build engagement.
    5. (12:00 Cathy has found that if you follow the intuitive lead of the child, turn-taking comes naturally. 
    6. (15:00) “You’re much better off doing what the child is already doing … The child’s idea is better than yours. So whatever that idea is, even if it’s not so conventional, you have to open up.” (Sima)
    7. (16:15) The work has to emphasize the child’s agency and the science of what happens before.
    8. (18:00) A non-verbal child doesn’t have to be looked at simply absent the ability to speak. There are building blocks already there that can be leveraged.
  3. Why patience is such an important part of the language development process.
    1. (19:45) Non-verbal interaction is the starting point of a longer journey towards speech development and capability.
    2. (20:30) Intention is as important in some ways as speech. If a therapist reflects that they understand what a child is trying to communicate, through mirroring and positive response, it reinforces the child’s intentionality in a positive loop.
    3. (21:30) If we respond to quickly by articulating a cue for the child, an opportunity to encourage communication is stymied and lost.
  4. More about the role of foundational pre-verbal capacities.
    1. (22:47) There are ways to assess where children are in relation to their foundational capacities.  
    2. (23:30) Ideas are important building blocks and some children need support to expand and add to what a child might already be doing.
    3. (24:45) “Language is based on diverse breadth and depth of ideas, even in little, typically developing children … So if the ideas are limited, then the talk is limited.” (Sima)
    4. (25:28) There are creative ways to take a non-verbal behavior (for example, tapping) and expand it through new ways to deploy it that are as an organic part of play.
    5. (27:00) It’s key for therapists to ascertain what a child knows and how to intuitively build upon that concept in ways that expand the idea and associated language. 
    6. ( 28:34) “This is all follow, follow, follow … We’re looking for what has meaning to the child and we’re not judging it.” (Sima)
  5. About Sima’s latest project, “To the Ones Who Love Me: Language Development.”
    1. (29:50) Sima’s series of books covers language development, cognitive development, social-emotional development and motor development. 
    2. (30:28) The book’s goal is to help parents understand some of the most important developments in the first year of life – all of which ultimately lead to language and communication.
    3. (32:00) Although she has many publications of which to be proud, Sima was especially moved by the task of writing in the voice and from the perspective of a very young child.
    4. (32:40) The book is dedicated to Sima’s mentor and visionary friend.
    5. (34:00) Proceeds from the book will go to the Queens College clinic in memory of its beloved late cheerleader and guiding force.
  6. About the power collaborating with Applied Behavioral Analysis practitioners.
    1. (38:00) A case study of a young girl who, based on an ABA-based program, was using language without meaning.
    2. (39:50) Language experts have a real opportunity to help ABA-oriented therapists expand their repertoire and other kinds of input.
    3. (41:50) “You have to be careful sometimes not to get into imitation without function connected to communication.” (Cathy)
  7. How Sima’s work studying the mental health of children has taken shape.
    1. (43:30) Sima’s interest grew out of a case 30 years ago in which she observed a significant change in a young boy’s affect, prompting her consult a therapist with whom she has collaborated ever since.
    2. (46:10) The mental health component colors every other aspect of speech, emotional and other development – as well as dynamics among all family members.
    3. (48:20) Sima finds that lots of feelings attach to the work for therapists, parents, siblings in addition to the actual child on the spectrum.
    4. (50:24) “(The patient) doesn’t only bring his communication problems to me. He brings his emotional self as well … So much of what he’s communicating is how he feels about himself. He doesn’t want to be autistic.” (Sima)
    5. (51:10) Sima recommends forming relationships (whether one-to-one or in groups) with psychotherapists who can “change your work in enormous and important ways.” 
    6. (53:45) Cathy appreciates the desire among therapists to come together in groups, including the possibility of galvanizing peers around psychotherapeutic training that Sima believes can have transformational impacts on the work.
  8. Empathy is a key ingredient in these stressful times.
    1. (56:20)  Cathy shares a revelation she had around the judgment or expectation she once felt when she failed to do physical therapy tasks assigned to her between appointments. 
    2. (58:20) Assignments, targets and processes are not as important for families in the end as it is to cultivate a healthy, positive atmosphere at home.
    3. (58:57) “The best thing parents can do is have a joyful, playful interaction with their child where the child can be seen and read and delighted in just for who they are.” (Sima)
    4. (59:37) Sima’s new book, “To the Ones Who Love Me: Language Development,” promotes above all the value of time spent together playing with and discovering your child.

About All About Kids:

AAK provides diagnostic evaluations as well as direct and consultative behavioral intervention services to children with Autism Spectrum Disorders. After comprehensive assessment, each child has a portfolio or program book designed specifically to meet his or her individualized needs. The quality of our ABA services are closely monitored through program and field supervision as well as ongoing consultation by BCBA’s/BCaBA’s, and Experienced Team Leaders. 

Click here for a link to comprehensive educational and support resources. Previous podcast episodes and more information about All About Kids is available here.


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