Tuesday, October 15, 2024

And open letter to practitioners of speech therapy based on "Natural Language Processing"/"Gestalt Language Processing" principles

Suppose I told you that I’ve been working for decades with a different population of language learners: people I’ve identified as "musical language processors." These are kids who pick out tunes on xylophones and chord progressions on pianos before they utter their first words; they learn their first words not from regular spoken language, but from song lyrics. That is, the words they initially tune in to and produce are sung, not spoken. And suppose I also told you that years of clinical experience have absolutely convinced me that the way to boost these kids’ language skills is to start by only singing words; never speaking them, and that speaking words is counter-productive and should be avoided in the initial stages.

Suppose I also cited for you the existence of adult, self-identified musical language processors who could tell you about how they learned songs before they learned speech, how their first language was song, and how, even though now they can speak fluently, they still translate spoken language into song? Suppose I told you that I know for sure that I myself am one of these musical language processors.

Based on all this, should you believe in the existence of musical language processors? And should you believe that I’ve come up with the most effective way to help musical language processors learn language?

No, you should not.

The field of psychology has taught us that first-person experiences, eye-witness experience, self-reports, and memories, including from childhood, are all unreliable. Practitioners, no matter how experienced we think we are, no matter how accurate we think our intuitions are, are easily deceived by first-person experience. Consider the litany of interventions, including in autism, that practitioners were convinced were successful but that turned out, under rigorous scientific scrutiny, to be, at best, ineffective, and at worst, harmful (especially when we include wasted resources and opportunity costs): facilitated communication, auditory integration therapy, sensory integration—to name just a few. To those who practiced them, they felt right, made sense, and looked effective. But rigorous, randomized controlled experiments told us otherwise.

In general, only rigorous, randomized controlled experiments can tell us whether our observations, intuitions, memories, and introspections are accurate. And, as far as I’m concerned, it is in that arena—the well-controlled empirical arena, the arena in which “empirical data” actually exists—where “back and forth conversations in which people share perspectives and assessments of empirical data” are worth having.

If you want to explore the accuracy of your intuitions about gestalt language processing, here’s what you could do (or, more ideally, invite an objective researcher to do):

1. Recruit a large number of children who meet your proposed criteria for being stage 1 gestalt language processors—presumably: autism diagnosis plus only producing echolalia.

2. Measure baseline language skills via the CASL, CELF, or some other comprehensive, standardized language measure.

3. Randomly divide the participants into two subgroups of equal size, a treatment group and a control group, matched on CASL or CELF scores, age, level of diagnosed autism, and amount and nature of previous SLP services.

3. Over an extended, pre-specified period of time, the treatment group receives a pre-specified schedule and quantity of NLA/GLP-based therapy from SLPs trained in NLA/GLP-based therapy.

4. Over an equivalent period of time, on an identical schedule, the control gets an equal quantity of standard SLP therapy from SLPs who aren’t trained in NLA/GLP-based therapy and who follow traditional SLP-based protocols.

5. At the conclusion of this time period, treatment groups and control groups are reassessed via the CASL or CELF, and the results are compared.

Have you ever considered doing such a study?

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