Charting the Cs: Cooperation, Communication and Collaboration.
Statewide Professional Development to Support the Workforce and Low Incidence Disability Areas.
Charting the Cs Conference 2024.
Unlocking Communication: Strategies for AAC 
Implementation with Gestalt Language Processors 
Lowell Buysse, M.S., CCC-SLP 
Moorhead Public Schools - Moorhead, Minnesota 
Kelsey Grommesh, M.S., CCC-SLP 
West Fargo Public Schools - West Fargo, North Dakota 

Learning Objectives.. 
In the 90 minute session we hope to …. 
 Provide a very quick overview of natural language acquisition and gestalt language 
processing. 
 Identify some strategies used with Augmentative and Alternative Communication 
users. 
 Discuss importance of customization of AAC for gestalt language processors. 
 Discuss Features to consider in an AAC app for gestalt language processors. 
 Look at some common AAC apps and customization features and tips 

Two Language Learning Types 
Analytic Language 
Single word units. 
Growth through increased language 
complexity. 
Productive and generative early. 
Usually generalizes early. 
 Gestalt Language 
Acquisition of multiword utterances 
function as single units. 
May appear grammatically sophisticated. 
Language growth requires breaking down 
large chunks. 
Inflexible at early stages with limited 
generative use. 

Two Types of Echolalia 
Immediate echolalia 
EX. “I want bread”....”I want bread” 
Processing Language 
1. thinking about language used 
2. not developmentally ready 
Taking a turn in conversation 
Committing language to memory 
 Delayed echolalia 
Ex. “I like to move it , move it” 
“it’s alright, it’s OK” 
First stage in Gestalt Language 
Development. 

What is a gestalt? 
For reference in this presentation, a gestalt is … 
 An intentionally defined unit of language . 
 It is processed as a whole unit. 
 Meaning is tied to an experience. 
 Often acquired during a highly emotional time. 
 Can be a whole sentence, one word, or a whole book! 

Gestalt Language Processing: 4 Main Stages 
Stage 1 
ECHOLALIA 
Scripting whole gestalts 
Strings of language from people or media 
Stage 2 
MIX & MATCH 
Breaking apart gestalts - (mitigation) 
Taking parts of scripts and combining 
them with other parts 

Gestalt Language Processing: 4 Main Stages 
Stage 3 
SINGLE WORDS & COMBOS 
Breaking the script down to one word 
and unit 
Making noun combinations 
May be two words in length 
Stage 4 
 ORIGINAL PHRASE 
New sentences and phrases without 
grammar 

Stage 5 
ADVANCED GRAMMAR 
Novel phrases or sentences 
Includes advanced grammar structures 
Things to NOTE: 
There are two stages of Gestalt 
Language Development before a Gestalt 
Language Processor gets to where an 
Analytic Language Processor starts… 
Single words 

AAC Research has NOT changed 
“best practice” strategies related to AAC and still used as guidelines 
 AAC modeling is still an effective intervention. 
 Least-to-Most prompting hierarchy is still effective. 
 Motor planning still impacts AAC users speed and accuracy. 
 AAC still supports increased speech production, NOT less. 
 Communication partner training still impacts AAC success. 
 Robust AAC is still important for communication. 

Strategy: Acknowledge ALL Communication 
Multimodal Communication …. 
No tech- low tech- high tech. 
Even if you are not sure of intention or meaning . 
 Get comfortable with silence. 
 Smile, nod, repeat back . 

Additional AAC Strategies 
Strategies for AAC implementation may include… 
 Focus on connection - keep it engaging to the individual. 
 Follow the users lead. 
 Use more declaratives- less questions 
 Model, Don’t Prompt. 
 Talk for real reasons. 
 Do not place demands on the user to respond. 

Resource: AAC APPS AT - A - Glance 
Gestalt Language Processing and AAC 
AAC Features 
AAC App Summaries 
Just-a-List: Lists of Free Apps 
Terms of use: This resource was the sole idea and creation of 
Angela Moorad, Ms, CCC-SLP, OMazing Kids AAC 
Consulting.LLC 

Why Customization Matters: Gestalt Language 
Processing 
The power of truly embracing and incorporating individual differences into an AAC 
system and AAC implementation plus customization for unique needs cannot be 
overstated! 
 It is a respectful neurodiversity affirming practice that.. 
 Builds connections 
 Fosters AAC ownership 
 Allows for authentic communication 
AAC systems and many AAC implementation strategies were designed with Analytic 
Language Learners in mind 

Customization for Gestalt Language Processing - Do’s and 
Don’ts 
Do’s 
Involve the AAC user in the process. 
Only add things that are meaningful to 
that user. 
Consider the function of the gestalts, teh 
contexts used, organization/design of 
that app when adding content . 
Embrace the interests of the individual. 
 Don’ts 
Don’t alter the inherent structure or 
features of an AAC app (other than 
sensory or access needs). 
Don’t replace core words or other items 
on the Home Screen with gestalts. 
There is no “standard set” of gestalts . 

Some things might be added for 
self-regulation and the joy they bring. 
Be open to using more than one AAC option to meet the needs. We all use “multimodal communication”. 
Individuals with some speech may choose to record their own speech on to the device. 
Don’t delete a gestalt button once that gestalt has been mitigated. 
Don’t switch to a different AAC system 
unless an eval with feature matching and 
trials of options has been completed. 
There is no one “best” AAC option for 
anyone - whether they are a Gestalt or 
Analytic Language Processor . 
Do’s 
 Don’ts 

Possible Mistakes we are making …… 
In programming for gestalt language processors we may need to re-think some of the 
ways we have been doing things. 
Are we… 
 Modeling single words as the starting point for all . 
 Hiding words/phrases that students are stimming on. 
 Not providing access to pre-programmed phrases. 
 Starting with only pre-programmed phrases or sentence starters (ex. I want, I see). 

Feature Matching for Unique Needs: Gestalt Language 
Processing 
Gestalt Language Processors may need some unique AAC features that are “in 
addition to” not “instead of” features that may be needed by that individual for an 
AAC app to be a “good fit” for them 
 best made based on an AAC evaluation with feature matching and trials of options 
to find the best fit for their unique needs 
 there is often not any one “best” AAC option for anyone regardless of whether they 
are a Gestalt or Analytic Language Processor 
 more than 1 and Multimodal communication should always be honored 
 preferences of the AAC user and those supporting the AAC use is very important 

Unique Features: Recorded Speech 
Recorded speech can capture the rich intonation associated 
with specific gestalt
In Stage 1 of Natural Language Acquisition the language 
learners are focused on intonation/sounds verses the words 
Try record from the “original source” or say with intonation that 
matches that source so it resonates with the individual. 
Do not attempt to add recorded speech to all buttons on a 
robust system - 
May result in a “sparked” interest for using AAC 

Unique Features: Video Clips 
Many Gestalt Language Processors are drawn to particular 
segments of videos and may play them over and over. 
May be used as “communication” - but may require some work 
to figure out the meaning for that individual 
Individuals with some speech may recite these lines in a 
scripted way 
Videos may play a part in self-regulation. 
Explore these as a way to supplement - not replace- how an 
individual is already using video. What is their preference? 

Unique Features: Video Music 
Many Gestalt Language Processors are drawn to particular 
songs or segments of a song and may play them over and over. 
May be used as “communication” - but may require some work 
to figure out the meaning for that individual 
Music may play a part in self-regulation. 
Some apps offer a way to program a button to play a song that 
has been downloaded to Apple Music app on that device. 
Program a button to give commands to a smart speaker- some 
offer smart speaker integration. 

Unique Features: Whiteboard 
Some Gestalt Language Processors may enjoy drawing to 
recreate a meaningful event or express oneself 
Some AAC apps offer a Whiteboard within the app. 
Drawing may play a part in sensory regulation. 
Some may enjoy drawing their own symbol for a button. Take a 
screenshot of their drawing on the board, crop- add to button. 
A separate Whiteboard app or other creativity app could also 
be used. 

Unique Features: Visual Scene Displays 
A picture scene can capture an “experience as a whole” - 
involve the AAC user in using the device camera to take pictures 
and then use them to create visual scenes. 
Some AAC apps offer premade templates for visual scenes. 
Some offer a way to resize a button to make a spot for a large 
photo surrounded by buttons. 
Some offer a way to create tappable “hot spots” directly on a 
photo. 
RESOURCE: search Angela Moorad - OMazing Kids AAC on TPT 

Unique Features: Color Coded Vocabulary Organization 
Color coding helps identify parts of speech for learning grammar 
(helpful for NLA Stage 4 and up). 
Color coding may improve speed of location targets in large 
arrays, may improve appeal of displays, and may help when 
modeling use. 
Most symbol-based AAC apps have color coding. 
● Color Coding is NOT the same as color alterations (ex. 
Adjusting for Cortical Visual Impairment (CVI). 

Unique Features: Using Google Maps for Communication 
Some Gestalt Language Processors are drawn to maps, 
addresses, countries and flags and apps like Google Maps and 
Google Earth. 
Some AAC apps have a way to access Google Maps via a button 
action or opening a website URL to allow Google Maps to be 
opened within the app. 
Some AAC apps support use of Split View or Slide Over to allow 
this. 
Information gained may be: location, miles, time to destination 

Unique Features: Backing up Customizations 
Given the amount of time invested in making customizations it is 
very important that you back up the AAC app frequently and in at 
least one way outside of the device. 
Backup every time you make customizations. 
If app does not have backup, take screenshots of images of 
customizations, recordings and videos - if you need to recreate. 
It is likely that Gestalt Language Processors may become 
especially attached to the way their AAC looks and sounds. 

Proloque2Go by AssistiveWare 
Features for customizations.. 
 Add folders 
 Add into CHAT folder 
 Create pop ups with mitigations 
 Audio Record / Sounds/ Expressions 
 Use of List view 

TouchChat by Saltillo 
Features for customizations.. 
 Add folder in GROUPS 
 Utilize Visual Scenes 
 Add Audio and Video - includes 40+ 
voices 
 Many vocabulary options / page sets 
 WordPower 

Features for customizations.. 
 built in Head Tracking 
 Utilize iOS Split Screen 
 program comments, questions, etc that 
are related to what is happening on the 
other side of the screen 
 EX. “did you see that?”, “play it again” 

TD SNAP by TobiiDynovox 
Features for customizations.. 
 Utilize Quick Fires 
 Phrases Folder 
 Edit topics page to add supports - NOT 
replace 
 Reset home page as needed 

Built in Visual Supports on Supports 
button. 
 Mini-schedule and First-Then 
 Scripts. 
 Social Narratives. 
Motor Plan, Core First, Scanning, Aphasia 
page sets available 

GoTalk Now by Attainment 
Features for customizations.. 
 easy to insert video 
 visual scenes 
 iOS voices and recorded speech 
 NO search feature 

Stay Connected 
There are many Facebook groups and Podcasts available to join or listen to. Many 
times questions and suggestions provide ongoing discussions related to a variety of 
topics related to evaluation, programming, and goal/objective writing. 
 Facebook: AAC and Gestalt Language Processing 
 Facebook: AAC for the Speech Language Pathologist 
 Facebook: TouchChat App Users Group / Go Talk Now Facebook group 
 Meaningful Speech Community 
Beware of rabbit holes, if you fall in - it may take a while to “get out” !! 

List of Resources: 
 AAC and Gestalt Language Processing: Where to start - Infinitec 2023 - Kate 
McLaughlin. M.S., CCC-SLP. 
 The Known and Unknowns of AAC and Gestalt Language Processing- 
Webinar- Emily Diaz, M.S. CCC-SLP and Lauren Greenlief, M.A. CCC-SLP. 
 AAC Apps At-A-Glance- Marge: Angela Moorad, M.S. CCC-SLP (Teachers Pay 
Teachers) 

Thank you! 
Lowell Buysse 
lbuysse@moorheadschools.org 
Kelsey Grommesh 
kgrommesh@west-fargo.k12.nd.us