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The Miller Method
Arianna ScattoneCaldwell College Post- Baccalaureate Certification in Applied
Behavior Analysis
Megan MarinelloCaldwell College Masters in Applied Behavior Analysis
Allison ErwineCaldwell College Post- Baccalaureate Certification in Applied
Behavior Analysis
The Miller Method The Miller Method is a cognitive
developmental system with links to works of Piaget, Von Bertanfly, Vygotsky, Werner and Kaplan.
Theory: “typical development depends on the ability of the children to form systems that are initially repetitive and circular but which expand as the child develops”
The Miller Method
The Miller Method addresses:
1.Children’s body organization
2.Social interaction
3.Communication
The Miller Method
Founders Arnold Miller PHD, Eileen Eller-Miller, M.A.,CCC-SLP
Founded the Language and Cognitive Developmental Center
(LCDC) in Boston, in 1965.
Treatment Cost: the typical fee is $150.00 per one hour session
Video Conferencing and phone calls: $250.00 of week.
The Miller Method Miller’s Goals:
Assesses interaction, adapt to the change and learn from others
Build’s child’s awareness of own body with cognitive play forms
Enable children to be functional, social and communicative
Use more abstract symbolic functioning rather than concrete
The Miller Method Two Major strategies to transform
development:1. Aberrant system transformed into more
functional behaviors
2. Introduction to relevant activities involving people and objects
- elevated on 2.5 ft. squares
- therapist guides child creating a connection between signs and words
The Miller Method Elevated Board Structures:
Eye contact improves: the child’s eye level to therapist
Toe walkers become more grounded walking
Children that did not follow directions on the ground were found to be more compliant once elevated
The Miller Method Elevated Square: Two Types1. Elevated Square A:18 months-5years old
-the square rests on 4 lightly made cross shaped pedestals
2. Elevated Square B: 18 months-10 years old - the square rests on 4 sturdy cubes
Both come with:- velcro stairs- “swiss cheese” and
parallel boards- slide
- detours: alternate routes
The Miller MethodInteraction Devices: promotes spontaneous play
1. Interaction Ramps: 2- 5 children can play on this at one time
2. Interactive See Saw: creates awareness
3. Flower Table Stool: design of table creates relationship with others
Helps therapist work behind child without child escaping from task
Stools are made without backs; prevents leaning, making them less withdrawn
The Miller Method Sign and Spoken Language Program:
Training films that allow children who are non- verbal to understand meaning though signs
Goals of training films: Food situations( 11 minutes): signs that help children function better in
food related events ( e.g., fork, cookie, egg)
Action meanings( 11 minutes): usage of signs and spoken words in a appropriate manner (e.g., stop, go, walk,jump) http://www.cognitivedesigns.com/quicktime/JUMPSEQ.mov
Two- sign/ Two word combinations( 15 minutes): understanding of verb + noun( eat apple), noun + verb( egg breaks), adjective + noun ( big ball), noun + adverb( chair down)
Familiar objects and events(6 minutes long): understanding of familiar objects in the surroundings ( e.g., sleep, wash, awake, hot)
The Miller Method The Symbol Accentuation Program
Teaches function of words Teaches children to read in big and small text Letter sound relationships
3 Phases of the program Sight reading: words are illustrated in an animated
sequence and followed up with flash cards http://www.cognitivedesigns.com/quicktime/SITSEQ.mov
Transition to Phonetic: makes children more aware of words they already know http://www.cognitivedesigns.com/quicktime/MOPSEQ.mov
Phonetic Reading and Writing: consonants combine with shorts vowels( a,e,i,o,u) and long vowels( ooo) http://www.cognitivedesigns.com/quicktime/FOOSEQ.mov
The Miller Method
Assessment Miller Umwelt Assessment Scale( MUSAC) Umwelt: “world around one” The assessment sorts out the history of the
child’s reality and spatial issues and provide interventions to solve it
The MUSAC kit provides manuals, forms, videotape 16 tasks for assessment
The Miller Method
Training 4 day workshop at LCDC
50 weeks of supervision
Cases: 3 children (two nonverbal and one verbal)
Written exam
Does the Miller Method Work? The Miller Method has shown to:
Improve human contact Decrease perseverative tendencies Develop receptive and expressive language Engage a child in symbolic function
Success is defined by clear and significant gains in a child’s ability to deliver speech, intervention, over-stimulation, and other social skills.
Will it Work for Your Child? The younger the better. Your child must have a good
neurological status (no cortical insult or seizure disorders).
If there is bond between your child with at least 1 parent.
Those with closed-system disorders progress better.
Parents must have a high support/demand stance.
Outcome Research
The Miller Diagnostic Survey (MDS): How well is a particular special child
progressing in his/her school program?
How well do comparable children progress in school programs with other approaches?
The Miller Diagnostic Survey(The Miller Method Newsletter)
After this survey is completed it is sent to the Language and Cognitive Development Center.
Responses are reviewed. Summary of Developmental Profile is
sent back to parents. At the end of the school year the same
survey is filled out. A statistical analysis comparing the two
developmental profiles will determine changes.
What the Survey Entails…. Medical issues Sensory Reactivity Body Organization Social Contact Communication Symbolic Functioning Abberant Behavior System Functioning
Examples of Questions When the child has a nasty fall, touches
something hot or is hit by someone, does he/she cry?
Does the child seek out things to climb (monkey bars, trees etc.) as if “the higher the better?”
When the child has an object in his/her hand and someone takes it, the child is distressed.
Never Rarely Sometimes Often Always
MDS
The second issue addressed concerns the relative effectiveness of different approaches.
Because the survey has a space to indicate the approach being used there is a clear basis for comparing one program with another with regard to gains achieved.
Testimonials
“After the first month Jonny learned how to ‘sign’. This was the first time in his short life he could communicate.”
“Approximately, four months after Jonny started the school year, he started to speak. What a feeling it was to hear my child’s voice!!!”
Janet (mother of an autistic child)
Testimonials “There is not enough I can say
about these wonderful people that have virtually saved my son from a life of mere existence to one of meaning and purpose.”
“It works. It is not a behavior modification program. It is a way of life.”
Shirley (mother of an autistic child)
Testimonials“I have observed many
different programs, and I have never seen results like this. When you see these children on the Square, it’s hard to believe they are autistic. We’re really excited about what the kids can do.”
Dr. Ruth Rivera Ed. D.Director of Special Services for the Bloomfield School District
Del Pizzo (2003)
Success StoryKyle Westphal Fountation (2005)
Angela: Student at LCDC Non-verbal with tantrums Four months dramatic progress Used new signs everyday (come, give,
go, plate, etc.) 3 months 3 weeks requests in words
using simple sentences Much happier Tolerated change Able to wait
Follow Up
Seven years later, at age 13, Angela reads, writes, and is in a regular classroom without any support. She has friends and responds to connection.
Independent StudyThe Miller Method Newsletter (1997)
Genese Warr-Lepper, Ph.D., University of Western Ontario
Susan Henry, M.Cl. Sc., Robarts School for the Deaf
Tracy Versteegh, B.A. (Hons.), University of Western Ontario
Purpose The study was done to determine the
effects of the Miller Method intervention on children with pervasive developmental disorders are severe receptive and expressive communication disorders and an identified hearing loss.
The effects were measured by standardized linguistic and behavioral tests as well as by data from checklists, scales and teacher and parent questionnaires.
Participants 5 students enrolled at the Robarts School for the
Deaf, London, Ontario. Diagnosed with pervasive developmental disorder
or severe receptive and expressive communication disorder related to neurological issues or syndromes.
All had hearing loss. 2 males and 3 females Ages from 4 years 11 months to 7 years 5 months 4 participants had a Closed System, Type B
disorder 1 had a System-Forming, Type B disorder
Design Two 45 minute individual sessions per
week over 8 months Therapy provided by Sue Henry (LCDC-
trained speech-language therapist) Participants received between 26-33
sessions 4 out of 5 parents participated and
carried procedures into the home During the last two months Miller Method
materials were brought to the school to help carry effects over to the classroom
Results
All 5 children made progress in their communication, cognition, and social-emotional development. (2.4 domain increase)
Proportional Change Index showed significant rates of development. (2.68)
Trends in Participants Increased ability to attend and
follow instructions in the class room Increase desire to interact and
communicate with others Improved eye contact with more
positive affect when communicating Decrease in undesirable and socially
inappropriate behavior
Parent’s Comments
Parents and teacher reports for all subjects were greatly consistent and congruent.
All parents had positive feedback toward the program.
Summary of Experiment
Children demonstrated more purposefully social and appropriate behavior at home and in school following Miller Method therapy
“Achievements of this nature cold be considered to have a meaningful impact on the quality of life for these children and their significant others.”
Does this Research Prove Anything? The Miller Diagnostic Survey
The questions are subjective. They are from the opinions of the parents.
Independent Study Weakly controlled and did not evaluate the
direct effects of the intervention. Based on subjective evidence.
Testimonials and Success Stories No objective evidence
Does the Miller Method hold up Scientifically?MADSEC (2000)
Treatment Approach Effectiveness
Applied Behavior Analysis Many Validated studies show consistent efficacy in improving social, communication, academic function
Miller Method (Symbol Accention Reading Program)
Very few studies measuring outcomes. Not well substantiated.
Does the Miller Method hold up Scientifically?MADSEC (2000)
“Shows promise, but is not yet objectively substantiated as effective for individuals with autism using controlled studies and subject to the rigors of good science.”
Summary
The Miller Method challenges children to organize their perceptions and understandings of their surroundings and create new, more functional systems.
Summary Addresses the three major areas of
impairment found in children with autism Social Interaction – child awareness of self
and relationship with others is strengthened by using special equipment
Communications Skills – technique developed specifically to teach children with autism
Stereotyped behaviors – perseverative and ritualistic patterns and behaviors challenged to create flexibility
Summary
Effective? Numerous studies and testimonials
claim success None of these show objective
evidence
Conclusion
The Miller Method allows a child with autism to be more successful, comfortable and flexible in the surrounding environment.
Empirical research must be done
References Cognitive Designs Products.(1997-2002). Retrieved September 29, 2007, from
http://www.cognitivedesigns.com/playthings.html. Del Pizzo, N. (2003). Not just the square deal: cutting edge method welcomes
autistic kids to life. Kidmasters, Spring, 2-3. Kyle Westphal Foundation. (2005). The Miller Method. Retrieve October 15,
2007, from http://kylestreehouse.org/The_Miller_Method.cfm Maine Administrations of Services for Children with Disabilities. (2000). Report
of the MADSEC Autism Task Force. Retrieved on October 3, 2007, from http://www.madsec.org/docs/ATFReport.pdf
Miller, Arnold & Eileen.(nd). The Miller Method: A Cognitive- Developmental Approach for Children with Body Organization, Social, and Communication Issues. In ICDL Clinical Practice Guidelines( pp 489-515). Retrieved September 29, 2007, from http://www.millermethod.org/pdf/chapter19.pdf
The Miller Method for Children with Autism Spectrum and Severe Learning Disorders. 1996-2004). Retrieved September 29, 2007, from http://www.millermethod.org/index.html.
The Miller Method newsletter. (1997, Spring Quarter). Language Cognitive Development Center of Boston, 2, 1-2.
The Miller Method newsletter. (2002, Spring-Summer). Language and Cognitive Development Center of Boston, 7, 1-2.
Zaks, Z. (n.d.). Information for Parents of Autistic Children. Retrieved October 5, 2007, from http://www.zaksfamily.com/autismparents.html#prosconschart