A Review of the Miller Method

A Review of the Miller MethodJessica JaruczykHeather PeltackLindsey Gallagher

Caldwell College Graduate Programs in Applied Behavior Analysishttp://www.youtube.com/watch?v=NzlG28B-R8Y

THE MILLER METHODLindsey1A Review of the Miller MethodJessica JaruczykHeather PeltackLindsey Gallagher

Caldwell College Graduate Programs in Applied Behavior Analysishttp://www.youtube.com/watch?v=NzlG28B-R8Y

Lindsey2

PhilosophyWe maintain that each child no matter how withdrawn or disorganized is trying to find a way to cope with the world. Our task is to help that child use every capacity or fragment of capacity to achieve this.

(What is Miller Method?, 2009)

Lindsey

Coping with the world main objective?3Founder of the Miller MethodDr. Arnold Miller3/11/1927 - 8/27/2011

Lindsey4Who was Arnold Miller?Native of the Bronx, grew up on L.I. Radio Operator in the Navy, World War IIB.A. from City College of New YorkDoctorate in psychology at Clark UniversityAustrian developmental psychologist Heinz Werner (mentor)Associate professor of psychology at the University of Montana (1960)http://articles.boston.com/2011-09-07/lifestyle/30123820_1_autism-therapies-parents-of-autistic-children-autistic-tendencies

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Native of the Bronx and grew up on Long Island,The son of a concert violinist. His parents also ran a Burgerland in Mineola, N.Y.He served in the Navy during World War II as a radio operator, before attending City College of New York on the GI Bill. He earned his undergraduate and graduate degrees in education from City College and played violin.Doctorate in psychology at Clark University. His mentor was the Austrian developmental psychologist Heinz Werner.In the early 1960s, Dr. Miller was an associate professor of psychology at the University of Montana.He was married 45 years to Eileen (Faythe), a speech pathologist from New York, with whom he shared his lifes work.Together, the Millers opened their development center in 1964.In 1974 they moved the center into a brick schoolhouse on Wyman Street in Jamaica Plain.They treated more than 40 children each year, many who were sent by special-education programs in nearby school districts.Dr. Miller said that about 70 percent returned to mainstream classrooms.After his wifes death, Dr. Miller focusing on training others in the Miller Method through videoconferencing and workshops.Last year, the Miller Method went head-to-head with the more widely used autism therapy known as Applied Behavioral Analysis during a demonstration in San Diego. Both therapies were used for an hour with a 4-year-old nonverbal autistic child.Dr. Miller said he believed the demonstration showed that his method was superior, and he debated leaders of the California-based Autism Partnership, who support ABA. Directors of the Autism Partnership countered that the demonstration was flawed.Dr. Miller published two books, From Ritual to Repertoire (Wiley, 1989), about the theory behind his treatment, and a laymans guide, The Miller Method (Kingsley, 2007).Dads biggest contribution to the treatment approach is to say there is an inner child in there. Hes in there. said Dr. Millers oldest son, Loren of Arlington, a filmmaker. We can bring him out and we can leverage the parts of these two worlds.In addition to his son, Dr. Miller leaves two other sons, David A. of Waban and Ethan B. of Chestnut Hill; a sister, Celia Sterling-Marsh of Laguna Hills, Calif.; and three grandchildren. Burial was in Sharon Memorial Park.

5Who was Arnold Miller?Married Eileen (Faythe), a SLP from NYOpened development center in 196440 children each year in special-education programs in nearby school districts.Dr. Miller said that about 70 % returned to mainstream classrooms.Focused on videoconferencing and workshops after his wifes death

http://articles.boston.com/2011-09-07/lifestyle/30123820_1_autism-therapies-parents-of-autistic-children-autistic-tendencies

Lindsey

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The MillersFrom Ritual to Repertoire (Wiley, 1989) The Miller Method (Kingsley, 2007)

Passed away 8/27/201 of pancreatic cancer

Lindsey

Published booksFrom Ritual to Repertoire (Wiley, 1989) [theory]The Miller Method (Kingsley, 2007) [laymans]

7Hes in thereDads biggest contribution to the treatment approach is to say there is an inner child in there. Hes in there. said Dr. Millers oldest son, Loren of Arlington, a filmmaker. We can bring him out and we can leverage the parts of these two worlds.

Lindsey

8History Founded by Arnold Miller and wife Eileen Eller-Miller in 1965Language and Cognitive Development Center (LCDC) in BostonThe Miller Method is guided by a cognitive-developmental systems theory with links to the work of:Piaget (1948, 1954, 1962), Von Bertallanfy (1968), Vygotsky (1962), Werner (1948), Werner and Kaplan (1963) Adapted to the needs of children with severe developmental challengesGrants and research funded by U.S. Department of EducationLindsey

9What is the Miller MethodThe Miller Method

http://www.icdl.com/graduate/documents/Chapter19.pdf

Lindsey

10What is the Miller MethodThe Miller Method is an integrated approach that addresses problems of body organization, social interaction, and communication in school, clinic, and home settings as presented by children on the autistic spectrum as well as those with significant challenges in learning or communication.

(Miller & Eller-Miller, 2000)

Lindsey

11What is the Miller MethodAssesses the adaptive significance of the children's disordered behaviorAttempts to transform the disordered behavior into functional activityLindsey

12What is the Miller MethodAttempts to expand and guide the children from closed ways (of living alone or in immediate circle like with parents) into social and communicative exchangesGuides and teaches professionals and parents as regards the ways and systems to be followed to facilitate children the children affected with autism and related disorders toward reading, writing, number concepts, symbolic plays, and development of typical classroom activities

Lindsey

13What is the Miller Methodhttp://millermethodcommunity.ning.com/video/autismspeaksvids-1

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14AssessmentsMiller Diagnostic Survey (MDS)Parent SurveyFew pages in lengthLCDC staff member writes a report of recommendationsGoes directly to cognitive therapist and Dr. Miller107 Likert-type questions Computer program organizes the responses A statistical analysis comparing the two developmental profiles will determine which changes in scored categories are statistically significant (Miller, 2002)$1000

(Miller, 2002c, Spring/Summer, Miller diagnostic survey, 2009,http://www.millermethod.org/)

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16AssessmentsSign and Spoken (2 times beginning and end)Receptive and Expressive Only start about 2 years agoSchool districts were asking for proof

Heather17AssessmentsUmwelt Assessment (Once a year- Beginning) Assessment to understand the world around youIf you are an open or closed systemWhat the child can and can not do

http://www.jonathanthurston.com/miller/languageintervention.html

Heather18Assessments

Capacity to interact with a person and an objectCapacity to adapt to change

Problem solving and learning from experience

Heather19AssessmentsVygotsky Test (Every time a videoconference was done)Object identification http://millermethodcommunity.ning.com/video/dillon-passes-the-vygotsky

Heather20Disorder Type A Type BClosed-systemDominated by only a few systems; unable to respond to any stimuli not related to their current systemMinimal executive functioningHave multiple systems; move from one system to another; prohibit others from entering their systemsExecutive functioning with many objects/systemsSystem-forming(Open- System)Unable to form systems due to poor sensory-motor coordinationMinimal executive functioningUnable to form systems because too sensorily driven by various stimuliLittle executive functioningDiagnosisHeatherA closed system are those children who are fixatated on spinning wheels and are ritualisticThe way you expand this system is doing it slowly. His idea is that these kids are stuck in the ritualsSo his idea is to help them deal with the world by little by little breaking those systems and expanding themChange it up constantly so they Change names on cubbies turn over tables and chairs

System forming kids are those who would be oblivious to this changes in the environment.. For these kids you would want to create a system, using the elevated square they could create ritualistic systems and then expand them.

Person vs. location expansion21Basic Treatments No criteria for mastery

No data collection

Heather22Elevated SquareTMVirtual Tour of the Miller Method

Heather

The Elevated Square, used in dynamic treatment of children in the autism spectrum, was developed by Dr. Arnold Miller and Eileen Eller-Miller of the Language and Cognitive Development Center, Newton, Mass. The Miller Method is in use in public school special ed facilities and private settings around the United States, Canada and other countries as an effective alternative to classic behaviorial approaches.As Dr.Miller long ago observed: "Most kids love to move." The Square was designed for total modularity and flexibility-- needed to keep up with children as they acquire new motor and communication skills and need new challenges during treatment sessions. Steps, slide, push-pull blocks, the unusual "Swiss Cheese" board, and other activities can be swapped in and out as needed by a trained MM practitioner and teaching assistant.The platforms and planks elevate children 30" off the floor, which has several useful functions: 1) autistic and PDD children often experience an enhanced sensation of awareness at height, 2) teachers and parents can interact with them at eye level, 3) the pathway around the square is used to order various interesting activities at corner station platforms.The Elevated Square seems deceptively simple, but this device is the culmination of 45 years research and treatment of autistic children. Either professionally constructed Elevated Square or plans for its construction are available at Cognitive Designs, Inc, www.cognitivedesigns.com.

23Why the Elevated SquareTM?Why do you have children on the autism spectrum walk on an "Elevated Square" 2.5 feet above the ground?Using for 30 yearsMore aware of themselvesIncrease eye contactMore focusedAble to communicate and learn Eliminates toe walking

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Heather25Elevated SquareTM

The Elevated Square seems deceptively simple, but this device is the culmination of 45 years of research and treatment of autistic children.

www.cognitivedesigns.com.

Heather26Sign and Spoken Language Relates objects and events to signs and spoken wordsManual signs adapted from American Sign Language4 segmentsActionsFoodFamiliar Objects/EventsTwo-word Combinations

Heather27Sign and Spoken Language DVD of Sign and Spoken LanguageVideo 0 5:16Video 1 1:45

HEather28Sign and Spoken Language Helps children that dont use words Repeat appropriate word while child is preforming actionNarrating childs action

Heather29ReceptiveLast 2 to 3 yearsStarted data collectionSit with studentShow me get up Student will do JessicaJust started data collection for whether the child can receptively or expressively identify the sign and spoken words. When school districts asked they began 30ExpressiveInterrupting situations to elicit signs or wordsE.g., on elevated square, scavenger hunts, videotapes in actionThe use of signs pulls spoken language and contributes to language development

Jessica

31Symbol Accentuation Reading Programhttp://www.cognitivedesigns.com/symbol.html

Teach symbolic function of printed words. Learn how to sight-read sentences in both large and small typeShift from sight-reading to phonetic readingAcquire letter-sounds relationships and blending and sequencing of letter sounds into meaningful wordsStimulates active participation by both students and teachers

Jessica

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Classroom InterventionsPennies in the JarPicture on Close pinsMr. Potato HeadNesting cupsLight Bright

Jessica

34Individual InterventionsBecoming part of their world

Puzzle Exchange

http://millermethodcommunity.ning.com/video/video/show?id=3566609%3AVideo%3A3770Jessica

Behavior throwing ripping 35Interactive InterventionsTug of WarWagon RidesTeeter TotterPig Piles http://www.youtube.com/watch?v=jZ2_22whhxU

Jessica

36SchoolsAges 2-12Jessica believes it only works to age 5 1 in NJ Per student $65,00050 students $3, 250,000 a yearSchool districts onlyThis does not include the aides or 1 in IsraelDistance Consultations/ Video Conferencing Oversight Program (VCOs) $150 an hour Takes place in private and public schools in Massachusetts, New York, New Jersey, Ohio, Pennsylvania, California, Canada, Israel, and secondarily in the homes of families equipped for videoconferencinghttp://millermethodcommunity.ning.com/video/the-first-conversation

Jessica

37Typical Day INSERT FULL DAY SCHEDULE

Jessica

Reciprocal face touchingRestabilizingRow row row your boat

38Criteria for certification Miller Method Specialist4-day training workshops at LCDCHours of supervision 50 weeks (1 hour per week)Cases coveredWritten examination

Jessica

Professional Discipline: Clinical and/developmental psychologists, pediatric nurses, occupational therapists, physical therapists, psychiatrists, social workers, special educators, speech and language pathologists are appropriate candidates for training and certification.

Four Day Miller Method Workshops: Participation in the Basic Four-Day Miller Method Workshop is mandatory; currently, participation in the Advanced Four- Day Miller Method Workshop is optional -- although recommended.

Supervision: A total of 50 weeks of supervision (1 hour per week) is required unless the advanced workshop is taken. Supervision may be taken either at LCDC, via videoconferencing oversight (VCO) or via teleconferencing oversight (TCO) supplemented by monthly analysis of videotapes.

Cases: Each trainee selects 3 children -- two non-verbal and one limited verbal with autism or PDD or severe communication disorder -- as the group on which they will be supervised. On a quarterly basis copies of notes on each child are sent to their supervisor. In the course of the year, each trainee conducts an Umwelt Assessment on each child, works out a treatment/education plan for each child and conducts treatment sessions. Those with VCO have their sessions supervised while they are conducting them; those with TCO will have a monthly videotape of their sessions analyzed and discussed over the telephone. Special education professionals learn to apply Miller Method strategies in the classroom.

Written Examination: At the end of the 50 sessions, each trainee is given a series of searching questions about the children with whom they have worked. On successful completion of the examination, certification as Miller Method Therapist (if a clinician) or Specialist (if a special educator) is awarded by the Language and Cognitive Development Center.

Authorized Miller Method school programs are defined as those which have a) a certified Miller Method Specialist or Therapist on staff, or b) an ongoing consultative relationship (usually via videoconferencing) with senior staff from the Language and Cognitive Development Center. Programs which do not meet this criteria may not present themselves to the public as Miller Method programs.

39Miller & ParentsAdvice to ParentsJessica

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Miller vs. ABAMiller vs. ABA in San Diego. Both therapies were used for an hour with a 4-year-old nonverbal autistic child.Dr. Miller said he believed the demonstration showed that his method was superior, and he debated leaders of the California-based Autism Partnership, who support ABA. Directors of the Autism Partnership countered that the demonstration was flawed.

Jessica

42Miller vs ABAMiller vs. ABAJessica

43Research Support of the Miller MethodCurrent outcome research includes studies by Cook (1998), Messier (1971), Miller and Miller (1973), and Warr- Leeper, Henry, and Lomas (1999). It was reported that a comprehensive controlled study contrasting the effect of functioning while elevated with comparable functioning on the ground is under way at the Language and Cognitive Development Center in Boston.

Jessica

44Conclusions

What are your thoughts?

A lot of holes in the research behind the Miller Method

We would like everyone to stand on their chairs before asking questions this will increase body awareness, attention to surroundings, problem solving, perceptual motor coordination and the is first steps toward meaningful communication.

ReferencesAbout the Millers. (2009). Retrieved from http://www.millermethod.org/Cook, C. E. (1998). Implementation of the Miller method in an early intervention program for children with pervasive developmental disorder (PDD): A case study. (Doctoral dissertation, Kent State University). Cognitive Designs, Inc. (2008b). Sign and spoken language program. Retrieved from http://www.cognitivedesigns.com/sign.htmlCognitive Designs, Inc. (2008c). Symbol accentuation reading program. Retrieved from http://www.cognitivedesigns.com/symbol.htmlCognitive Designs, Inc. (2000d). Symbolic playthings. Retrieved from http://www.cognitivedesigns.com/playthings.htmlDiscussion forum. (2009). Retrieved from http://www.millermethod.org/Distance consultation. (2009). Retrieved from http://www.millermethod.org/For parents/caregivers of children with autism or PDD. (2009). Retrieved from http://www.millermethod.org/ReferencesFor professionals seeking training in the Miller method. (2009). Retrieved from http://www.millermethod.org/Miller, A. (1996, Spring/Summer). The Miller umwelt assessment. The Miller Method Newsletter. Retrieved from http://www.millermethod.org/Miller, A., & Eller-Miller, E. (1989). From ritual to repertoire: A cognitive-developmental systems approach with behavior-disordered children. New York: John Wiley & Sons, Inc. Miller, A., & Eller-Miller, E. (2000). The Miller method: A cognitive-developmental systems approach for children with body organization, social, and communication issues. The interdisciplinary council on developmental and learning disorders: Clinical practice guidelines: Redefining the standards of care for infants, children, and families with special needs. (pp. 489-515). Retrieved from http://www.millermethod.org/ Miller diagnostic survey. (2009). Retrieved from http://www.millermethod.org/What and where is the LCDC?. (2009). Retrieved from http://www.millermethod.org/What is Miller method?. (2009). Retrieved from http://www.millermethod.org/