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A Review of the Miller Method

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1 A Review of the Miller Method
A Review of the Miller Method Lindsey Jessica Jaruczyk Heather Peltack Lindsey Gallagher Caldwell College Graduate Programs in Applied Behavior Analysis THE MILLER METHOD

2 A Review of the Miller Method
A Review of the Miller Method Lindsey Jessica Jaruczyk Heather Peltack Lindsey Gallagher Caldwell College Graduate Programs in Applied Behavior Analysis

3 “We maintain that each child – no matter how withdrawn or disorganized – is trying to find a way to cope with the world.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.” Lindsey Coping with the world – main objective? Philosophy (“What is Miller Method?,” 2009)

4 Founder of the Miller Method
Dr. Arnold Miller 3/11/ /27/2011 Lindsey Founder of the Miller Method

5 Who was Arnold Miller? Native of the Bronx, grew up on L.I.
Radio Operator in the Navy, World War II B.A. from City College of New York Doctorate in psychology at Clark University Austrian developmental psychologist Heinz Werner (mentor) Associate professor of psychology at the University of Montana (1960) Lindsey 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 life’s 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 wife’s 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 layman’s guide, “The Miller Method’’ (Kingsley, 2007). “Dad’s biggest contribution to the treatment approach is to say there is an inner child in there. He’s in there.’’ said Dr. Miller’s 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. Who was Arnold Miller?

6 Who was Arnold Miller? Married Eileen (Faythe), a SLP from NY
Opened development center in 1964 40 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 wife’s death Lindsey Who was Arnold Miller?

7 The Millers “From Ritual to Repertoire’’ (Wiley, 1989)
“The Miller Method’’ (Kingsley, 2007) Passed away 8/27/201 of pancreatic cancer Lindsey Published books “From Ritual to Repertoire’’ (Wiley, 1989) [theory] “The Miller Method’’ (Kingsley, 2007) [layman’s] The Millers

8 “Dad’s biggest contribution to the treatment approach is to say there is an inner child in there. He’s in there.’’ said Dr. Miller’s oldest son, Loren of Arlington, a filmmaker. “We can bring him out and we can leverage the parts of these two worlds.’’ Lindsey He’s in there…

9 History Founded by Arnold Miller and wife Eileen Eller-Miller in 1965
Language and Cognitive Development Center (LCDC) in Boston The 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 challenges Grants and research funded by U.S. Department of Education Lindsey History

10 What is the Miller Method
Lindsey What is the Miller Method

11 What is the Miller Method
The 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. Lindsey What is the Miller Method (Miller & Eller-Miller, 2000)

12 What is the Miller Method
Assesses the adaptive significance of the children's disordered behavior Attempts to transform the disordered behavior into functional activity Lindsey What is the Miller Method

13 What is the Miller Method
Attempts to expand and guide the children from closed ways (of living alone or in immediate circle like with parents) into social and communicative exchanges Guides 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 What is the Miller Method

14 What is the Miller Method
Lindsey What is the Miller Method

15 Assessments Miller Diagnostic Survey (MDS) Parent Survey
Few pages in length LCDC staff member writes a report of recommendations Goes directly to cognitive therapist and Dr. Miller 107 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 Heather Assessments (Miller, 2002c, Spring/Summer, “Miller diagnostic survey,” 2009,http://www.millermethod.org/)

16

17 Assessments Sign and Spoken (2 times beginning and end)
Receptive and Expressive Only start about 2 years ago School districts were asking for proof Heather Assessments

18 Assessments Umwelt Assessment (Once a year- Beginning)
Assessment to understand the world around you If you are an open or closed system What the child can and can not do Heather Assessments

19 Assessments Capacity to interact with a person and an object
Capacity to adapt to change Heather Assessments Problem solving and learning from experience

20 Assessments Vygotsky Test (Every time a videoconference was done)
Object identification Heather Assessments

21 Diagnosis Closed-system
Disorder Type A Type B Closed-system Dominated by only a few systems; unable to respond to any stimuli not related to their current system Minimal executive functioning Have multiple systems; move from one system to another; prohibit others from entering their systems Executive functioning with many objects/systems System-forming (Open- System) Unable to form systems due to poor sensory-motor coordination Unable to form systems because “too sensorily driven” by various stimuli Little executive functioning Heather A closed system are those children who are fixatated on spinning wheels and are ritualistic The way you expand this system is doing it slowly. His idea is that these kids are stuck in the rituals So his idea is to help them deal with the world by little by little breaking those systems and expanding them Change 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 expansion

22 No criteria for mastery
No data collection Heather Basic Treatments

23 Elevated SquareTM Virtual 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, Elevated SquareTM

24 Why 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 years More aware of themselves Increase eye contact More focused Able to communicate and learn Eliminates toe walking Heather Why the Elevated SquareTM?

25 Heather

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

27 Sign and Spoken Language
Relates objects and events to signs and spoken words Manual signs adapted from American Sign Language 4 segments Actions Food Familiar Objects/Events Two-word Combinations Heather Sign and Spoken Language

28 Sign and Spoken Language
DVD of Sign and Spoken Language Video 0 5:16 Video 1 1:45 HEather Sign and Spoken Language

29 Sign and Spoken Language
Helps children that don’t use words Repeat appropriate word while child is preforming action Narrating child’s action Heather Sign and Spoken Language

30 Receptive Last 2 to 3 years Sit with student Started data collection
“Show me get up” Student will do Jessica Just started data collection for whether the child can receptively or expressively identify the sign and spoken words. When school districts asked they began Receptive

31 Expressive Interrupting situations to elicit signs or words
E.g., on elevated square, “scavenger hunts,” videotapes in action The use of signs “pulls” spoken language and contributes to language development Jessica Expressive

32 Symbol Accentuation Reading Program
Teach symbolic function of printed words. Learn how to sight-read sentences in both large and small type Shift from sight-reading to phonetic reading Acquire letter-sounds relationships and blending and sequencing of letter sounds into meaningful words Stimulates active participation by both students and teachers Jessica Symbol Accentuation Reading Program

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34 Classroom Interventions
Pennies in the Jar Picture on Close pins Mr. Potato Head Nesting cups Light Bright Jessica Classroom Interventions

35 Individual Interventions
Becoming part of their world Puzzle Exchange Jessica Behavior throwing ripping Individual Interventions

36 Interactive Interventions
Tug of War Wagon Rides Teeter Totter Pig Piles Jessica Interactive Interventions

37 Schools Ages 2-12 1 in NJ 1 in Israel
Jessica believes it only works to age 5 1 in NJ Per student $65,000 50 students $3, 250,000 a year School districts only This does not include the aides or 1 in Israel Distance Consultations/ Video Conferencing Oversight Program (VCO’s) $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 videoconferencing Jessica Schools

38 Typical Day INSERT FULL DAY SCHEDULE Jessica Reciprocal face touching
Restabilizing Row row row your boat Typical Day

39 Criteria for certification Miller Method Specialist
4-day training workshops at LCDC Hours of supervision 50 weeks (1 hour per week) Cases covered Written 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. Criteria for certification Miller Method Specialist

40 Advice to Parents Jessica Miller & Parents

41

42 Miller vs. ABA in San Diego
Miller 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 Miller vs. ABA

43 Miller vs. ABA Jessica Miller vs ABA

44 Research Support of the Miller Method
Current 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 Research Support of the Miller Method

45 Conclusions What are your thoughts?
A lot of holes in the research behind the Miller Method Conclusions

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48 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.

49 About the Millers. (2009). Retrieved from http://www. millermethod
About the Millers. (2009). Retrieved from 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 Cognitive Designs, Inc. (2008c). Symbol accentuation reading program. Retrieved from Cognitive Designs, Inc. (2000d). Symbolic playthings. Retrieved from Discussion forum. (2009). Retrieved from Distance consultation. (2009). Retrieved from For parents/caregivers of children with autism or PDD. (2009). Retrieved from References

50 For professionals seeking training in the Miller method. (2009)
For professionals seeking training in the Miller method. (2009). Retrieved from Miller, A. (1996, Spring/Summer). The Miller umwelt assessment. The Miller Method Newsletter. Retrieved from 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 ). Retrieved from Miller diagnostic survey. (2009). Retrieved from What and where is the LCDC?. (2009). Retrieved from What is Miller method?. (2009). Retrieved from References


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