“Mrs. Striner, you called the meeting—why don’t you begin? We appreciate the agenda you prepared.”
The school psychologist gestures for me to start. I take a deep breath. Where do I even begin?
“Before we dive into the agenda, I want to bring us back to why we’re here—Sienna. Over the past several weeks, we’ve noticed an exciting increase in her speech. She’s eight now, and for years we’ve tried to pinpoint exactly what’s been holding her back. It’s not Apraxia. She’s been evaluated for Autism, and while that wasn’t the conclusion, she wasdiagnosed with anxiety. So is it the anxiety that’s interfering? The truth is, it’s been an ongoing challenge—at times, a mystery. I know in my heart that she has so much to say.”
I pause. “Just before spring break, something shifted. Her speech therapist noticed a few things…”
We’ve known since Sienna was little that she uses echolalia. She can quote entire scenes from Sesame Street. And when she or her sister says something funny, it tends to make her highlight reel. She’ll repeat it, again and again. One of her current favorites? ‘Shut up, Haley.’
Everyone laughs—six people sitting around the table—and I smile, then continue.
“I attend her speech sessions weekly. Her therapist often asks where certain phrases come from—TV? A family memory? She compiled a four-page list of all the spontaneous phrases Sienna has used in sessions. As I looked them over, it hit me: many of these phrases hold meaning. They’re not random. They’re associations. They’re glimpses into how her brain works—little puzzle pieces that, when understood, start to reveal the bigger picture of who Sienna is.”
Some phrases made contextual sense. Others didn’t. But the common thread was their intent. Her therapist explained how difficult it’s been to collect concrete data on Sienna. She’s elusive that way—she only participates when she’s comfortable, when she wants to. And that makes evaluating her so difficult.
I turn to her learning support teacher. “You know what I mean. It took months to build trust with her. But once you did? She soared. The problem is, starting over every school year like that takes a toll. It affects her academic growth. And the only evaluations the district has done have come from strangers observing her in brief spurts. That doesn’t reflect who she is—or what she’s capable of.”
Her outpatient speech therapist recently recommended evaluations for the following: Exposure Anxiety, Pathological Demand Avoidance (PDA), and Gestalt Language Processing.
Another breath.
“There’s currently one doctor in Pittsburgh diagnosing this constellation of traits, and the waitlist is long. Sienna’s appointment is scheduled for January 2026.”
I let that sink in before continuing.
“That’s why I called this meeting. After diving into all of this—after years of wondering—I believe we’ve found the missing key. I finally understand how to unlock Sienna’s voice. But I can’t reach the door to unlock it. That’s where you come in.”
Let’s talk about Gestalt Language Processing.
“Sienna doesn’t acquire language the way most of us did. Her brain doesn’t isolate single words and build from there. Instead, she learns language in chunks—through phrases, music, and emotionally resonant moments. Sometimes her phrases are spot-on. Other times, they appear out of context, but they always hold meaning.”
Someone asks, Can you give us an example?
“I can. Bluey is one of her favorite shows. She really connects with Bingo, Bluey’s younger sister—who’s sensitive, silly, and often overlooked. In one episode, Bingo is excluded from play and sits alone, singing a song: ‘Poor little bug on the wall, ding ching. No one to love her at all. Ding ching.’”
When Sienna sings this, it’s her way of telling us she feels sad. But unless you’ve seen the episode, you wouldn’t recognize it for what it is. I have dozens of examples like this. They’re called gestalts. And this is where we’re running into a wall. Most of the available research focuses on the autistic population. Should we revisit the possibility of an autism diagnosis? She was evaluated a few summers ago, but perhaps it’s time to explore that again.
Personally, after reading about Exposure Anxiety and PDA, I believe we’re dealing with both. And yes—an autism diagnosis might be the easier route. I’m open to pursuing another evaluation if that’s what opens doors. Use whatever language, whatever label, gives her the support she needs. My only hesitation? The current political climate in this country. A year ago, I wouldn’t have thought twice about labels. But everything feels different now.
I understand that Exposure Anxiety and PDA are psychological conditions, and I know the district can’t formally assess them. But I believe they are directly impacting Sienna’s academic experience.
What we can do is implement better strategies—ones rooted in the Natural Language Acquisition (NLA) framework. It’s a full program. It may even be something the district already has access to. But we need to track her gestalts across settings. We need shared context between school and home so we can work as a team.
We need to update her IEP.
We need consistent, trusted adults in her life so she’s not constantly starting from scratch.
So with all that in mind… where do we begin?”
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