The Miller Method® Best Alternative to ABA Therapy

The Miller Method® is a comprehensive cognitive-developmental systems approach designed to address the unique needs of children on the autism spectrum. It was developed by Arnold Miller, Ph.D. with Eileen Eller-Miller, M.A., CCC-SLP at the Language and Cognitive Development Center in Boston.

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The Miller Method focuses on four key areas: body organization, social interaction, communication, and representation. The method is used in both clinical and classroom settings to help children on the autism spectrum overcome developmental challenges and progress in a typical fashion.

The cognitive-developmental systems theory

The cognitive-developmental systems theory is at the heart of the Miller Method. This theory assumes that typical development depends on the ability of children to form systems, which are organized chunks of behavior that become more complex as children develop. These systems allow children to become aware of the distinction between themselves and their immediate surroundings. Children then combine their systems in new ways that permit problem solving, social exchanges, and communication with themselves and others about the world.

However, children on the autism spectrum often struggle with this process. They may become stalled at early stages of development and struggle to progress to more advanced stages. This is due to their difficulty in reacting to and influencing the world. They often lack a sense of the body in relation to the world and engage in scattered or stereotypic behavior.

The Miller Method uses two major strategies

The Miller Method uses two major strategies to help children overcome these challenges. The first involves transforming children’s aberrant systems into functional behaviors. This is accomplished by identifying the specific challenges that each child faces and developing strategies to address them. For example, if a child engages in lining up blocks, the therapist might work with the child to transform this behavior into a functional activity that involves building something.

The second strategy involves introducing developmentally-relevant activities involving objects and people. These activities are chosen to fill developmental gaps and help children progress to more advanced stages. The process is facilitated by narrating the children’s actions while they are elevated 2.5 feet above the ground on an Elevated Square or similar challenging structures. This elevation helps children improve their sign-word guidance of behavior and body-other awareness as well as motor-planning and social-emotional contact. It also helps children transition from one engaging object or event to another or from object involvement to representational play.

Parent Role

Parents play a critical role in the Miller Method. They are involved in the program from the beginning and work closely with therapists to ensure that their child’s achievements at the Center are generalized to the home and elsewhere. This collaboration helps ensure that children on the autism spectrum receive the support and guidance they need to overcome developmental challenges and progress in a typical fashion.

The Miller Umwelt Assessment Scale

The Miller Umwelt Assessment Scale (MUASC) is a tool used to understand the unique reality constructed by each behavior-disordered child. It is based on the concept of Umwelt, which refers to the subjective “world around one”. The MUASC helps in identifying the nature of a child’s reality and provides interventions to resolve their problems.

The assessment kit includes a manual, forms, and a videotape that introduces tasks that have been most helpful in this regard. For instance, the Swinging Ball task is used to assess a child’s reality system. A child who has achieved an expanded reality system will participate in the game of pushing the swinging ball back and forth with an adult. On the other hand, a child with a more circumscribed reality system may push the ball away each time it comes without noticing the adult who is sending it. Finally, a child may not even react when the ball collides with their body, indicating the most removed reality system.

The MUASC includes 16 tasks that help assess a child’s shift from the most circumscribed reality to more expanded realities. These tasks involve familiar situations such as coping with a Swinging Ball moving towards them, climbing up steps, walking across, climbing over or around various obstacles, and dealing with a step-slide arrangement, blocks, using rakes to get objects, cups and bowls that must be stacked in a variety of ways, and symbolic play, picture recognition, reading and number capacity, and awareness of people.

The assessment helps clarify a child’s developmental status in various areas such as body schema development, coping with the environment, social contact, and representation/communication. Once the child’s status in each of these areas becomes clear, teachers or clinicians can plan interventions that are relevant for that child.