12 Feb Echolalia: What is it and What to Do

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Echolalia — What is it?

You may have observed echolalia, you may have heard the term before, or it may be a foreign concept to you altogether. Echolalia is a type of imitative communication behavior in which a person repeats, or “echos” sounds, words, or phrases they hear. These repetitions might be heard from familiar people (i.e. family, teacher, classmate), or might be something they have heard on TV or in a song. It can be confusing to understand the concept and the message of a speaker using echolalia—so it is crucial that we understand what it is, and equally what it is not. Echolalia is not inattention, a lack of desire to engage, a lack of intelligence, or an inability to learn language. Echolalia is often associated as a function of autism spectrum disorder (ASD), but it can also be seen in individuals with aphasia, dementia, traumatic brain injury, and schizophrenia. This post will focus on the types, underlying causes and expressions of echolalia when used by children with ASD, as well as ways to support and foster language growth for these children.

Echolalia should be viewed as a bridge to learning language for individuals who learn language differently. The more that we seek to understand the different ways that people communicate and learn language, the better we can come to understand our unique differences and improve our communication and connection. The more we understand about echolalia, the better we can come to understand the intended message of the individual and help to foster their continued language development.

Immediate vs. Delayed

Echolalia is commonly categorized as either immediate or delayed echolalia. Immediate echolalia occurs when a person repeats back the message they hear immediately. If a child asks their classmate, “What did you have for lunch today?” and the classmate directly repeats back the question verbatim, they are using immediate echolalia. The second type is delayed echolalia, when a child repeats back something they have heard hours or days before. For example, a child might come home after school and before dinner say, “It’s time to line up,” repetition of a rule emphasized by the teacher earlier in the day before lunchtime. Because of the time delay in delayed echolalia, the words often seem out of context and the message of the individual can easily be confused.

Why do children with ASD use echolalia?

In many cases, echolalia is an attempt to communicate with reciprocal conversation, practice communication, or learn language.

  • Communicative Purpose → Echolalia is oftentimes an attempt to communicate a message. Although the message content may seem out of context, or in an unclear grammatical form, there are ways to help decipher the meaning from the message. Similar to all communication attempts, echolalia is used to initiate and maintain conversation, ask for things, draw someone’s attention to something, and agree or protest. For example, when asking for ice cream, a child might say, “Do you want some ice cream?,” as they’ve heard their parent offer ice cream this way before. If a child imitates, “Do you want to go to the park?” immediately after being asked, the repetition of the question might be a “Yes!” response.
  • Difference in Language Learning → Many children with ASD learn language differently. Typically developing children generally learn language by understanding and using single words. Around 2 years old, these children will begin stringing 2 words together. In contrast, children with ASD often learn and practice language in “chunks.” These children will learn phrases and short sentences, without necessarily understanding what the individual words mean. They commonly have a difficult time breaking down the phrase or sentence into smaller parts. For example, a child might say, “It’s time for you to go to sleep,” when their mom turns off the light, as they associate bedtime with the phrase. The child can produce this repeated phrase heard in the past (delayed echolalia), but would have a difficult time understanding the words on their own (“it’s,” “time,” “for,” “you,” “to,” “go,” “sleep”). Because the child does not understand all of the individual words, they can misuse certain words (i.e. pronoun “you”).
  • Delayed Language Learning → Repetitive speech is a common process of language development. Young children learn language by repeating words and phrases they hear, mixed with production of their own words. Typically developing children reduce this repetitive speech pattern around the age of three. Although most children with ASD or speech and language delays develop independent thought, some will continue this repetitive speech pattern into childhood as they continue to learn language.
  • Processing time → Immediate echolalia is sometimes used as a way to “buy time” while the child processes the language of their communication partner, and decide what they want to say. Echolalia in this form is an attempt to remain in conversation, stay on topic, and process a response.
  • Self-calming / Self-stimulating Tool → In some children, echolalia is used as a self-calming tool when they are anxious or overwhelmed with a sensory challenge. For example, if a child is in a new situation and feeling stressed, they might repeat phrases aloud they have heard from their parent (i.e. “breathe, everything will be alright”). Echolalia can be used as a self-stimulating behavior, in the same way that you may see a child with ASD use hand-flapping, rocking, or other self-soothing behaviors.

 

For Parents, Caregivers, Therapists

How to Support a Child Using Echolalia for Communication

  • When you don’t understand the child’s message, think about the context of the current situation, and if possible, think back to the time the child might have heard the words or phrase for the first time. It can be difficult to determine a message’s meaning, but context and understanding the child’s perspective can help.
  • Break down the larger “chunks” of language into single words. Teach the meaning of the single words to help the child learn to mix and recombine their words to form their own messages.
  • Model the correct form of the question, comment or request for the child. For example, if you ask your child, “do you want some water?” and they respond, “do you want some water?” and you have determined that their intended message is “yes,” model the correct response for the child – say “Yes, I want some water.”
  • Follow the child’s lead. Observe the child, and watch and listen for subtle clues about their message when you are communicating with them. You may want to jump in, with follow up questions and comments – instead, give ample wait time for the child to respond or repeat their message.
  • Echolalia can sometimes be very frustrating for a child whose message cannot be understood. Be patient, help the child to break things down to foster the child’s development and communication.
  • As children who use echolalia regularly in their speech begin to develop more language and learn to break down the chunks of speech, they will begin to produce more unique messages and reduce their echolalic speech. Celebrate this growth in language development, and continue to foster it. Echolalia may become more prevalent when a child is stressed, confused, tired or frustrated.

 

Echolalia is a form of communication. Although it can attract negative attention, and has some adverse effects on the child if they can not communicate their wants and needs, echolalia should not be looked at as something that needs to be “extinguished.” Although possibly delayed or different, the child is learning to express their wants and needs, and this growth should be celebrated and fostered.

 

References

  • Lowry, Lauren. 3 Things You Should Know About Echolalia. The Hanen Centre. www.hanen.org/Helpful-Info/Articles/3-Things-You-Should-Know-About-Echolalia.aspx.
  • Rudy, Lisa  Jo. (2020, January 16). “Why Does My Child With Autism Echo Words and Sounds?” Verywell Health. www.verywellhealth.com/why-does-my-child-with-autism-repeat-words-and-phrases-260144.
  • Schaber, A. (2014, August 14). Ask an Autistic #18 – What is Echolalia? [Video]. YouTube. https://www.youtube.com/watch?v=ome-95iHtB0.