What is Echolalia? Technically Echolalia refers to the meaningless repetition of words or phrases spoken by another person. It occurs in autism, cerebral palsy, and other language-related disorders. It was initially considered a symptom of language impairment.

Stimming behavior involved in the restricted, repetitive movement of motor organs, e.g., articulators, is considered a culprit for Echolalia. However, with more research and knowledge of language development, neuroscientists now consider it a learning strategy for children who are still developing their vocabulary & language understanding skills. Furthermore, Echolalia is an adaptive response to create an auditory feedback loop. This article will discuss why one should not block Echolalia. What kind of role echolalia plays in language development? How can you turn your child’s echolalic speech into functional speech and language?

Echolalia: Why does it occur in autism?

Echolalia occurs in children with autism because of a lack of appropriate pragmatic or communicative skills. As we know, Autism Spectrum Disorder (ASD) is a neurobehavioral developmental disability that can affect how someone communicates, behaves, and learns. People who have ASD often see, hear, and feel things differently than other people do. These differences can cause them to naturally repeat what they’ve heard or seen, as they might be needed a little longer processing time. This repetition sometimes occurs without understanding or meaninglessly.

Echolalia: What to do?

 If your child repeats words constantly, try not to give attention negatively when he does it. The more you respond, like telling him ‘no’ or correcting his speech – the more likely he will keep repeating those words! Also, limit TV time as this may encourage kids to mimic commercials and cartoons.

Your child may have limited language; therefore, try to expand his vocabulary. This can be through games, flashcards, books, or other activities that teach words and develop communication skills. Extention & expansion are helpful strategies to build up language in this scenario. However, you need to join the child’s thinking pace. The following blog will provide you with further detail on joint attention.

Also see: http://terteeb.org/blog/2021/05/24/joint-attention-an-important-tool-for-communication-cognition-development/

Echolalia & Gestalt learners:

One great way to get kids who repeat phrases beyond imitation is by asking what they mean instead of telling them what it means. For example, if a kid says, “Blue car is going fast,” you could ask him questions like “What does ‘fast’ mean?” or “Why is the car going fast?“. You’ll notice he might not know the answer. This means he is a gestalt learner and going through Naturalistic language acquisition. An estimated 75-90 % of autistic children acquire language this way. On the other hand, neurotypical children learn nouns first, then adjectives and verbs. Later they start joining them. And start communication with meaningful, grammatically correct sentences. However, the echolalic child has a different language learning hierarchy. Therefore, when teaching your child, never assume he understands just because he’s repeating something back and fro. Always check for understanding first with yes/no questions before giving further instructions. Always remember! Socially appropriate language use is based on receptive language, not expressive language.

Strategic Plan for Echolalia:

 More recently, theories have suggested that overall stimming may provide regular and reliable self-generated feedback in response to difficulties with unpredictable, overwhelming, and novel circumstances. If you’re looking for a way to turn Echolalia into functional speech and language, the first step will be to set your child up with phrases that can be used in real-world situations. Like the previous quoted example, If a kid says, “I want an apple,” you could ask him questions like “What does ‘want’ mean?” or “Why do you want an apple?”. You can use this situation in role-play with dolls and toys. Remember! The use of carrier phrases may provide more meaningful context to understand the meaning of the particular word.

Echolalia: Use as a Language Learning Strategy

Echolalia is a learning strategy among neurodiverse children. It can help children expand their vocabulary. Additionally, ASD children express their feeling or emotion related to that particular situation through Echolalia. Understanding how echolalic speech works before you attempt to teach your child new words or phrases is helpful.

There are many different ways that Echolalia manifests. For example, ask your child, “What does this do?” They may respond with what they heard (and not know what it means) by saying, “What does this do? This does……”

This response comes from immediate imitation without understanding the meaning behind the repeated word or phrase. Another common form of Echolalia seen in individuals who use language repetitively is script-based repetition. When an individual repeats a phrase or question word-for-word and does not answer with his own. Some examples of script-based responses include:

“Do you want juice?”

Response: “You want juice!”

Or asking what they would like to do on Friday night and getting back an exact repeated response such as “I don’t know” (instead of answering the question).

Noun echolalia refers to using words without any functional purpose (i.e., saying “water” when you want water but don’t know how to ask for it). In contrast, the verb echolalia consists of using phrases without having any real meaning behind them (for example, “I go now” instead of “I’m going home now”).

Turning Echolalia Into Functional Speech And Language

Turning Echolalia into functional speech can be achieved by involving children in conversations about their favorite topics. Maintaining joint attention with them while speaking rather than eye contact is essential. It would help if you also looked at questions requiring more than one-word answers – instead of asking, “Do you want some water?” say something with an auditory hook like, “Hmmm! it looks like you are thirsty; what do you want?” This strategy enhances social skills by encouraging children to listen carefully.

Another option will be throwing simple questions back at them if they have sufficient language. So they have no choice but to answer. For example, if a child says, “I want juice,” you can respond with, “Do you want some orange juice?” while having apple juice in hand. This strategy also enhances social skills by encouraging children to listen carefully.

Following are a few suggestions to incorporate into a strategic plan to facilitate functional language acquisition:

1. Turn-Taking
2. Requesting
3. Verbal Completion or Auditory Clouser
4. Interactive Labelling
5. Rehearsal and Pretend play
6. Situation Association and Story Telling

Difference Between Functional and Non-Functional Echolalia:

Functional Echolalia has some communicative intent. At the same time, non-functional Echolalia is an auditory self-regulatory mechanism (of course, it’s a function). Moreover, functional Echolalia is spontaneous and higher-pitched, and the child may use it unconsciously at this stage. Non-functional Echolalia is deliberate, slower, and lower pitch. The child is often aware of how others respond when hearing them repeat phrases.

How To Tackle Echolalia:

It may be that the child is simply echoing what they hear because of its pleasurable effect on others. In this case, you might want to think about how you respond when hearing his echolalic phrases, perhaps ignoring them altogether. It’s a challenging area to address, and it’s worth checking with an SLP for guidance before implementing any strategy.

Alternatively, sometimes the child knows what and why he is saying. This is because he has a limited vocabulary and can’t access the language semantics. In this case, social stories might help to teach alternative ways of asking for things. Communicative play is helpful as well.

Stages of Echolalia

There are four stages of echolalia, according to Gestalt.

Examples of the stages of Echolalia to self-generated grammar: What stage do you think your child is in?

1. Stage I Immediate & Delayed Echolalia: At this stage child repeats the whole utterance, poem, song, or dialogue along with intonation. Although, the child does not understand the meaning of his utterance at this stage. However, some feelings or emotions are associated with intonation and delayed Echolalia.
   • The use of carrier phrases is a saver at this stage.
   • Expention & extension are the best communicative strategies at this stage.
2. Stage II Mitigated Echolalia: The learned echolalic phrases are chopped into small chunks and then mixed and matched. For example, “Give me a blue car” and “Let’s have fun” could be mitigated at stage II as “Blue car, have fun.” Usually, at this stage, sentences are grammatically incorrect.
3. Stage III Isolation & single word: Echolalia is further mitigated as single words at this stage. These single words are used to make a two words phrase. For example, “car go,” “Blue have.” Language at this stage looks regressed compared to the previous stage because it does not follow any grammar rules. Modeling the correct language and parallel speech are your handy strategies for this stage.
4. Self-generated: At this stage child use bit longer sentences with incorrect grammar. Gradually, the mean length of utterance starts increasing. For example, “I want” “I want out”, “I want out go”, I want out go now”.

Conclusion:

To sum up, verbal stimming or Echolalia is a form of imitation; therefore, it plays a vital role in language acquisition. Moreover, Echolalia provides significant opportunities to learn motor planning and strengthen the auditory cortex along with auditory feedback. The multidisciplinary team is required to work in collaboration to turn your child’s Echolalia into functional speech.

Reference:

https://www.healthline.com/health/echolalia#outlook-and-prevention

http://www.hanen.org/Helpful-Info/Articles/3-Things-You-Should-Know-About-Echolalia.aspx

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Field, E. (2020). Building Communication and Independence for Children Across the Autism Spectrum: Strategies to Address Minimal Language, Echolalia and Behav or. Jessica Kingsley Publishers.

Gernsbacher, M. A., Morson, E. M., & Grace, E. J. (2016). Language and speech in autism. Annual review of linguistics, 2, 413.

Luyster, R. J., Zane, E., & Wisman Weil, L. (2022). Conventions for unconventional language: Revisiting a framework for spoken language features in aut sm. Autism & Developmental Language Impairments, 7, 23969415221105472.

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