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Echolalia & Autism: A Stepping Stone to Meaningful Speech.

“The opposite of talking isn’t listening. The opposite of talking is waiting” – Fran Lebowitz

Echolalia, a loaded term for sure, for many parents. It can reflect an impressive capacity for auditory memory and recall, but also, the challenge for reciprocal communication.   As a speech pathologist, I have found that echolalia is often not understood for what it is – a pathway for communication.  As you will read below, research has confirmed that these “chunks” of recalled verbage are actually symbolic representations for an actual message.  Our challenge as parents, educators and therapists is literally to “listen between the lines” for the true meaning, and to insert ourselves into this one-way conversation, to piggy back on the main idea, to pry, and to turn this language into a conversation! – Cris

Echolalia is a gestalt language-processing style, in which an individual repeats or imitates vocal behavior – whether their own speech, the speech of others, or verbalizations they’ve absorbed from media sources such as TV, movies, or the radio.

The gestalt processing style is where language is acquired and given meaning through learning a whole phrase or unit, rather than a single word. For example – the whole phrase ‘come get changed for bed’ simply means ‘bed’ to a child.

Echolalia can be immediate – or delayed.

+ Immediate: a child is repeating or imitating something they just heard (within two conversational turns). Example: “Justin, would you like a glass of water?” – Justin says ‘water’ instead of ‘yes’.

+ Delayed:  a child is repeating or imitating something that occured                                                                                                     previously, whether 2+ conversational turns ago, or days prior.

Echolalia is a hallmark of communication development for those on the spectrum. For years, echolalia was seen as a maladaptive and disordered behavior, but most experts now agree that Echolalia is ‘a bridge to meaningful, self-generated speech with communicative intent’ (1). With ASD and Echolalia, children associate a meaning, event, or emotion with vocalizations they’ve made, or heard from others/media sources.

For example:

  • Justin loves Cookie Monster – he thinks Cookie Monster saying “Me Want Cookie” is hilarious, and thus associates the emotions of ‘funny’ with “Me Want Cookie”. Justin will thus repeat “Me Want Coookie” during any situation he finds funny, whether related to Sesame Street or not.
  • Lisa associates the phrase ‘hold you’ with being held, as she has heard others asking her Can I hold you or Do you want me to hold you prior to picking her up in the past. Lisa requests you to hold her by coming up to you and saying ‘hold you’ instead of ‘Will you hold me?’.
  • You ask Alex “Would you like goldfish?” and he echoes “goldfish”. In this case, Alex could be meaning yes or no when he says goldfish.

Echolalia is a tool for those with ASD to “affirm, call, request, label, protest, relate information, complete verbal routines, [and/or] give directives” (1) as well as important means of self-regulation. Peers can support language development, social closeness, and relationship building through changing their interactive style with an individual displaying echolalia.

  • The repetitive nature of echolalia naturally allows for turn taking, and reciprocative commenting. Use comments, affirmations, and reflective questions to help facilitate advanced comprehension and language acquisition, through the echoing process.
    • When the child is echoing to request (4): model what they should say, and have them repeat the request // reply to what the child did say to clarify that their repetition did not convey what they meant (“No, I don’t want a cookie, but you doYou should say ‘I want a cookie’ instead of ‘You want a cookie’“).
    • When the child is echoing on questions (2, 4): there are multiple strategies to address expressive language acquisition, that help a child to answer questions.
      • Sometimes (2), it can be more effective to stop asking general questions (Do you want…. / yes or no?) and instead use a sentence stem model, to allow an individual to reply (Saying “I want___” and waiting for them to reply); this method can be supplemented with photo or object cues for those with more limited vocabulary – and the verbal answer can be modeled, once they’ve made their choice.
      • If the individual is replying to questions by repeating part of the phrase, rather than answering (yes/no, etc) – then the affirmations should be modeled, and practiced. Carrie Clark of Speech Language & Kids has a great ‘cheat sheet’ for Echolalia (4) that exemplifies how to utilize repetition to teach an individual how to spontaneously reply to a variety of questions, without using echolalia.

To learn more about echolalia, and strategies that can be implemented to build meaningful, self-generated communication – visit some of our favorite resources below.

Resources

1 – American Speech Language & Hearing Association | 7 facts about Echolalia 

2 – NoodleNook | Teaching Students with Echolalia

3 – iCanForAutism | Autism & Echolalia – four tips

4 – Speech Language & Kids | Echolalia Cheat Sheet

5 – CogniFit – Health, Brain, & Neuroscience | Echolalia

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Development: Holly Borg, Steve Lienhard & Melody Sharp

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