Echolalia: What it Means and What to Do (and not do!)
If you’re new to the concept of echolalia, be sure to check out our first blog post on this series, Echolalia: Repeating Words and Phrases.
Most children go through a period of developmental echolalia. During this time, children repeat back words and phrases modeled by their caregiver. Generally speaking, use of echolalia begins to decrease around the age of 30 months. Children continuing to use echolalia after 30 months should be evaluated by a speech and language pathologist as they may be a gestalt language learner.
Children who continue to use echolalia may have a ‘gestalt processing style’ (Blanc, 2012). Children who are gestalt learners, start by learning entire units/sentences of speech. Over time, children learn to break down complex sentences into individual words and then recombine those words to create unique messages.
As gestalt processors learn how to break apart and recombine these sentences, it is vital to acknowledge that their use of echolalia serves a purpose.
What an Echolalic Phrase Means:
Many individuals still operate under the mistaken idea the repeated phrases are just that - repeated phrases. From this viewpoint, these echolalic messages are ‘random’ and don’t serve any communicative function.
More recent research and information shared by individuals who use(d) echolalia themselves paint quite the different picture. All information shared, including echolalic phrases, has a meaning and is communicated for a purpose.
Sometimes, the meaning of an echolalic phrase is very clear.
Child: “do you want juice?” while holding out his cup for juice (asking for juice)
Child: “it’s okay” while brushing themselves off after a fall (letting people know he or she is not hurt)
Child: “It’s a big fire truck and has five lights, that’s a lot” while showing off a new toy (showing/sharing a new toy)
While the child requested juice using the question form, it’s not a far leap to realize that the child is asking for juice. Children who use delayed echolalia may ask for items using the question form since that is what is modeled by their parent/caregiver. Because children are repeating back phrases said *to* them, pronouns used or the perspective of the sentence may be different than what you would expect from a child who is an analytic language learner.
Other times, the meaning of phrases and sentences can be less clear. Since children who use echolalia learn language in complete chunks, sometimes entire phrases are used when only a portion of the phrase is applicable. As a result, children can use seemingly unrelated phrases to communicate a thought or idea. In other instances, a child can use delayed echolalia to communicate a feeling experienced at another point in time. The relationship between the phrase and the initial incident may have been clear to all listeners but the link to the new incident/situation may be less clear. It can take a little detective work to identify the communicative function of the phrase.
Child: “The thunder and lightning is far away” in response to a loud noise in the classroom (caregiver response to an event that previously scared the child).
Child: “The lions are sleeping, maybe next time” (used to communicate that something was closed or no longer an option for that child).
Some children may repeat the same phrase(s) multiple times. This can be done to self-regulate or as a form of engagement with others.
Remember, gestalt language learners are still learning how to deconstruct and reconstruct verbal communication. If a child is not yet sure how to initiate interactions or engage in relationship-building communication using unique phrases, that child will use whatever they currently have available in their repertoire. Therefore, it is not uncommon for children to use the same phrase (delayed echolalia) to initiate social engagement with others.
Barry Prizant and the Indiana Resource Center for Autism have put together a great chart outlining additional examples for functional categories of delayed echolalia.
What to Do:
Because echolalia serves a purpose, it’s important that we support children using echolalia and treat communication attempts the same way we would respond to uniquely generated communication attempts.
Identify the purpose of communication - gather information from caregivers, keep track of when phrases are used to notice patterns.
Respond to the comment based on what the child intended to communicate.
Model multiple ways to share the same message.
Use scripted/echoed sentences in multiple settings to expand the function.
Provide examples of age appropriate phrases and scripts a child can use for interactions and in different settings.
Combine multiple phrases/scripts in different ways to highlight how language can be combined.
Treat an echoed phrase in the same way you would treat a uniquely created phrase - build conversations, make comments, ask questions.
What not to do:
We much prefer to focus on ‘what to do’ as we believe in searching for and highlighting positive exchanges. However, all too often adults treat echolalia solely as a ‘behavior’ and not as functional language. As a result, adults try to extinguish the ‘behavior’ of echolalia - typically by ignoring. This is not recommended and takes a very narrow viewpoint of the complex nature of echolalia.
Our biggest ‘don’t do this’ is “don’t ignore”. When asked why adults ignore echolalia, the typical responses include:
They already shared that message
I already answered that question and I’m teaching them to only ask a question once (or I’m teaching them they need to listen to my answer)
If I don’t respond, that’s telling them they need to share something new/different
If I respond, they’ll never learn to share their own thoughts and ideas
The problem with this viewpoint is that it is assuming that all children learn language in the same way. Children who have an extended use of echolalia are telling us that they do not learn language in the same way - they learn language a little differently. Different is not wrong. Children who learn differently do not need to be ignored until they start learning another way (and ignoring children doesn’t help them learn skills!).
If a child is repeating the same information multiple times, it’s important to first highlight the function of that message. Is it self-calming? Is it a way for a child to initiate interaction? Is it a way to protest or share something is wrong? Once you’ve identified the function, model additional ways to achieve that function or alternative ways to request that information. The key here is to model - not demand or require a child change their current way of communication.
In the meantime, use the above “What do Do” recommendations to help expand a child’s communication. Also, consult with the child’s speech-language pathologist for specific strategies tailored to that particular child and for individualized ways to support that child’s language development.
As a child’s expressive language grows, their use of echolalia naturally decreases. This happens because echolalia is no longer needed to communicate. Children will generate spontaneous and unique messages when they have the skills and ability to generate spontaneous and unique messages. Until that time, it is our job to respect their current mode of communication.
References:
Blanc, M. (2012). Echolalia on the spectrum: The natural path to self-generated language. Autism Asperger’s Digest, March/April, 2013.
Prizant, B. M., Wetherby, A. M., Rubin, E., Laurent, A. C., & Rydell, P. J. (2015). The SCERTS model: A comprehensive educational approach for children with autism spectrum disorders (Volume 1: Assessment). Baltimore, MD: Paul H. Brookes Publishing Co.
Wetherby, A. M., & Prizant, B. M. (2000). Autism spectrum disorders: A transactional developmental perspective (Volume 9). Baltimore, MD: Paul H. Brookes Publishing Co.
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