All About Echolalia
As children learn to talk and communicate with others, it is common for them to repeat what they’ve heard. By age 3, frequent repetition of words and phrases will typically subside. For children with Autism Spectrum Disorder (ASD) or other developmental delays, however, repetitive speech or echolalia, often continues to present further into childhood. Echolalia can negatively impact socioemotional wellbeing, as it can result in difficulties communicating with others and expressing one’s thoughts and feelings. Keep reading to learn more about echolalia, and how we can best help children with echolalia find their own voice.
Background on Echolalia
Echolalia is the repetition of phrases and noises that have been heard before. For example, immediate echolalia may present when a parent asks his child, “What do you want for breakfast?”, and the child immediately responds with, “What do you want for breakfast?”. Delayed echolalia may present when a parent asks his child, “What do you want for breakfast?” and the child answers with a phrase he’s heard hours/days earlier, “Buzz LightYear to the Rescue!”.
Children with echolalia do not respond with these repetitive phrases on purpose; oftentimes, it may be how they learn language and attempt to communicate with others. Below we will discuss the different types of echolalia, as there are two main categories: interactive echolalia and non-interactive echolalia. Interactive echolalia is attempted communication with others, while non-interactive echolalia is meant mostly for personal use. Below please find two tables that describe interactive echolalia and non-interactive echolalia in more detail.
If your child has ASD and is exhibiting echolalia, research tells us that there are patterns in the way it progresses into more flexible and spontaneous speech. Thus, there is comfort in knowing that echolalia can be a useful stepping stone to spontaneous speech.
How to Treat Echolalia
In order to effectively treat echolalia, it is important to understand why the child is repeating or echoing, as all children use echolalia for different purposes. Some children use echolalia because it is how they best communicate wants/needs, while other children use echolalia to self-soothe.
This is where it becomes important to be your child’s own detective; observe your child and his/her interests, listen carefully, and wait patiently without talking. After determining what it is your child needs/wants, be your child’s interpreter by using specific strategies listed below. These specific strategies may be implemented either in speech therapy with a skilled speech-language pathologist, or in the home setting:
|When echolalia is due to delayed language skills
- Instead of targeting echolalia, target building vocabulary and overall language skills
|When echolalia is used to request
- Model correct sentence/question for him/her to repeat. Slowly build awareness to the error
|When a child echoes the last word of questions (e.g., “do you want milk?” Child: “milk”)
- Choose one question type (“do you want it?”)
- Ask the question and immediately answer it (“do you want it? yes”); hopefully the child will learn to only imitate “yes”. If not, prompt child to imitate “yes” (or “no”, depending on question)
- Keep asking the question type, but slowly fade cueing by providing only the first sound of the answer (“do you want it? y-y-y…”)
- Continue asking the question type, and fading cueing by mouthing the first sound of the answer
- Once one question form is mastered, start over with a different question form (“what is this?”)
|When a child echoes your praise (e.g., “What does the cow say?” Child: “woof woof! Good job!”
- Repeat the correct answer, pause, and then give the praise. Use the same fading system as above.
|When echolalia is self-stimulatory
- Some children use echolalia as a form of comfort, since it is predictable (e.g., repeating favorite tv scripts/movie scripts). Other times, it is because children are bored. If the child is using echolalia in an environment where it is acceptable (e.g., home), it is okay and recommended to continue letting your child do so. If it is an unacceptable environment (e.g., classroom), it is important to figure out why the child is using echolalia. Analyze whether a child is stimming because he/she is stressed, and find alternative ways to de-stress the child. If a child is bored, use gentle reminders to tune him/her back into the present activity.
Speech-language pathologists and their team will be able to help determine more of why your child is displaying echolalia, and how to best help him/her. If you live in Florida, please call Exceptional Speech Therapy to receive a free screening and/or comprehensive speech-language evaluation, both virtually or in-person.
As always, we wish for your child to be a successful communicator, all the while being happy and enjoying the loveliness of childhood.
Andrea Scola, M.S., CF-SLP
Exceptional Speech Therapy Blog Writer