What you need to know about Echolalia

Communication

One day I was hanging out with some friends and we were all swapping funny autism stories.  I shared my story with the punchline, “And that’s why delayed echolalia is a mom’s best friend!”

But there was one person who didn’t laugh.  She looked confused.  She asked,

“What’s Echolalia?”

Echolalia is the repetition of phrases, words or parts of words.  Echolalia may be a sign of autism, another neurological condition, a visual impairment or a developmental disability.

Almost all toddlers go through a stage in which they “parrot” words and phrases that they overhear.  Mimicry is an efficient way to experiment with different sounds and practice emerging social language skills.  This is a normal and critical stage in language development.

But what does it mean when this stage goes far beyond the toddler years?  What is the function of echolalia?

In her book Helping Children With Autism Learn, author Bryna Siegel writes, “There are two basic forms of echolalia: immediate echolalia and delayed echolalia.  The presence of these tells us something about how the child is trying to process language.”

Immediate Echolalia

When a person repeats back something that he or she has just heard, that is immediate echolalia.  For example, if a parent says, “It’s time for a bath,” the child may repeat, “Time for a bath.”  Siegel comments that by repeating back the words, the child is demonstrating that she can hear accurately, can physically produce speech and can remember it long enough to reproduce it.  The next step is comprehension of speech, which may take months or years to develop.

The Reason for immediate Echolalia

Some adults with autism explain that immediate echolalia is a way of communicating, “I heard what you said, and I’m still processing it.”  Immediate echolalia is an attempt to remain in a conversation and give an on-topic answer, before the meaning of the conversation is fully grasped.

One way to increase comprehension during a conversational exchange is to offer visual or tactile supports – or to involve as many senses as possible.

For example, my kids love the story about Curious George getting sprayed by a skunk, but no matter how much I explained with words, they didn’t understand what that smell was…until I stopped the car one afternoon and rolled down the windows.  “Boys, that’s the smell of skunk spray,” I said.  My children were overjoyed, because they finally understood!

Echolalia MeltdownMeltdown Potential

A common scenario in the autism community is the meltdown caused by a misunderstanding of immediate echolalia.  A caregiver will ask a child, “Do you want grapes or apples?”  The response is almost always the second choice, “Apples,” and the caregiver assumes that is what the child actually wants.  The child then starts screaming uncontrollably when presented with apples, because the child responded while still trying to comprehend the two choices — and preferred the grapes all along.

PECS or picture cards are a great way to introduce choices or transitions, and thus prevent meltdowns.

A Desire for Conversation

Siegel concludes, “For most children, immediate echolalia is a developmental phase that occurs when they begin to understand the function of words but can’t always decode what a word means soon enough to give a specific and relevant reply.”  It is important to realize that immediate echolalia represents a desire for inclusion in conversation.  Even more importantly, immediate echolalia is a desire to comprehend and learn language.

Delayed Echolalia

Many people like to memorize and recite “catch phrases,” or sometimes whole paragraphs – perhaps scriptural verses, inspirational or historic speeches, or funny scenes from the movies.  As long as the phrases are repeated in an appropriate social context, this is a widely accepted social behavior.  Delayed echolalia is the repetition of phrases after a period of time – several minutes or a year after the phrase was originally heard – and the phrases may pop up any time, any place.

Here are three possible reasons for delayed echolalia.

1. Self Stimulatory Behavior

Delayed echolalia is sometimes a self-stimulatory behavior with the sole purpose of satisfying the speaker.  My older son has always enjoyed reciting sentences that he reads in books.  I came to realize that he sees the book in his mind, and entertains himself by “reading” his favorite sections over and over.  The line “George, what’s that smell?” came from the Curious George story about the skunk, and leads to hysterical laughter.

He also repeats sections from his favorite videos, as if watching the video inside his head.  When delayed echolalia is used for personal entertainment in this way, it can prevent real-life interactions.  The caregiver can take this as a cue to re-direct gently to a more constructive activity.

2. Communicating the Mood

In my experience as a parent, delayed echolalia is often an impressionistic way of communicating mood.  If my son hears a sentence such as, “The pool is closed today,” and experiences disappointment, he will repeat that sentence every time he feels disappointed.

A sentence that inspires a feeling of joy and elation such as, “Our hotel room is on the 17th floor,” will be repeated every time he feels joy and elation.  If he does not fully understand the content of a conversation, but wishes to participate, he will pick up on the general mood of the conversation and repeat sentences that he associates with that mood.

In these situations, my strategy is to acknowledge his emotions (“I remember how happy you were at the hotel in Niagara Falls, and I see that you also feel happy now”) and re-direct him to the present circumstances.

3. A Day in Review 

Delayed echolalia can also be a way to process memories as they come bubbling up to the surface of the mind.  My son used to come home from preschool and recite phrases and sentences that he heard during the day: the good, the bad and the ugly.

He especially liked to repeat what the teacher said to other children who misbehaved – he even captured his teacher’s tone of voice: “Kevin, we keep our shoes on in school.”  “Joey, we use gentle hands.”  “Tommy, we don’t stick our hands in the urinal.  It’s not a waterfall.”

For me it was like getting a daily news report of the major events at preschool.  My son was communicating to me that his school was a loving, supportive environment, and that he enjoyed his teachers and classmates.  And that’s why delayed echolalia is a mom’s best friend.

Karen
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  • http://specialchildren.about.com/ Terri Mauro

    Totally agree about the value of delayed echolalia for getting a report of the school day. One caution, though: If your child is repeating things said at school when he gets home, he’s also probably repeating things said at home when he gets to school. So if you’re, say, upset with a paraprofessional, beware of saying something like, “That aide needs to do her job!” where your child can hear, if you don’t want some very awkward school meetings to follow.

    • http://www.facebook.com/profile.php?id=1556774338 Karen Wang

      Yes, it’s true that echolalia can be very embarrassing for the caregiver!  I quickly learned that I had to watch everything I said around my son, because my words would be repeated at the most inopportune moment possible…sometimes a full year after I said something.  My son is especially known at school for repeating everything I say to him when he gets into trouble.  His good-humored teachers have informed me that I have no secrets.  But that’s another story.

  • Deerhart23

    Many people only associate Echolalia with autism and I am glad you pointed out that it occurs with other conditions as well.  We watched our son go through both of these stages, watched him take the delayed echolalia and eventually applying the phrases appropriately (and usually with sarcasm and humor) in conversations.

    And yes we have seen the whole movies, etc running in his head as well (especially when he was bored) when he was younger.  That too eventually turned into inspiration to take those things and change them to his own preferences/wants, and spinoffs.

    In the end it was my child’s CAPD that was causing the echolalia so it eventually melted away.  But they sure where some interesting years.

    • kvl

      I have a almost 3 year old who has both immediate and delayed Echolalia, although he has language ( and some social) delays, he was NOT diagnosed with Autism.  Just wondering when your child’s echo began to fade, and functional speech began?  My son is in O.T  3 times a week, and we are seeing tiny pockets of spontaneous individual speech.  The only diagnoses we recieved was a receptive language disorder

      • Deerhart23

        He had functional language at the same time but the echolalia started to disappear by the end if kindy (and a year if earobics) and was completely gone by the start of 2nd grade.

        It was also in this same time that we saw huge improvements in his overall language and closed most of the gap in testing, raising from verbal IQ in the low 70′s to about 100 at start of 1st grade and 2nd grade results around .

        At age 3 we had a lot of parroting with an answer after it, which moved to using heard phrases responses to things. They would make perfect sense if you knew where the phrase came from. Now we only here it if he is trying to confirm that is what he really heard, which everyone does he just may do it a little more often because of the CAPD

  • http://twitter.com/CommGreenhouse Comm Greenhouse

    Thanks for this great post! So important that SLPs see the communicative value of echolalia and use it as a starting point for planning therapy. I’ve see way too many instances where the first reaction was to try to extinguish this rather than use it to the child’s advantage.
    Carole
    http://www.PrAACticalAAC.info

  • http://twitter.com/spectrum_life Leigh Forbes

    A great post, thank you! I don’t have echolalia, but I do enjoy memorising things – and, when I fail to stop myself, I will still come out with (for example) Shakespearian speeches that I learned at school.

  • darmom

    This was a really insightful article!  It definitely answered many questions about a condition that has been extremely puzzling at times.

  • http://www.HorizonsDRC.com/ Nicole Beurkens

    Great article!  I would also add that another reason for delayed echolalia can be a need to cope in the moment.  I know many individuals with neurodevelopmental disorders who, when overwhelmed or overstimulated, will begin to script/use delayed echolalia as a way to try to help themselves feel more of a sense of control in the situation.  They are trying to process everything that is happening, but often cannot.  In an attempt to help pull themselves back together and feel more secure they will begin repeating things (scripting/delayed echolalia).  Whenever I hear individuals doing a lot of repetitive talking like this it is a signal to me that they are overwhelmed and can’t process effectively in the moment.  Reducing the pressure and overwhelm usually helps them be able to process more effectively and the repetitive speech stops.  Just another thought for those of you who see this in your kids/people you work with.

    Thanks again for the informative article!

    -Nicole Beurkens (Licensed Psychologist)
    http://www.HorizonsDRC.com

  • Tcattcs

    I’m looking around because of a concern I have about a coworker and I’m wondering if this is it.  She constantly repeats sounds. She’ll repeat the doorbell every time it rings, or a door slamming. When walking outside she’ll repeat the sounds of birds immediately and as many times as the bird makes the noise like she has to respond.  What’s going on?

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