Echolalia
Echolalia is the repetition or imitation of sounds, words, and phrases spoken by another person, and it is a normal part of language acquisition in children. While it can be associated with conditions such as autism, schizophrenia, and brain trauma, experts increasingly view echolalia as a form of communication rather than merely a behavioral symptom. There are two primary types of echolalia: immediate, where the repetition occurs within the same conversation, and delayed, where the person uses previously learned phrases in response to a context. For some children, particularly those with developmental disabilities, echolalia can continue beyond the typical age of language development and may include imitating lines from media or sounds from their environment.
Historically, treatment efforts aimed to reduce echolalia, but current perspectives emphasize its value as an indication of communicative intent, suggesting that it can facilitate future language development. Techniques have evolved to support those with echolalia in enhancing their communication skills, such as modeling appropriate responses and using starter sentences. Understanding echolalia can help caregivers, educators, and peers respond more effectively to those who exhibit this behavior, fostering a more inclusive and supportive environment.
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Subject Terms
Echolalia
Echolalia refers to sounds, words, and phrases repeated or imitated by one person after another person utters them. It is a normal part of the process by which children learn to speak. Echolalia is also considered a behavioral symptom of autism, schizophrenia, Tourette’s syndrome, brain trauma, and several other conditions. Treatment for these conditions often includes efforts to minimize echolalia. However, experts now believe that the practice is part of the person’s efforts to communicate, and it should be seen as a positive sign of future language growth, especially in autistic children.
Background
In Greek mythology, Echo was a wood nymph who talked to the goddess Hera and distracted her while her husband, Zeus, had affairs. When Hera discovered what Echo was doing, she cursed her so she could only repeat what others said. The word echo came to be used to refer to sounds that are repeated by a person or reflected by the acoustic arrangement of a room or natural formation, such as a cave or canyon.
Echolalia is part of the process by which children acquire language. A parent may ask a child “Do you want a cookie?” The child then repeats sounds that resemble the word cookie one or more times. The child may also imitate part of the sentence, such as “want cookie,” instead of the single word. To the child, that imitated word or phrase represents the entire thought “I want a cookie.”
This is part of the gestalt process, by which children acquire language. Simpler concepts represent more complex thoughts. For example, a child may hear the sentence “We’re going for a ride in the car” and associate the entire sentence with the simple designation “car.” By around the age of thirty months, most children shift from this form of communication to being able to separate other parts of complex phrases. Instead of hearing the word car and thinking it is time for a ride, the child can understand a parent who says “I’m going to wash the car.”
However, in some situations, echolalia is not phased out during the early preschool years. Children with developmental delays and disabilities, such as autism, continue to repeat words, phrases, or other things they hear, such as dialogue from shows and movies, animal sounds, or songs. For a time, it was thought that this was a symptom of the child’s condition. Part of the treatment plan would often include efforts to minimize echolalia. Many experts now believe that these children and those with other conditions who exhibit echolalia are demonstrating intent to communicate. They endorse methods and techniques to help build on the imitations or repetitions to help the person enhance language ability.
Overview
Speech experts identify two main forms of echolalia: immediate or delayed. Immediate echolalia refers to repetitions or imitations that occur during the same conversation, usually no more than two turns of conversation after the initial utterance. For example, a teacher may tell a child “Here is your book,” and the child replies with “Your book.”
Delayed echolalia refers to the repetition of something that the person has learned but has not been part of the recent conversation. The utterance is used in an effort to communicate something the person desires in place of a direct request for an object or action. For instance, a child who suddenly starts singing a commercial jingle for a fast-food place he often goes to with a grandparent may be trying to communicate a desire to go to that place or to see the grandparent.
Echolalia can also appear as part of a person’s efforts to self-regulate his or her behavior or to rehearse an action before it is completed. For example, a person who is asked to get ready for bed may start repeating the steps to getting ready aloud. The person may repeat these steps softly several times before beginning the process or during the process. This is seen as an effort by the person to guide his or her behavior.
The technique is also often used by children who are blind but for a slightly different reason. Without access to the usual visual cues used by those with sight, blind children use sound cues to determine who is in a room with them and where the person is located. As a result, many children with visual impairments will repeat words or phrases to generate responses from those around them to gain the information and sense of place they need.
Parents, siblings, teachers, and friends may become upset by the repetition that an individual with echolalia exhibits, especially if they do not understand the role it plays in the person’s condition. The delays in response while the person utters repetitive words and phrases can be frustrating. It can also be frustrating to try to understand why the person is repeating certain words or phrases. For example, a person with echolalia may suddenly start quoting dialogue from a movie that includes inappropriate language because she is experiencing the same emotion as the character from that movie. This is the person’s way of trying to communicate that emotion, but it may happen at an inappropriate time, or someone who does not understand echolalia may misinterpret it.
For many years, the treatment for people who exhibited echolalia was to try to extinguish the behavior. Experts have come to understand the role it plays in communication and now see it is a positive sign that the person is trying to communicate. Instead of endorsing extinction of the practice, experts now encourage those who live and work with people who exhibit echolalia to guide the person to be able to communicate more fully.
Experts suggest a number of techniques to help the person expand his or her communication skills. Caregivers can teach those with echolalia the appropriate response to routine questions, such as “What is your name?” They can rephrase questions so that the echoed response will be an appropriate answer. For instance, they might say “John wants water?” instead of “Do you want water?” They can ask the question and softly model the answer by saying something like “Do you want a hamburger…I would like a hamburger.” The use of starter sentences is another possibility. For example, the caregiver might say “I want some ‗‗‗‗,” while holding up a glass of water.
Bibliography
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“Echo and Narcissus.” Auburn University, www.auburn.edu/allynbaconanthology/documents/EchoNarcissus.pdf. Accessed 15 Sept. 2018.
Heffner, Jeffrey. “Echolalia—Repetitive Speech.” Synapse, www.autism-help.org/communication-echolalia-autism.htm. Accessed 15 Sept. 2018.
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“Stop Copying Me! Echolalia and Autism.” Speech Science, 17 Dec. 2017, www.speechscience.org/16-schoolbased-issues/2017/12/17/stop-copying-me-echolalia-and-autism. Accessed 15 Sept. 2018.
Stubblefield, Heaven, and Ana Gotter. “Echolalia.” Healthline, 28 Oct. 2016, www.healthline.com/health/echolalia#outlook-and-prevention. Accessed 15 Sept. 2018.
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Vicker, Beverly. “Functional Categories of Immediate Echolalia.” Indiana Resource Center for Autism, Indiana University Bloomington, www.iidc.indiana.edu/pages/Functional-Categories-of-Immediate-Echolalia. Accessed 15 Sept. 2018.