Echolalia in autism can be confusing for educators and parents who are trying to teach their child or student to talk. They are happy the child is verbal, but aren’t sure how to guide the child from echolalia to spontaneous, flexible speech.
WHAT IS ECHOLALIA IN AUTISM?
Echolalia is simply the repeating or echoing of what someone else has said. This can be repeating sounds, words, phrases, or sentences. Repeating words is actually a normal part of language development in young children! It is a phase that they pass through when learning how to speak from those around them. After learning these single words, young children will start to string them together to speak in phrases and eventually sentences. The difference with some autistic children is that they seem to get “stuck” in this phase. They also may echo more than just single words. Many times, children with autism will repeat long sentences without understanding what each word means. These sentences are often more complicated in a grammatical sense than what they could come up with spontaneously. An example of this might be a child with autism who says “It’s time for you to go to bed” when his parents bring him into his bedroom at night. He has linked that phrase with that routine, but really doesn’t know what each of those words mean (e.g. “it’s”, “time”, “go”, “bed”), but knows that the chunk of words together goes with the activity he is doing. He doesn’t use these words spontaneously in other sentences and if his parents pointed to his bed and said “what is it?”, he may not be able to say “bed” on his own. Speech/language pathologists and other professionals usually consider language to be “echolalic” when most of the words or phrases used by the child seem to be repetitions that they have heard vs. new utterances that they come up with on their own.
AUTISM AND ECHOLALIA: WHAT ARE THE DIFFERENT TYPES?
There are different “types” of echolalia in autism. One is “immediate echolalia”, and just like it implies, it is when someone immediately imitates something they have heard. For example, you might say “what is it?”, and the child repeats “what is it?”. Sometimes, in echolalia, the child echos the entire sentence, and other times, they repeat the last couple of words in a sentence. An example of this would be “what do you want for lunch. Pizza or hot dog?” and the child says “hot dog”. If you switch up the choices and say “hot dog or pizza” they will say “pizza”. When the words are repeated at a later time, it is called “delayed echolalia”. An example of delayed echolalia would be a child who says, “do you want to go outside?” when they are getting their shoes on. This is likely a phrase they have heard many times, that is linked with that routine. Delayed echolalia might also consist of lyrics to a song, line from a favorite book or movie. That brings us to “scripting”. Scripting is when children can recite long lines or scenes from shows, cartoons or movies.
WAYS AUTISM IN ECHOLALIA CAN BE HELPFUL
ECHOLALIA’S EFFECTS ON PRONOUN DEVELOPMENT
HOW YOU CAN HELP SHIFT ECHOLALIA IN AUTISM
You’ve learned about what echolalia in autism is, the different types of echolalia, and some of the functions of it. Now, the focus should not be on stopping the echolalia, but on expanding language so you can build a bridge to spontaneous language. I would definitely start by doing a language sample and tracking the number of echoed words and phrases. I’ve done this with students and was able to come up with a percentage, such as “48% of utterances were immediately echoed”. This way, you can track this over time to see if your intervention is reducing the amount of echolalia and increasing the spontaneous flexible production of utterances. We can help children who use echolalia by directly teaching them identify and label vocabulary and verbs in pictures and then moving on to combining them into short phrases. It is also important to teach them to imitate motor actions and to follow one-step directions, so you are targeting comprehension vs. just imitating what you say. For information on how to do this, you will find a list of my past blog posts and FB Lives on these topics. As these communication skills develop, often with visual supports to add structure, the echolalia will start to diminish. Another important piece of this is to implement an effective communication system to help the child learn to INITIATE communication. With young children with autism, I often start with a communication book, like PECS (the Picture Exchange Communication System). The great thing about PECS is that it teaches children to initiate communication rather than only respond to what other people say. This is HUGE for teaching children to spontaneously communicate. I will be addressing how to make a low tech communication book in a blog later this month. As the child learns to initiate communication using a book with visual choices, at the same time that they are working directly on their receptive language skills, you should slowly see a reduction in echolalia. Let’s go back to that lunch example. If you are spinning your wheels when you give your child or student “choices”, think to yourself, “how can I make this visual for now so I can ensure understanding?”. So, if you say “do you want a hot dog or pizza” and the child just repeats whatever the last word or couple of words in your sentence are, try offering a choice board with the two options. Say “what do you want” and put your hand out. See if they will give you the picture. For me, this has helped a lot and has also prevented meltdowns in the lunchroom. I’ve had students who are echolalic simply repeat the last thing I say (hot dog), so that is what was sent to the lunch room as their choice. Then, we get to the lunchroom and the hot dog is placed on the tray and the student has a huge meltdown because they actually wanted pizza. THIS can be the problem with echolalia and why a “backup system” for communication can be so helpful. One last helpful tip is to use visual sentence strips around the house and classroom to practice structured labeling. For example “I see ….” or “It’s a ….”. Click here for your free set. The pictures are a bridge to help with communication and understanding.
Additional Resources & Trainings:
Click here for free sentence starter strips.
Click here for your free echolalia language sample form.