Understanding Echolalia in Autism Spectrum Disorders

Echolalia is the precise repetition or echoing aloud of words, sounds, or sentences. An autistic child may repeat the words of people they know (family, friends and teachers) or say sentences from their favorite videos and films. I can remember when my son, Marc, was in elementary school he could repeat entire scenes word for word from the BBC’s Pride and Prejudice.

There are different types of echolalia. When a child repeats words right after they’ve heard them, that is called immediate echolalia. When words are repeated at a later time, this is called delayed echolalia. In the case of delayed echolalia, the sentences may seem unusual because they’re used out of context. Marc used to say, “Do you want to play some more?” any time he wanted to stop an activity because he heard that phrase from his speech pathologist who was trying to get him to continue with an activity when he wanted to stop.

Why do autistic children use echolalia?

Typically developing children begin learning language by first understanding and using single words, and then gradually stringing them together to make phrases and sentences. Autistic children learn language differently. Their first attempts at language may be more in chunks like phrases and sentences as they are unable to break down units of language into smaller parts. These memorized sentences may be more grammatically complex than they could construct on their own and the individual words may not be understood.

An example of this is a parent may say, “It’s time to eat your dinner.” Every time it’s suppertime, the child says that sentence – “It’s time to eat your dinner” –  but they are not yet able to use those words individually or understand their meaning. We can help children who use echolalia by teaching them how to break down longer chunks of language and understand what the individual words mean so that they can use them more flexibly.

Verywellhealth’s article Why Your Child With Autism Echoes Words and Sounds states 3 reasons why children use echolalia in speech patterns:

• Self-stimulation: Often called “stimming,” this use of echolalia speech patterns is meant as a calming strategy. The repetition can be used to cope with overwhelming sensory challenges.
• Prefabrication: The use of repeated phrases and scripts helps to communicate when it is too difficult or stressful for the speaker to form their own original words.
• Self-talk: Memorized phrases may help a child to talk themselves through a difficult process using phrases heard from parents, teachers, or television.

Repetitive echolalia speech patterns may be used for different reasons and those purposes can change over time. It’s also possible for a child to use echolalia for multiple purposes at the same time. Think of echolalia as a key first step toward more typical forms of spoken communication.

Echolalia is a way to communicate

In Hanen Certified SLP Lauren Lowry’s article 3 Things You Should Know About Echolalia, she listed a few reasons how echolalia can have a communicative purpose:

• To ask for things (e.g. a child might say “Do you want a cookie?” to ask for a cookie, as he’s heard others offer cookies this way before)
• To start an interaction or keep it going (e.g. a child might initiate a game of Hide and Seek by saying a line from the game, like “Ready or not, here I come!”)
• To draw someone’s attention to something (e.g. a child might draw attention to something he’s noticed by using a line he’s heard before to draw attention to something else, like “It’s a bird, it’s a plane, it’s Superman!”)
• To protest something (e.g. if a child imitates “You don’t want to wear those pants?” as his parent is getting out his clothes, he might really mean “I don’t want to wear those pants”) Note – I used this example about my own son at the beginning of this post.
• To answer yes (e.g. if a child imitates “Do you want some yogurt?” right after he’s been asked that question, he may actually want some yogurt and really mean “yes”)

When trying to figure out the meaning behind echolalia, look at the context and remember the time when the child may have heard the phrase. I used both of these techniques when trying to determine what Marc really meant to say when using the sentences he spoke. Keeping a language journal can be helpful too so that you can let other people know who are involved in a child’s life what those phrases really mean.

How to model language

Here are a few ideas on how to model language for a child who is echolalic:

• Use language that will still make sense and be appropriate if echoed. “Time for bed” works better than “Are you ready to go to bed?”
• Model short phrases even if the child can speak using long, memorized sentences. The child needs the simplicity to connect the meaning with the words even though their memory allows them to say longer phrases and sentences. We began with “I want ______” with our son.
• Avoid using questions if the child doesn’t answer questions yet.
• Use names instead of pronouns as pronouns are often confusing and not understood. Even as adults, both of my children struggle with pronoun usage.
• Expect comprehension difficulties. Children who understand language well do not routinely echo whole sentences to communicate.
• A child will need direct instruction on using pronouns and answering or asking questions, but for now, avoid them to minimize confusion while they master early speech and communication skills.
• Make comments on things a child is doing (while eating, playing, driving, bath time). For example, at bath time – “Washing your ears, filling the tub with water, pulling the plug.”

Be sure to use visual supports to help support language development, build vocabulary, and turn pictures into words. Keep modeling language, commenting, and speaking in simple sentences to foster comprehension. Think of echolalia as a stepping stone or a bridge to more flexible language.