"To Be" or "Not To Be" That is Echolalia: ABA Sessions

While observing an ABA session this week, one of the things I found common in many children was the way they responded during conversations. They would constantly repeat certain words and phrases and only those phrases.

After the session, I learned that the term for this is Echolalia. This form of speech involves the repetition of words and sounds a person has heard or been asked recently.

Most children in early childhood mimic words and phrases that they hear their parents say or the people around them. Mimicry is an important stage in development that ensures a child is leaning core language skills.

However, what if this mimicry goes beyond early childhood? What does this mean for the child?

Echolalia is commonly seen as a “symptom” of autism. Parents usually point out that their child is "repeating what they say" during a diagnosis. There are two forms of echolalia called  immediate echolalia and delayed echolalia. Understanding the presence of echolalia helps understand how child is trying to process language.

Immediate echolalia refers to words or phrases echoed immediately after they are heard. For example, during the therapy session the clinician said, “time to go play,” and the child replied, “time to play”.  By repeating phrases the child does demonstrate that he or she can produce speech and efficiently reproduce it, but might struggle to comprehend what is being said.

For many on the spectrum, this form of echolalia is a way of communicating. The clinician explained that "sometimes immediate echolalia is necessary and for many  is a way to remain in a conversation and give an answer without feeling nervous or anxious”. It's like a desire to be included in a conversation without being sure of what to say exactly. While many parents feel frustrated and concerned for their child, immediate echolalia is still a good indicator that the child is trying to communicate.

If a child continues to repeat phrases for a longer period of time, then it is referred to as delayed echolalia. The phrase is repeated a day, month or even a  year after it was originally heard and can may pop up at any time or place. For example, the child I was observing loves to talk about nursery rhymes. Thus, he’d repeat “clap your hands” randomly as if he was watching a video at the moment.

The clinician explained that this other form of echolalia was a way to sometimes express mood. If a child is feeling happy and excited he’ll say something like “clap your hands” which is something he associates with a happy situation. This helps kids on the spectrum join in conversations without fully understanding the context. They will pick up on the mood of the conversation and repeat sentences that they associate with that mood.

To improve speech and prevent constant echolalia, therapists recommend PEC Cards (like cards with different pictures). Picture cards can provide visual cues that can help formulate different conversations. For delayed echolalia, redirecting conversations help bring the child back on topic.

See you next week with another topic from an ABA session!