It’s no secret that verbal repetition and imitation are important parts of early speech and language acquisition. Speech and language input create a framework for children to understand their environment, say first words, learn new vocabulary and exercise increasingly complex functions of communication. As children hear language around them, they begin to assign meaning, repeat words and eventually use language in novel ways to become independent communicators.
Echolalia, a form of verbal imitation, is one of the most common characteristics of communication in people with autism spectrum disorder (ASD). Although previously seen by some as maladaptive behavior, an increasing body of evidence led most experts to recognize echolalia as a bridge to meaningful, self-generated speech with communicative intent. As speech-language pathologists, we play a part in helping family members and fellow professionals understand the important role echolalia plays in language development and communication of people with ASD.
Here are seven important facts about echolalia for SLPs to know and share:
- Echolalia represents a gestalt language-processing style. This means children first assign a single unit of meaning to longer segments of spoken language. What a child initially perceives as “comesitdownatthetable” may simply mean “table” to them, for example. Gradually, the child can isolate smaller and smaller parts from the original phrase and use individual words and grammatical structures to produce original sentences. Children with autism essentially learn language from the top-down, rather than bottom-up.
- Echolalia can be immediate or delayed. Immediate echolalia occurs within two conversational turns of original language input, whereas delayed echolalia occurs after more than two conversational turns take place. When a child repeats learned routines or phrases that are more complex than they can formulate on their own, that usually signifies delayed echolalia. Though delayed echoic responses may not fit current conversational context to an unfamiliar listener, they often relate personally to the child. For example, a repeated sentence or phrase can represent a significant memory, emotion or area of interest.
- Echolalia is a verbal behavior, not a vocal stereotypy. People with ASD might echo their own speech, the speech of others and/or audio media from radio or television. Echolalia always involves repetition of verbalizations in some form—not vocalizations. SLPs can help distinguish true echolalia from non-speech vocalizations such as vocal stereotypy.
- Echolalia supports relationship-building and social closeness. In addition to supporting language acquisition including vocabulary and syntax development, echolalia creates opportunities for people with autism to interact and engage with others through conversational turn-taking. This verbal reciprocity supports relationship-building and social-emotional closeness with others.
- Echolalia serves a variety of communicative purposes. Echolalia provides a way for people with autism to affirm, call, request, label, protest, relate information, complete verbal routines and give directives. Nonverbal indicators of engagement and comprehension, such as eye gaze, body language and gestures are often observed in combination with echolalia.
- Echolalia aids self-regulation. Most experts say echolalia improves communication even when a specific function of communication can’t be identified. Even when a child’s echoes seem out of context, for example, echolalia still supports important aspects of cognitive functioning including rehearsal, learning and self-regulation.
- SLPs can support language learning through interaction. Following a child’s lead by using low-constraint language models—like comments, affirmations and reflective questions—can support natural language development in children with ASD who demonstrate echolalia. This sets up a facilitative interaction style, which can yield more sophisticated communication with higher levels of comprehension—for example, requesting information or commenting.
By recognizing differences in language learning styles, defining echolalia, and embracing its social, communicative and cognitive functionalities, we can positively influence the way echolalia is perceived and treated. Widening our scope of treatment options helps increase language-learning opportunities for people with autism.
Kylie Grace Davis, MS, CCC-SLP, is a school-based SLP in southwestern Colorado. email@example.com