I wanted to write an article about echolalia because I think it is something that affects many families of children with special needs. I found an excellent article which I discuss below that can help caregivers elicit more spontaneous speech with their child, specifically during mealtime.
What is echolalia? Echolalia is the repetition of sentences, phrases or words. It is commonly seen in children and adults with varying disabilities, but more specifically in Autism.
As humans, we naturally echo other people’s speech in some way, such as quoting each other, repeating stories, etc. As babies develop their own speech and language skills, they learn by imitating other people’s speech, which is typical and an important part of development. However, what is the difference between echolalic speech and delayed or disorder speech? To check out the difference between echolalia and delayed speech, read this article here.
There are many different perspectives of echolalia from caregivers, interventionists and other professionals. Some people view echolalia as meaningless speech that should be disregarded. Others find important significance in this type of speech. I found an interesting article titled Examining the Echolalia Literature: Where do Speech-Language Pathologists Stand? by Lillian Stiegler that took an in depth look at the origin of echolalia, the different perspectives, recent research and provided tips for interventionists and caregivers on how to facilitate more meaningful speech with an individual who is echolalic.
Is all echolalic speech meaningless? From my perspective, echolalic speech is not meaningless. I have usually found that those who present with echolalic speech often use this type of speech to connect with others in some way. For those individuals on my own caseload with echolalic speech, they often change their tone, add their own words or use unaided communication to augment the word, phrase or sentence they are repeating. Other times it’s a way to take a turn in conversation or connect with their communication partner.
What are the different types of echolalic speech? There is immediate echolalia speech, which is a person repeating back the exact utterance that you spoke to them. Then there is delayed echolalic speech that applies to utterances that are produced more than two conversational turns after the original utterance and is characterized by a higher level of linguistic complexity that the person generated independently (Stiegler, L., 2015).
In the research article Examining the Echolalia Literature: Where do Speech-Language Pathologists Stand?, the author found that echolalic speech has been used it for requesting, providing information, answering “yes” and maintaining conversational turns. For example, an individual with autism may struggle with what to say within a conversation, so he or she would repeat what the speaker said. It does not mean that this person doesn’t understand the sentence spoken to them, it just means that they are using it as a strategy to “take a turn”. Another example of echolalic speech would be answering a question. The individual may not know the answer so instead of saying “I don’t know” he or she might just repeat the question because they know they have to respond in some way.
Would you like to reduce echolalic speech with your child? Lillian N. Steigler (2015) recommended some excellent tips in her article, which I reworded and modified below with examples to use during mealtime given that this is a special time for families to come together and discuss their day.
1. Encourage initiating communication (for example, at dinner allow your child to start the conversation themselves by waiting and not asking questions immediately).
2. Look for indications of comprehension such as looking at you, moving their body in a position closer to you, gestures, etc. For example, during mealtime as you are discussing your day, your child repeats a phrase but moves closer towards you and adds a gesture.
3. Don’t ask too many questions. Try using fill in the blank prompts such as “At camp today, you played with _______”. When reading a book during mealtime, limit “wh” questions. Use fill in the blank or just wait for your child to comment but use a visual cue such as pointing at a picture and looking at your child for a responses.
4. Don’t teach scripted phrases which will increase echolalic speech (e.g. such as “May I have my dinner now?”). The author states “interventionists and partners should model carefully selected, individualized, age-appropriate, high frequency socially communicative utterances (e.g. “How was your day today?”).
5. Search for patterns of echolalia that encourage social closeness with others such as “I love you”.
For more ideas on how to increase spontaneous speech, check out this post here.
Stiegler, Lillian. “Examining the Echolalia Literature: Where Do Speech-Language Pathologists Stand?” Examining the Echolalia Literature: Where Do Speech-Language Pathologists Stand? American Journal of Speech Language Pathology, 10 July 2015. Web. 03 Aug. 2015. <http://ajslp.pubs.asha.org/article.aspx?articleid=2397394>.