Echolalia and Speech Therapy

I had this “aha” moment the other day when I was reading more about echolalia. Echolalia is when a person echoes a word or sentence that someone (or even something like a TV) speaks. For a really good paper on it, go here.

Many high-functioning autistic adults say that nouns and verbs make sense to them because they can picture what that is. Literally they see a picture of “jumping” and know what someone is talking about. But filler words have no meaning. Words and concepts like “Will, faith, To Be, etc” have no concrete visuals to assign to it and therefore are much more difficult to process.

After reading that if FINALLY made sense why H. can’t say YES! The word yes has absolutely no meaning for him. He doesn’t say it because it has not value to him. When I ask him “Do you want carrots?” he looks at me and says “carrots.” No matter how hard we work on having him answer yes, it is the noun or the verb that describes what he wants that he answers with. When he was little(er) he would come bring his toys to us and say their name, like “Woody!” We would answer “yea” or nod our heads. And it was like this response wasn’t good enough – he would just stand there and say “Woody! Woody. Woody” until we responded with “Woody.” He was looking for confirmation that he was naming something correctly and that he got it right and us nodding or saying “yea” had absolutely no weight because it doesn’t mean anything to him. He wanted us to say the name of what it is.

Now that I grasp this, it makes it much easier to see if from his perspective. It would be like going up to someone in a foreign land saying “Is this a bathroom?” and having them respond “QPDRUVG.” We would just sit there and say, “so is that a yes or a no – is this a bathroom? Bathroom?” Until they responded in a way we could understand, hopefully with an affirmative “bathroom.”

Getting H. to assign a value to the word Yes is one of the things we are working with a Speech Pathologist on. It is super unnatural for him so we’re working hard on it. He’s actually pretty good at “no” for the most part so it’s just transitioning him away from repeating the noun or verb that he is favoring and does want for the word yes.

Most people who see H. in public don’t know he’s autistic. He’s high-functioning, imitates other kids, plays with other kids (for the most part), and is super friendly. He’s a happy kid and other kids seem to like him (thankfully). It is when you try to have a conversation with him that something clicks and you’re like “ok there’s something different here.”

Here’s are some definitions of echolalia and examples from our home:

Echolalia is reflective of how the child processes information. The child with autism processes information as a whole “chunk” without processing the individual words that comprise the utterance. In processing these unanalyzed “chunks” of verbal information, many children with autism also process part of the context in which these words were stated, including sensory and emotional details. Some common element from this original situation is then triggered in the current situation which elicits the child’s echolalic utterance.

Me: “Do you like Buzz Lightyear?”
H: “Buzz Lightyear, the coolest toy ever! He shoots lasers…” etc (I don’t remember the whole line, but it’s from Toy Story 3)

Conversational turn taking: The child recognizes when he is to take a conversational turn and that some sort of response is required. However, the child lacks the spontaneous generative language to engage in the conversation, so he relies upon an echolalic utterance to take his “turn” in the conversation.

Me: “H. how was school today?”
H: “Learn ’bout numbers and letters.”

Initiation of communicative interactions: The child is beginning to recognize and notice others. Because he lacks the spontaneous generative language skills to initiate a communicative interaction with someone, he uses an echolalic utterance.

Friend: I’m xxxx, and I’m 3
H.: “Hi, my name is H. about spring is flowers” (in school he memorized a line to say when they held up his name. Now we can’t get him to stop repeating the entire line – which is missing “my favorite thing”…before the spring part.

Utterances that may be used as self-direction for his own actions.

He self-talks all the time to help get through tough situations.
Me: “It’s time for bed”
H: “Park! Park! Park!”
Me: “No right now it’s time for bed.”

H: “It’s time to jump in bed.” or “You can go to the park after you take a nap”

Indicating affirmation in response to a previous utterance

Me: “Did you have a nice nap?”
H: “Did you have a nice nap?”

Requesting: The child uses echolalia to request a desired object, action or event.

Teacher: “Do you want ranch with your broccoli?”
H: “Do you want ranch with your broccoli?”

The great thing about echolalia is that is can be a really positive sign because if he can echo he can talk. And at least he has language. The key is turning that language into conversations that make sense to both the utterer and the receiver. H. loves his SLP and is so good about going, playing, talking, and cleaning up at the end. He’s really getting the hang of it! And we learn how to help him better. It’s been really good.


2 thoughts on “Echolalia and Speech Therapy

  1. ok-long comment: I am a SLP working in early intervention in the Jordan school district and I LOVE how much you retain from your therapy sessions! I am also a HUGE proponent of getting OT involved for kids with sensory difficulties; they are magicians when it comes to self-organization and explaining feeding and all kinds of stuff. I am glad that you like your SLP, I generally see a big difference when families are involved and carry-through on the techniques we try during therapy. Are you still doing the GAPS diet?

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