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Echolalia and Autism

Lillian Stiegler, Ph.D

June 26, 2006

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Question

I am currently working with a 5 year old child who is certified as having Autism Spectrum Disorder through the school system. What advice should I offer the parents regarding how to deal with and approach a child who quotes lines from movies, books and o

Answer

I believe your client is using echolalia. Echolalia is a fairly common, but unconventional verbal behavior. Some children with autism spectrum disorders will repeat what another person says within one or two conversational turns after the original utterance, and this behavior is called "immediate echolalia". What your client is demonstrating, however, sounds like "delayed echolalia". That is, he/she is repeating others' utterances hours, days, or longer after they are originally produced.

Echolalia can serve a variety of communicative and/or noninteractive functions. For example, an echoed utterance may be used as a turn filler. If the child would like to participate in an interaction, but doesn't have the language comprehension/production skills to be able to formulate an original response, he/she may simply offer an echoed utterance. It is as if the child is saying, "I want you to know that I'm with you, but my language isn't developed enough to be able to converse with you." On the noninteractive side, echolalia is sometimes produced as a response to anxiety-producing situations.

Individuals may avert eye contact and repeat long chunks of discourse from a video or speaker; Dustin Hoffman's character did this in the movie Rain Man. This can be viewed as an unusual strategy for self-calming. For more on the various communicative and non-interactive functions of echolalia, see the seminal work of Prizant & Duchan, 1981 and Prizant & Rydell, 1984.

Echolalia can be annoying to individuals who see it only as pathological communication behavior. It can, however, be viewed as a valuable bridge toward more conventional use of language. As your client's overall language skills improve, it is likely that the echolalia will decrease somewhat. Rather than trying to decrease or control it as simply a maladaptive behavior, I would urge the parents to learn as much as they can about echolalia, and (with your help) try to figure out if their child is using echolalia communicatively, noninteractively or both. This will help determine the best ways to respond whenever he/she uses echoed utterances.

Imagine the following scenario: This child is with his family at a busy ice cream parlor. Every one else is ordering ice cream cones. The child with autism says, "Help me Obi Wan Kenobi! You're my only hope!" Obviously, this is not conventional ice cream ordering language, but if the family recognizes and interprets it as a means of requesting a turn to order...something good can happen. They can respond by pointing out choices. If the child cannot attend to multiple choices presented verbally, perhaps choices can be offered visually, in a binary format. The important thing would be to figure out the intention behind the echoed utterance, then respond appropriately. This will take time, trial and error, and probably some tantrums along the way, but it would be well worth it.

Dr. Lillian N. Stiegler has been a speech-language pathologist for 23 years. She is associate professor of communication sciences & disorders at Southeastern Louisiana University where she teaches courses on autism spectrum disorders, early language intervention, and neurophysiology. Dr. Stiegler resides in Covington, LA.


lillian stiegler

Lillian Stiegler, Ph.D


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