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Therapy Strategies for Echolalia

Nancy Creaghead, Ph.D

December 13, 2004

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Question

What are the best resources for therapy strategies for children (3 yrs.) who appear to have echolalia. What are the best therapy techniques for the parents to do at home?

Answer

It's hard to answer this question without more information. Some of the reasons why a three-year old child might use echolalia include: (1) lack of understanding of the questions, (2) inability to formulate an answer, (3) lack of understanding of the pragmatics of questions -- i.e. that an answer is expected. One theory is that children may echo because they understand the pragmatics of turn-taking (that a response is expected) but they are not able to provide an appropriate answer because they do not understand questions or because they are not able to formulate answers. Echolalia can be a strategy for at least providing a response. It's helpful to try to determine why the child might be using echolalia and whether the child is exhibiting other language problems that may be related.

Barry Prizant and colleagues have discussed the possible functions of echolalia for children with autism. The theory is that, like other seemingly meaningless or inappropriate behaviors, echolalia may actually convey communication intent. The child may not be able to formulate appropriate language for the purpose or situation, and the only way that the child can develop a response may be to copy what someone else has said. A detailed analysis of the context in which the echolalia is used might be helpful in determining if it is related to a pattern of communicative intent. The following are several articles on this topic.

Prizant, Barry M., and Judith Felson Duchan. "The functions of immediate echolalia in autistic children." The Journal of Speech and Hearing Disorders. 46, No. 3 (1981) , pp. 241-9.

Prizant, Barry M., and P J Rydell. "Analysis of functions of delayed echolalia in autistic children." Journal of Speech and Hearing Research. 27, No. 2 (1984) , pp. 183-92.

Prizant, Barry M. "Language acquisition and communicative behavior in autism: toward an understanding of the "whole" of it." The Journal of Speech and Hearing Disorders. 48, No. 3 (1983) , pp. 296-307.)

If the child seems typical in other ways, I would suggest that the clinician and family might try to provide answers that the child might use in response to questions -- take advantage of the imitation by providing appropriate answers to be copied. I have seen young children use echolalia when they were not able to answer questions. The problem, of course, is that it is non-productive to repeat the question. Helping the child see what an answer looks like has sometimes helped. This can be easier with more than one child or another adult to serve as a model.

I don't know if the child in question is on the autism spectrum or if the child is typical in other ways. Some additional information about the child might be helpful in providing some suggestions if this information is not helpful.

Nancy Creaghead is a speech-language pathologist and professor at the University of Cincinnati, where she teaches in the area of language disorders in preschool and school-age children. She can be reached at nancy.creaghead@uc.edu.

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