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Think back to being a new parent. You are sitting in the kitchen with your baby in a high chair, and while you are spooning food into their little mouth you instinctively say things to them like: “here comes the airplane” or “open” or “yummy apples”. One day, the baby repeats “airplane” or “apples” and you are overjoyed.
This type of interaction is typical and it is a great example of how children learn language. They hear a word, they watch your mouth when you speak and they start to babble. Eventually the babbling is a little more controlled and they begin to make the same shapes with their mouths and they try to imitate what they hear. If they make a mistake, mom or dad is usually quick to show them how to make the sound or the word. Just think about how many times you may have pointed to your own mouth and said “say mmmmm” when you were teaching a baby how to say “mama”.
The whole process of learning how to speak is one of the most naturalistic forms of learning that we experience as babies and young children. But at some point, the repeating fades and as the baby learns how to manipulate words and make requests, they form their own thoughts and learn how to say them out loud to communicate what they want or need.
Very simply put, by age one most babies have a small arsenal of important words that they use. Mama, Dada, doggie, kitty, baba, num nums, ball and other important words that help them to acquire people or objects or gain attention.
By age two, words become short statements like “gimme ball” or “I want ball”. The statements aren’t very complex, just enough to get what they need but not enough to really explain anything in detail or reason. By age three, there is a little more complexity to a child’s communication and it is easier to ask them questions and get answers. For example: “what’s wrong, baby?” and the baby says, “I fell down!” Voila! We have communication.
After the age of 2 ½, the imitation and repetition of words should decrease and independent thoughts and words should become more pronounced. When a child with autism has echolalia, word and phrase repetition happens as an immediate and involuntary response to words and phrases that have just been spoken by others. Delayed echolalia is also an involuntary repetition of words and phrases but the response is not immediate. Delayed echolalia can present itself later the same day or several days later and continue for a prolonged period of time. For example, after watching a movie a child with autism can repeat a line from the movie over and over again later that day and continue the echolalia for several days or longer.
When to Seek Treatment for Echolalia
Throughout all of this learning, there has been plenty of repetition of words and phrases. But, what happens when the repetition of words and phrases doesn’t stop by the expected age? Rather than a “yes, please” to the question “would you like a cookie?” the child repeats your original question back to you and says, “would you like a cookie?” Or maybe they just repeat the last word of a phrase and answer with “cookie”.
Like any good parent, you may wonder at what age you should start to be concerned enough to seek advice from a professional. The right answer is this…when you feel concerned. There is nothing harmful about having your child examined for speech deficits at an early age. If something is wrong, you have an early start to finding the right resources to help your child and if there is nothing wrong at all, you have peace of mind that everything is going as it should.
Why Your Child With Autism Echoes Words and Sounds
Children with autism use echolalia for many reasons. In the early stages of developing language, children with autism will use echolalia to learn words and phrases just as their typically developing peers would.
Right around the age of 2 ½, the typically developing child will start to reduce the amount of echolalia and communicate their own thoughts with the repertoire that they have stored.
When a child with autism continues to use echolalia beyond the age of 2 ½ , there is a purpose to it. The most obvious purpose is to communicate. For example, if you visit grandma and you walk into her house and she says, “say hello to grandma”- a child with autism is likely to respond with “say hello to grandma”. This isn’t the ideal response, but it is a response and it is communication so it is a good starting point.
Some children with autism may use echolalia as a sensory outlet (automatic response). The act of repeating words or phrases can have a calming effect on the child with autism.
“Self talk” is another form of echolalia that might help a child with autism through situations that cause stress or confusion. They may have a phrase that they can repeat that keeps them from responding inappropriately in certain settings. For example, in a room full of people that becomes too loud or overwhelming a child with autism may repeat a phrase such as, “excuse me, it’s too loud” or “can we go now?” to indicate that they need to step away from the crowd or the noise.
Echolalia is sometimes the first indicator of autism or developmental delays in a young child who is just learning how to speak. Depending on the severity of it, there are various ways to treat this speech deficit by determining how and why your child is using the echolalia.
5 Tips on How to Treat Echolalia in a Child with Autism
If your child is using echolalia, it is always best to seek out professional help from your pediatrician. Your pediatrician will most likely refer you to a developmental specialist who will inevitably refer you to a speech pathologist or therapist.
Speech therapists can help to determine what type of echolalia your child is using. The two main types of echolalia are immediate and delayed echolalia.
Immediate echolalia is the immediate repetition of a word or phrase after it is spoken.
Delayed echolalia is the repetition of something that the child heard earlier. For example, if the child watched a movie or heard someone say something that caught their attention they might repeat the phrase over and over later on as a way of processing what was said or maybe as a way to soothe themselves with some self talk.
Here are a few simple things you can do to help a child with autism who is using echolalia:
- Model language– this is important with children who have autism and it is equally important for their typically developing peers. The best way to teach is to model. Reading to your child (with clear speech) is one of the most entertaining and enjoyable ways. But, even in your day to day interactions there are plenty of opportunities to model good language skills. Teach them useful words and phrases that they can use in place of inappropriate responses. For example, if they don’t like dogs, teach them to say, “I don’t like dogs” or “No dog, please” in place of screaming or hitting and kicking or running away.
- Substitute questions with statements – a very typical response to a question from a child with autism is a repeat of the question. If you ask, “do you want some chicken?” your child may repeat, “do you want some chicken?”. To elicit the correct response, say things the way that your child should say them in order to teach them. Instead of “do you want some chicken?” you would simply say, “chicken” or “I want chicken” and when they repeat that you use the opportunity to respond with, “ok, you can have some chicken”. This eliminates the repetition and models an appropriate exchange between you and your child.
- Start the sentence- if a child with autism needs something and they use single words to make a request you can prompt them to repeat the request with a full sentence by giving them the first few words. If they say, “bathroom”- you could say, “I need to go to the ______.” When they repeat the phrase, be sure to reinforce them with verbal praise or a high five. Make them feel good about the communication skills that they are building.
- Respond as they should- take every opportunity to model the right response. If you ask your child, “are you ready to go to school?” and the child repeats the question, you could respond with “I don’t go to school anymore, but you need to be at school in 15 minutes!”
- Give them the response (then slowly fade out)- when teaching new words or the answer to a question- immediately deliver the correct response and allow the child to repeat the response. For example, if you are holding up a picture card of a red ball you could ask, “what color is this ball?” then answer “red”. Ask the question again and try to get the child to answer “red” independently. Slowly fade your prompting as they answer independently.
ABA Therapy for Echolalia
Since language is learned by imitation, it is always prudent to expose your child with autism to as many settings and communication experiences as possible.
Working with your child at home, sending your child to school, seeking help from a speech therapist and ABA therapy are a good combination of resources to expose your child to opportunities for communication.
Circle Care Services, a New Jersey based ABA agency, is experienced in working together with New Jersey speech therapists to deliver therapy for children with autism. Circle Care is one of the best resources for families in New Jersey to help children with autism to improve language and communication skills. Your child with echolalia will learn to communicate more independently under the supervision and guidance of our compassionate ABA therapists.
By getting in touch today you are taking the first step towards helping your child to become more effective at communicating. This will give them the greatest opportunity to learn and grow along with their typically developing peers.