Echolalia……….What It Is and What It Means
Echolalia is repeating or ”echoing” what another person has said. Children who are echolalic imitate what they have heard someone say in everyday life, lines they’ve listened to from a book, lyrics to a song, or a script from a show or movie. Professionals most often characterize children as “echolalic” when many of the words or phrases a child uses seem to be repetitions from a previous activity rather than new utterances a child comes up with on his own.
Children with echolalia use what many parents describe as “more advanced language” than they can typically generate. For example, a toddler who is exhibiting echolalia can quote long segments from a favorite TV show or sing an entire song word for word, but yet he can’t ask for milk when he needs it or answer a question his dad asks him. Even though this child ”talks” since he can technically say lots of words, he doesn’t seem to completely understand what he’s saying. In essence, he’s just repeating words without really being able to “use” them.
Echolalia is one of the characteristics sometimes noted in children with autism. In fact researchers have found that up to 85% of people with autism who are verbal exhibit echolalia in some form. The silver lining in this is that echolalia is actually a positive sign that children with autism may eventually be able to learn to use language to communicate.
Echolalia is also a part of normal language development. This phase begins around 18 months of age when a child has mastered imitating words and is just beginning to imitate phrases. Experts tell us that echolalia peaks around 30 months of age, and declines significantly by the time a toddler turns 3. This coincides with when a child becomes conversational and truly begin to talk on his own, generating his own original thoughts, asking new questions, and responding to questions appropriately.
In children with autism, echolalia occurs with greater frequency and lasts for a longer period of time that it does in children with typically developing language. For example, a child with typically developing language may be able to quote a few phrases from a favorite TV show, sing a song, or learn to count to 10 by rote, but he doesn’t do this repetitively many, many times a day, and when he does do this, it seems to “fit” what’s happened rather than leaving adults or other children around him wondering, “Okay………..What’s that about?”
Children with motor planning issues, or apraxia, also can “get stuck” in this phase for a couple of different reasons. First of all, children with apraxia begin speech therapy with very poor imitation skills. Once they learn how to repeat what they’ve heard, they seem to want to hang onto this phase for a very long time. Secondly, repeating may become the “motor plan” they learn best, and it may be easier for some of these children to map a previously rehearsed message than come up with a new one. (Although it is true with apraxia that children can come up with spontaneous utterances better than imitated ones, this is not usually the case once they have been in therapy for a while. It may be easier to pull out a tried and true phrase or sentence than learn a whole new one.)
Echolalia is classified as immediate echolalia or delayed echolalia.
Immediate echolalia is the repetition of words or phrases that occur immediately or very soon after the original words are spoken. An example of immediate echolalia is the child who repeats a question such as, “Do you want some juice?” rather than responding yes or no.
Delayed echolalia is the repetition of words or phrases that are echoed after the fact, even hours, days, weeks, or months later. An example of delayed echolalia is a child who might sing, “Happy Birthday” when someone new enters her home.
Echolalia can also include not only the words spoken, but the exact imitation of a person’s inflection, tone of voice, and volume.
Professionals used to view echolalia as something that should be eliminated. However, current researchers tell us that many times echolalic speech can serve a purpose for children with autism. For example, a child who wants to go outside may say to his mother, “Let’s put your shoes on,” as his way of requesting this activity since he’s heard his mother say this many times just before he gets to leave the house. A child may say, “Want me to hold you?” when he’s crying or “It’s okay Ben,” when he’s upset since his parents have said this to him in this context over and over again.
I’ll give you another real-life example. A darling little boy on my caseload last Christmas called Santa Claus “It’s Santa,” all season long because the first time his mother taught him this word, she declared enthusiastically, “It’s Santa!” He lifted the whole phrase and his mother’s elevated and joyful tone of voice as this character’s name. When his teacher at preschool asked him, “Who’s that?” it was appropriate for him to respond in this way, but during a speech therapy session when I gave him a choice for play by asking, ”Do you want Santa or this reindeer,” and he replied, ”It’s Santa,” it didn’t make much sense.
In these cases echolalia is representative of how these children process information. They learns in “chunks” without processing meanings of individual words. This learning style is called a “gestalt” style of language acquisition. Children who learn this way also process the sensory and emotional components of the event. In the previous example with Santa, the little boy processed “It’s” as a part of Santa’s name along with the enthusiasm in his mother’s voice. Everytime he said this, he repeated it in just the way she originally said this to him shortly after Thanksgiving well into January.
Sometimes echolalia does not serve an identifiable purpose. For example, the child who repeats every line from the book “Go Dog Go” for no apparent reason while in the grocery store. There’s no dog in sight and no link to associating this book with riding in the cart while his mother selects food.
I try to teach parents with children who seem to be stuck in echolalia to look at this as an opportunity for us to know exactly what he or she is having difficulty learning. Echolalia can serve a purpose for us. For example, the child who is walking around aimlessly quoting a movie or book may need help in finding an appropriate activity, or he may be feeling stressed or anxious and uses this routine to calm himself. A child who asks his mother, “Do you want a cookie?” needs help in learning to initiate requests in a more appropriate way. A child who repeats a question needs help learning the meaning of the words so he can accurately process the question, or he may need specific cues to learn exactly how to answer. A child who repeats, “Good job (his own name)” needs to learn a declarative phrase such as, ”I did it!” A child who repeats his brother’s words may just be trying to take a turn in conversation and doesn’t know what else to say.
By taking a moment to determine if the echolalic utterance serves a purpose, discovering what the child’s intent is, and then finding ways to teach your child what he should say in this context, you’ll be much more effective than trying to eliminate echolalia.
Look for a follow-up article this week for more specific ideas to work on functional language for children with echolalia at home and during speech therapy sessions. Laura
Comment by anon on 18 June 2008:
My son is about to turn 3 and i think he may have echolalia but does not have autism and this is confirmed by our pediatrician. The issue I see is that if a friend or relative asks him how are you he doesn’t say fine, he will say something which is associated with that person eg. A friend showed him the moon so he responds where is the moon. Do you think this is an issue. My son has yet to go to a speech pathologist but I want to take him to one. Any suggestions to a stressed out mother welcome.
Comment by Laura on 19 June 2008:
Anon - Please read my articles in the receptive language section about answering questions. Here are the links for the ones I’d try first.
Techniques to Work on Answering Questions
link 1.
and Improving Receptive Language Skills
link 2.
Hope this info helps! Laura
Comment by anon on 19 June 2008:
Thank you. I will try this.
Comment by Jo on 29 June 2008:
Can a child have echolalia without autism? Can he grow out of it and learn to make spontaneous speech? What kind of therapy is needed? The boy is 7.
Comment by Laura on 29 June 2008:
Echolalia can be associated with other kinds of speech-language issues. It is a part of normal language development, but at a much younger age than 7. I would highly advise you to have him evaluated by a speech-language pathologist. This can be done thru a speech-language pathologist in private practice, thru a children’s hospital, thru a university speech and hearing clinic, and if you live in the USA, thru your local public school system, even if your child does not currently attend public school. Please discuss this with your child’s doctor. In my opinion, this could be a very serious issue at 7, but I have not seen your child, so I cannot give you more specific advice other than to have him evaluated by a competent professional. Laura
Comment by Jo on 30 June 2008:
Thanks, Laura. I live in Malaysia and it’s hard to find a doctor who truly understands developmental disorders. Thanks for pointing me in the right direction.
I think this boy may be on the autism spectrum (he has other symptoms). If echolalia is a good sign that the child is developing speech, does this mean that he will someday be able to communicate with his own words?
Comment by Laura on 30 June 2008:
I never give up on a child learning to communicate, so 7 is not going to be TOO old, but my primary clinical experience in language development is birth to 3 and then early preschool years. Keep looking for a professional there to help you since she/he will be able to see your child and make recommendations that are specific to him. Are you in/near a city so that you have access to a children’s hospital? ASK ANYONE who might have any prior experience if they know how to locate a speech-language pathologist - teachers, physicians, social workers, dentists, or any mother who looks like one of her children has special needs.
I once treated a little boy whose parents who were Christian missionaries in Malaysia while they were home in the US on furlough. Their son had Down Syndrome, and he was able get speech therapy from a person in private practice, so keep looking for one, even if she’s hard to find.
If anyone else has ideas for how Jo can find a therapist in Malaysia, please respond. Laura
Comment by Ashi on 6 July 2008:
hi laura,
wants to know more about phonological disorder as my son has problems in saying some words like with sounds of “L” i.e will say chocate rather than choclate , and with sound of “R” and N”, Moon will be “moo”.
thanks
Comment by Laura on 6 July 2008:
Ashi - Here’s an article explaining phonological disorders. Hope this helps!
http://teachmetotalk.com/2008/03/16/is-it-apraxia-or-a-phonological-processing-disorder-sorting-out-the-differences-in-toddlers-preschoolers-2/
But let me encourage you to spend most of your time focused on LANGUAGE with him. Any child with both receptive and expressive language issues PLUS autism PLUS the whole bilingual issue has a lot on his plate so that articulation would be the least of my concerns for him if I were you. My advice would be to focus on what he communicates by improving language FIRST, then worry about speech sounds later. Again - I hope you have a great SLP you’re working with so she/he can help you sort all of this out and prioritize your goals for him! Laura
Comment by Anonymous on 6 July 2008:
Dear Laura
My 32 months old son had some kind of speech delay. At 18 months he was saying 10 words, at 24 months he was still at 10 words. We enrolled him in speech therapy once/week. At 28 months Andrew was still behind with his language but at 32 months he tested appropriate for his age on receptive language and above his age on expressive language. We use 2 different languages at home and his preference was English so he was tested in English.However since his grandma moved in with us and now is more involved in his life he likes to speak French as well and speaks it sometimes better than English. Most of his language came in just 3-4 months ago and while we are ecstatic to hear him talking we are also concerned about the huge ammount of echolalia he is using on his speech. We already booked an appointment with a developmental pediatrician to get an assessment but the assessment will be in 4 months from now. Is there any chance that he might be echolalic without being autistic? From your article echolalia peeks arround 30 months of age (which will be his corrected age because he was born earlier)….Any advice will be greatly appreciated.
Many thanks,
Niki & Andrew M.
Comment by Laura on 7 July 2008:
Anonymous MOM and DAD - He could be echolalic without being autistic, especially considering his language delay. However, if you have any suspicions about autism, please follow your gut instincts and have him evaluated by the developmental ped. I am wondering if your SLP ever mentioned this possibility to you? Let me also caution that sometimes children are technically “talking” but not really using their words to communicate. Is he initiating conversation and asking for things he needs? Is he asking & answering questions? Does he exhibit any of the other signs/symptoms of autism other than echolalia? These are questions that will also let you know if you should follow thru with the dev ped appointment. Hope this helps! Laura
Comment by SLP on 20 November 2008:
Can a child have BOTH immediate and delayed echolalia? I work with a student who presents with both forms and little spontaneous language.
Is there a term if both are present? Are there any treatment techniques?
Comment by Laura on 21 November 2008:
I have seen children with delayed and immediate echolalia. When I document this, I note both. Glad you’re enjoying the site! I also wanted to let you know about an upcoming segment of my podcast, Teach Me To Talk with Laura and Kate. During December we’ll be discussing echolalia and treatment techniques. Hope you can join us! Laura
Comment by jenn on 19 May 2009:
my son is 5.5 years old and he repeats (in a whisper) things that HE has said not others, is this considered echolalia? He has been doing it for a really long time-
Comment by Laura on 20 May 2009:
Jenn - That’s a good question, but before I weigh in, I’d like to ask you a few questions about him. Does he use spontaneous language? How often does he do this? Does this interfere with his ability to communicate with others? Is he really repetitive with this? Does he get speech therapy, and what does his SLP think? Laura
Comment by Michael W. Casby on 29 September 2009:
Excellent resources for parents, professionals, and students. The content and processes presented are very contemporary and appropriate for work with young children. Very nice work here; very enjoyable and educational.
Comment by Anonymous on 4 October 2009:
Hi Laura, my son is 28 mos. old and is into speech therapy for the past five months due to receptive and expressive language delay. I’ve also been using the techniques from your dvd teach me to listen and obey and teach me to talk. His receptive language has dramatically improved and he can follow numerous commands, but his expressive language is still delayed. Recently, he’s starting to imitate words when I ask him to, like if he wants to eat he says “eat” then I ask him to say “cracker” and he will say “cacker”. If I say where’s the tree or car or flower etc. he will point to them and say the words sometimes not so clearly. This was a big improvement from him. My concern is how will I know if it is echolalia? I’ve been waiting for him to finally imitate my words, but now I’m scared what if all this is considered echolalia. His SLP says he has good joint attention, great attention span, his eye contact is not that good, but improving.
Another thing we’re worried about is that we noticed he is doing a lot of toe walking lately.
Hoping to get feedback from you. Thanks!
Joy
Comment by Hazel on 5 October 2009:
Hi Laura,
My son is 28 mos. old was diagnosed with receptive and expressive language delay when he was 22 mos. old. He is currently into speech therapy.
I’ve also been working with him at home using the techniques I got from your Teach Me To Listen and Obey and Teach Me To Talk DVD’s. His
receptive language has tremendously improved, and he can now understand most of our commands. His expressive language is still delayed though.
Recently, he started to imitate words that I speak. Example if he wants a cracker he will use sign language at the same time he will say the word “EAT”,
I will then ask him to say the word “cracker” , which he will follow with “cacker”. If I ask him to point to his eyes, nose mouth, he would say the word
“eyes”, “N” for nose, “mott” for mouth, etc. If I ask where’s papa?, where’s the tree, flower, car?, etc. He would point and say the words although
some not perfectly clear like tree is “tee”, car is “cah”. This was a huge development for him. Now that he’s starting to imitate words, I am concerned
what if all these is echolalia? How will I know?
Another thing that bothers me is we noticed he is walking on his toes more often now than before. Other than these he seems ok. He has good joint
attention, great attention span according to his SLP. His eye contact is not so good, but he is improving. His motor skills both gross and fine are ok.
He also has very good visual-spatial skills.
Hoping to get your feedback on these.
Li
Comment by Hazel on 8 October 2009:
Hi Laura,
I’m hoping to get feedback from you. I think I posted twice ‘coz I thought the first one didn’t go through.
Thanks!
Comment by Laura on 8 October 2009:
Hazel - I thought I’d already responded to you, but I don’t see that post either!!
Don’t worry about echolalia at this point. Usually that’s more with kids who quote entire sections of movies, songs, etc… without understanding the words or using very many single words. What you’re describing sounds like normal imitation - the kind you WANT to see in expressive language development with new talkers. The truth is, even echolalia is a good prognostic indicator that a child will eventually talk on his own, vs. not saying anything, even in imitation.
From what you’ve said, it sounds like he’s making good progress in a short amount of time! Keep using the strategies you’re learning from the DVDs and from your SLP. If she’s not worried about his attention and participation, then you shouldn’t be overly concerned either. It sounds like he’s on the right track, and based on what you’ve said, so are you!! Hang in there!! Kids don’t go from a huge delay to “typical” overnight, so keep celebrating his successes, as I know you are! Thanks for your questions!! Laura
Comment by tracy on 9 October 2009:
Hi Laura, you mention that it is not correct for an SLP to model two word utterances like” big ball” or “blue truck” when attempting to increase utterance length, could you explain why? thank you.
Comment by Laura on 9 October 2009:
Tracy - If I knew what context you’d heard me say this in, I’d be happy to explain what I meant, but I’m not quite sure what you’re talking about. Did you hear me say that on a podcast, or was it in something you read here on the site? Give me more information, and I’ll be more than happy to explain my train of thought. Laura
Comment by mital on 20 November 2009:
Hi,
My son is 4 1/2 years old. Few months ago, we came to US. Previously we were in India. We got the diagnosis of language delay when my son was 2 years old - From that day
onwards my family and I were working hard to teach him
our native language and by age 4 he was able to talk complete sentences and able to understand and answer
wh questions (why and when rarely)but he had delayed echolalia and limited eye contact and less interested in peer play.
In US, he been recently dignosed as having mild ASD. We put him in a disabled preschool here last month and he has started learning english - he can now understand basic sentences in english but answers in our native language.
The thing I always worry about him is this delayed echolalia. He has this, if he is so excited or engaged in some activity like drawing etc,. He is having a high pitched voice and I took him to the park last week he was sitting on the slide and telling to himself “come dog, come on will you bite me?” in our native language even though there was no dog out there and every one in the park looked
differently at him. Will this be for him for the lifetime or will he outgrow or In what ways I can help him out?
Comment by Matt on 21 November 2009:
Laura,
My son has always been a little behind on speech, lots of grunting for a while, then a few words came, now at 3 everything is words, however some of it is echolalia. He repeats a lot of phrases, but all are in an appropriate manner or situation (”Stay in the driveway”, or “Stay by the car”) He also has immidiate echolalia where he repeats questions or statements we make. At the same time he can tell us what he wants, initiates many observations on his own and answers most yes/no questions and a few other questions where a choice needs to be made. We are in the process of a speech evaluation and of course the potential of Autism has been thrown on the table by a few observers. Echolalia is the ONLY trait that he demonstraits on the spectrum. Otherwise, he follows and understands directions, overall is well behaved, makes eye contact, doesn’t have any sensory issues, while a little shy still he still likes to play with kids he is familiar with and doesn’t have any odd hand motions or is obsessed with spinning or other type of visual stimulus. We do not think its Autism. Can Echolalia exist outside of autism? (and be corrected)
Comment by Laura on 23 November 2009:
Mital - First of all congratulations in doing the right thing in getting your son’s language delay diagnosed at such an earlier age and then working with him so that he’s now using full sentences. As I’m sure you know, echolalia in autism, even mild autism, is difficult to treat. It’s also equally difficult to look at a child at 4 and predict what he’ll look like at 6, or 10, or 18. The experts tell us that echolalia is likely to be replaced by novel language as children progress. However, some people with autism use echolalia as a way to help themselves regulate even into adulthood. What you can do is keep him in treatment as long as he needs it followed by lots of “work” at home to make sure you’re doing your part in helping him to learn more complex language. Also ask your SLP at school what else you can do to help him at home. Thanks for your question. Laura
Comment by Laura on 23 November 2009:
Matt - He will not be diagnosed with autism if he does not meet the criteria, and echolalia alone will not make him eligible for this diagnosis. However, let me gently add that sometimes parents come to me with what they think is “only one” characteristic of autism when in fact, there are other subtle markers that a parent, in our devoted affection for our children, have chalked up to “his personality” or a “quirk.” This may not the case at all with your child, so please don’t get offended, but it does happen consistently in my practice, so I’d like to provide a word of caution for parents who may be reading this and in that situation.
As children learn more language, echolalia should decrease as novel words, phrases, and sentences replace the repeated ones. Some children are more repetitive than others when learning language, especially when there have been delays, as in your son’s case. What I’d encourage you to do is to keep targeting that language at home and get him in speech therapy to give him and you new treatment ideas.
Thanks for your question and good luck with him! Laura
Comment by Matt on 24 November 2009:
Laura - Thanks for responding so quickly! I understand your point regrading a parents point of view. In our case I feel we are being honest with ourselves. We went into this screening thinking we had a boy that needed speech therapy to catch up. At the inital screening when they threw out Autism we were totally shocked (hadn’t ever crossed our minds). Also, his pediatrician since birth does not think that is the case either.
We are seeking speech therapy, that was the reason for us going through this screeing process to see if he qualifies. They gave us the C.A.R.S test which we took ourselves and with them. Either way, based on that test’s parameters he is not even “mildy Autistic”, the only areas he scored 2-2.5s in were the speech and communication areas. With a total score of 32 being “mildly Autistic” he was nowwhere near that…more in the low to mid 20’s (15 being the lowest score possible)
What are your views on the “over diagnosis” of Autism these days? Agree? Disgree?
Comment by Laura on 3 December 2009:
Matt - Glad you’re getting the eval done so you can see what is going on with him. With such a low score on the CARS, it’s unlikely that autism is the culprit!
In my area I do not believe that autism is overdiagnosed at all in toddlers and young preschoolers. However, it may be overdiagnosed in school-age children here based on reports I get from moms with children I treated as toddlers who in my mind were not on the spectrum when they were 1 and 2. My feeling is that if parents want a diagnosis so that their insurance will pay for speech therapy, they can almost always talk someone into saying he/she is autistic. Is it the right thing to do? NO, but if it means a kid gets services when he otherwise wouldn’t, then I’m not going to fault them for trying.
Thanks for your questions!
Laura
Comment by Nicole on 16 December 2009:
My son is 3 1/2 and his occupational therapist say he has Sensory Integration Disorder.Another occupational therapist recently told me he echo’s. They said he does it because his sensory system gets over loaded. I had no idea what she was talking about so I looked it up online, which is how I came across this site. My question is how do I help my son? He cannot relay any information to me or answer any of my questions, he just repeats what I said back to me. He has trouble communicating, making friends and get his needs met if I’m not around to intervene.
Comment by Laura on 22 December 2009:
Nicole - Treating echolalia can be really difficult. I hope that he’s getting speech therapy too. If not, I’d highly recommend that you have his language skills evaluated by a speech-language pathologist. Although it sounds like he’s “talking,” he’s not really “communicating” with you. Follow the ideas listed here in the article on echolalia and take a look at the other articles here in the expressive language section. You may also find the articles in the autism section helpful as well. Echolalia is often present in children who are on the spectrum. Of course I can’t see your son, so I can’t make that assumption, but you may want to discuss this with your OT to see if further evaluation is warranted so that you can get your son all of the help he needs to learn to make friends and communicate with others, ESPECIALLY when you’re not around. Let me know if you need other help, and thanks for your questions. Laura
Comment by moonz on 4 March 2010:
dear Laura,
I had already written to you about my daughter, who is now 4 yrs old she has speech difficulty. Upon the advice of a pedeatrition we enrolled her to a normal school,since we dont have any therapist where we live. since her going to school she has improved in her speech ,from monosyllable to bisyllable and two words sentence or some times three.but the problem we have encountered is that she is unable to write till now.her writing ability are writing an ‘o’and ‘H’that too not perfectly.I have tried to teach her slanting line and bumps that are necessary for alphabet writing,but all in vain,because she prefers to write only the circle and capital ‘H’.
Now her lower kinder garden will be comming to an end and the teachers will not promote her.I have been patiently practicing with her different strokes,but all in vain as she dosen’t write different strokes.can u give me advise on this.
moonz
Comment by Laura on 5 March 2010:
Moonz - Many children aren’t ready for handwriting at 4 because they don’t have the foundational or prerequisite fine motor skills. Can she manipulate lots of different small toys during play? Does she place small-knobbed puzzle pieces into the appropriate spots in a puzzle? Can she snip paper with scissors? Can she use lots of different “tools” with Playdoh - cut it with a plastic knife, use a smaller roller, etc…? Can she use a set of plastic tweezers to pick up small objects? Does she use a mature grasp on the pencil with her fingers and thumb rather than a fist?
Have her teachers give you other ideas about how to work with her at home with handwriting. There’s also a workbook set you can order called “Handwriting Without Tears” that may be helpful to you. Google it for more info.
Since you don’t have a speech pathologist, you likely don’t have an occupational therapist either, huh? That’s the professional who would help with handwriting. Ask your physician about this referral as well.
Hope these ideas help! Laura
Comment by moonz on 11 March 2010:
Dear Laura
Thank u for the comment.I have given her a puzzle set of 6-8 pieces,and after showing her how to fit she could do with out help.she is now perfect in that.Now she fits with memory,where each puzzle goes.
Rest she plays with tea ,cooking sets,csn use a knife to cut,roll dough,build blocks in different shapes.
Only recently, 2 months ago she has learned to ride a tricycle.
It seems to me she has learned out of frustration,as there were three more kids and one tricycle,this happened during our vacation in our home land.
Her grasp of the pencil is with fingers and thumb but she does it with less confidence.
At school, the teachers held her hand for her to write the letters.She wants the same at home,it has become a habbit for her,I wish for her to write on her own now as her motor skills are developing.
I have observed that she writes when I give her in dotted form of letters,but after practicing with her for 2-3 days she can’t write I think I have to be patient till her motor skills develop.
moonz
Comment by Laura on 12 March 2010:
Moonz - It sounds like you’re on the right track with the kinds of activities you’re doing with her. I would give her the hand-over-hand assistance to get her started, but quickly fade your help so that she can do it on her own. Again check out the handwriting programs I mentioned. Good luck! Laura
Comment by Jezzy on 24 March 2010:
I’m so glad I found your site! My daughter is 33 months old. For awhile, we thought she might be “advanced” because she knows all of her letters, can count to 30 (sometimes 40), and loves to memorize books. It wasn’t until recently that we realized that all that memorization could be a “red flag”. She also memorizes entire episodes of “The Wonder Pets” and we hear her reciting them alone in her room. She can answer questions, but it’s hit-and-miss, and often followed by a non-sequitur. For example, this morning I was getting her some blueberries. She saw what I was doing and said “No! Grapes!”. I said, “OK, grapes”, to which she replied, “Look, Wonder Pets, there’s the baby kangaroo”. Uh…OK. My husband and I agreed to make an appointment with her pediatrician, but what can we do in the meantime in addition to modeling our own words? Do we have to cut out “The Wonder Pets” altogether?
Comment by Laura on 25 March 2010:
Jezzy - Thanks for your question. If you cut out Wonder Pets, do you think she’d move on to memorizing and reciting another favorite show? That’s what usually happens. I’d probably limit her TV watching right now and do everything you can to keep her engaged and interacting with you for the majority of the day. The more she “practices” her social (real) language with you, the more the echolalia should decrease. I’d really try to keep her engaged with you with choices to follow-up with your question. For example, with the grapes you could have asked, “In the red bowl or blue bowl?” “Want juice or milk?”,”Eat them here or in the dining room?” With kids who are echolalic I try to avoid asking the questions with “Do you want ____” since they often imitate that whole question as their way of requesting, so try to model your question in a way that won’t sound odd if she imitates what you’ve said.
I think a speech-language evaluation with someone who specializes in treating preschoolers with autism is a good idea. A specialized preschool for her for the fall is also something else I’d recommend. Many local public school systems offer preschool for children with social communication/language delays. I hope your pediatrician agrees and can point you in the right direction. Your daughter has lots of strengths, so you’ll want to have her in therapy to give her the jump start she needs and hopefully maximize her skills so that she’s as ready as she can be for kindergarten. Thanks again for your questions. Laura
Comment by Sol on 7 April 2010:
Hi Laura,
My son just turned 4 and he has both immediate and delayed echolalia. However, he can verbalize what he is doing and can speak in a few words(usually 1 or 2 sometimes more)to meet his needs. He has excellent rote memory. I have access to some books in helping children to talk. One book is meant for typical chiildren that are delayed and the other is for autistic children. He has not yet been diagnozed of ASD. Will it hurt than help to use strategies that are mentioned in the autistic book before a diagnosis. Thanks.
Comment by Laura on 8 April 2010:
Sol - Nothing you can do to help him learn to learn will ever hurt him. Implement any idea that makes sense to you while you’re waiting on his formal evaluation.
Echolalia, while worrisome in that a child is not learning language in a typical way, is still a great indicator that a child can and will learn to talk, and eventually on his own.
Congratulations for searching for ideas to help him. You’re doing a good job
Laura
Comment by Sol on 9 April 2010:
Thanks Laura for your quick and valued response. I would like to provide a little more detailed information about by 4 year old boy.
The following autistic symptoms he has.
- He does not have one to one conversation; can say yes or no appropriately and able to verbalize what he is doing and what the others are doing, but does not ask questions other than ‘what is this’ or ’show me this’ while pointing at a book. However, overall he is very verbal with appropriate comments about his environment; he rarely makes a comment that does not make sense.
- He has both immediate and delayed echolalia but I would say moderately. This is more when he is around known people and less in the presence of strangers
- When his name is called while being close to him he does not respond most of the time, but always responds when I call his name from the next room; this puzzles me.
- When I vacuum the carpet sometimes the sound irritates him and he cries; at other times he would enjoy and want to see what I am doing, and he would even take his toy vacuum and pretend to clean. He also does not like the sound that cows make ‘moo’.
The following autistic symptoms he does not have
- He has language enough to meet all his needs/ requests even though sometimes they are one or two words. There are times when he uses more words
- He has good pretend play; pretend to make and drink tea and give others, pretend to drive a car or ride horse. Also he imitates the movement of animals like kangaroo, wombat. He imitates tv characters; would this be considered pretense or repetition. Is it positive or negative?
- He points to things especially in books and identifies what they are; He knew all the alphabets and numbers upto twenty before his 3rd birthday both visually and phonetically. He has excellent memory; will be able to identify and remember things, animals etc.. from books even if he sees it just once.
- He would bring books and toys to you frequently and ask to read or play with him
- He makes good eye contact. When he plays with a toy he would make eye contact with you between play and sometimes look at you and make a comment with respect to his play
- Likes to be held and cuddled
- Has no problem in change of schedules or wearing any texture of clothing
- When the parents come after work he would always rush to greet you and say ‘Hi mama/papa’
- No stereotyped behaviors; does not have abnormal movements of hands or body; does not lineup anything
- No temper tantrums
- A contented child
In addition his walking happened quite late at 19 months. Is there a connection between echolalia and good memory?
I will be very grateful if you could please dissect the above for me. He has not received any diaganosis as yet. I know that if you do not meet the whole criteria it could be diagnozed as PDD(NOS). How much worried should I be and if and how my is he different from a typical child that has developmental/ language delays.
Thanks very much again and I am very glad I was able to find your website and appreciate profusely the service you provide.
Sol
Comment by Sol on 13 April 2010:
Hi Laura,
My apologies for the lengthy note sent previously on April 9,2010. Based on what I have mentioned in that note, would you please let me know which of your resources(DVDs, books)would be most suitable to help my son who is 4yrs. 2mths.
Thankyou
Sol
Comment by Laura on 13 April 2010:
Sol - I just re-read your comment. Sorry I missed it before. Thanks for sharing your details about your little boy. Even though your son’s language is delayed, he has some nice strengths to build on. I hope that you’ll have him formally evaluated so that an SLP can SEE him and how he responds and uses language so that he/she can diagnosis him and more importantly, teach you how you can work with him to help him at home.
My DVDs are for adults to watch to teach you how to work with your child at home. If he’s never been in speech therapy before and you’ve not already had professional recommendations with how to work with him, I’d recommend Teach Me To Listen and Obey 2 (if he’s not understanding a variety of words) and then the last couple of strategies from Teach Me To Talk for ways to work with him to target more advanced expressive language. Watch the clips and decide for yourself if these will be appropriate for you to help him.
Thanks for your questions! Laura
Comment by J/A's mommy on 9 June 2010:
Hi…I have a 32 mo. old son. I recently started to worry w/ the fact that he doesn’t answer yes/no questions. When asked a question he will repeat the last word/s.
Mom- do you want something to eat?
J- eat
Mom- what would you like?
J- like
Mom- do you want a sandwich or some soup?
J- sandwich or soup
I can’t get him to answer. He is able to say many words (over 200) but usually does not string more than 2 or 3 together. He also recites partial quotes from some of his favorite cartoons. he will do so spontaniously or while watching them…mostly finishing sentences for cartoon characters,so on. He is a very hyper and active boy. I was initally worried his speech delay was related to autism. looking over the list on this site he does show 3 or 4 signs (quoting, repeating vs. answering, hyperactive, occasionally flaps his hands if he is really excited about something- that has decreased.) He is very sociable w/ kids and adults, is very affectionate, he seems to be on target as far as everything else is concerned. He is able to follow direction, likes to engage us in his play, he is able to make needs known with simple 1-2 words. His preschool teachers say he is smart, loves flashcards and loves story time. They do agree he is a little delayed in speech but they believe he understands what is being said to him. He enjoys new things,places, people, foods,etc. Should i seek a referral to speech therapist or possible evaluation for autism? Thanks!
Comment by Katie on 12 June 2010:
Hi! I’m very glad I found this site. My son is 33 months old. HE was diagnosed with Autism Spectrum Disorder (by a developmental pediatrician) in November 2009. Therapists who specialize in autism started coming to our house and with therapy I have seen improvement. The problem is, Some therapists don’t think he has autism and they don’t mind coming out and saying it. That makes it hard for me because I don’t know who to believe. I noticed signs of possible autism very early on. My son never explored my face when I would feed him his bottle as an infant. He NEVER answered to his name and when he started therapy they documented that he answered his name ONLY 10% of the time and now 5 months later it’s 60% of the time. His eye contact is inconsistent and he seems to have (all therapists agree) echolalia and delayed echolalia. If you ask him, “shane”, what’s your name? He will say “what’s name?” If you ask how old are you he’ll say “old are you.” HE can memorize and sing long country songs and will recite phrases from movies or tv randomly throughout the day. His expressive and receptive language are both at about 1 year and 9 months old (he’s almost 3). He does flap on occasion but it has gotten better now that we have been using PECS Pictures. He used to only play with anything with wheels or his roller coaster beads. Now with therapy he will play with other things but prefers to play alone. He has always lined things up (blocks, cars, stuffed animals). He loves to rock and he likes deep pressure on his head, hands and legs. He is about to start school and ‘m afraid some of the opinions of him not having autism of some of the staff will effect him or his right to therapies. They already refused to give him Occupational Therapy even though his adaptive skills are at 9 months to a year old with eating, feeding himself and dressing. What can I do and In your personal opinion do you think that the developmental pediatrician was correct about him having Autism spectrum disorder? THANK YOU!!
Comment by Laura on 14 June 2010:
Katie - I’d go with the autism dx because it usually does ensure that he’ll get more therapy time than any other dx. Ask your therapists to remove any mention of this in their notes so that they don’t jeopardize his chances of more services when he turns 3. Explain that you are THRILLED with his progress and understand from all of your research that he still continues to exhibit red flag characteristics of ASD and that you’d rather continue to assume that he does meet this criteria so you can ensure he gets proper tx. No therapist in their right mind will disagree with that!
I like this question so much that Kate and I are going to discuss it on our show this Thursday. You can tune in for our answers, or better yet, call in yourself! We love to hear from moms!!! Laura
Comment by Laura on 14 June 2010:
JA’s mommy - Even though his vocabulary is increasing and he is using phrases, it does sound like he has some difficulty understanding and processing language since children with typically developing language can answer the kinds of questions you’re describing by 2 1/2 or 30 months. You can get him assessed by your local early intervention program, but chances are, he won’t qualify since he won’t meet eligibility requirements since he’s not significantly delayed. However, you can and should continue to work with him at home to help him learn to understand and answer questions. There are tips in articles here on the website in the receptive language category. Search the word “Answering Questions” and it should link you to a couple of articles. I will be addressing this in a couple of weeks on the podcast since I routinely get questions about questions!!! Tune in for those answers! Laura
Comment by Deji on 4 August 2010:
Hi Laura, am currently working with echolalia child of about 7 years, here in Nigeria. but the parent major concern is the academic aspect, thou she is trying her best, let say she is below average. she is also good with art and computer games. so what are you suggesting i should do. i seriouly need your suggestion. thanks inanticipation.
Comment by Deji on 4 August 2010:
pls, can you give me some tips to teach echolalic child. thanks.