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June 02, 2008 | Laura | Comments 58

Echolalia……..What To Do About It

This is a follow-up article to my recent post ”Echolalia……..What It Is and What It Means.”  link

I am always so frustrated when I go to a continuing education conference or read an article by an expert when the bulk of the time is spent addressing the identification/assessment aspects of an issue, and then about 5 minutes or 2 lines is spent giving recommendations for intervention.  In an effort to overcome this irritating trend, I constantly remind myself to spend most of time on this site writing about the part most of us want and need when we seek information, that is the ”What To Do About It” part! 

I hope that you’ll find these strategies helpful for your child at home or the children on your caseload.  This list has been compiled from my personal knowledge from the tried and true recommendations I use with my own clients as well as BETTER strategies I found as I researched this article. 

Let me also add that treating echolalia can be very frustrating, not only for a parent, but for a professional.  With a child who is echolalic, your teaching mistakes are often amplified because he is repeating EXACTLY WHAT and HOW you taught him.  I have one darling little boy on my caseload right now who is making me rethink every word that comes out of my mouth during his sessions, and I do this language thing all day, everyday!  I understand your frustration if you too are searching for a better way to teach language to a child who learns in this way. 

However, I hope you’ll too find solace in what I have for my particular little friend……… at least he’s talking!!!  He may be mixing up pronouns, re-asking my poorly worded questions, and imitating things I didn’t fully intend for him to repeat, BUT HE’S TALKING!  Compared to nonverbal children whose parents are eagerly anticipating their first little peeps, this is a huge, dramatic, BIG DEAL, and it should not be viewed as something we need to eliminate. 

On the other hand………… it is NOT normal for a child to repeat so many of the phrases and sentences he hears with an obvious difference in how he understands and processes language.  It is heartbreaking for me when I evaluate a child and hear from a grandparent, a teacher,  or even a parent who is oblivious to the fact that their child’s language is not “advanced” when they are able to quote large chunks of a Disney movie or know the words to every commercial they hear on TV.  Even when parents have initiated the evaluation on their own, I think sometimes they still wish I’d come in and say that everything really is fine, even when they know in their heart of hearts that it’s not.  So with that in mind, let’s get on with learning what to do about echolalia. 

The KEY to treating echolalia is to model every word, phrase, or sentence in just the way your echolalic little friend should say it.  Easier said than done, right?  This can be hard!  Even when I am teaching a parent how to do this and modeling it for them, I can still screw it up.  (As the mother of the little boy I mentioned can attest!)          

Initially this means that you need to stop asking this child so many questions and giving so many directions, and start modeling more requests, labels, and comments.  You need to say things EXACTLY the way you want your child to say it since he learns by repeating EXACTLY what you’ve said.  

Some parents and professionals balk at this advice saying, “He’s got to learn it the right way.”  Well that is wrong, at least for now.  One thing I try to tell parents is not to look at echolalia as right or wrong;  it just is.  This is how he learns.  This is what we’ve got to work with.  Learn to use this heightened skill of imitation to your advantage.        

MORE SPECIFIC EXAMPLES -   

1.  Model language from your child’s point of view.  Model the kinds of words and phrases he can actually imitate AND understand.  

Narrating play with a child who is echolalic is EXCELLENT because he will likely rehearse this even when he plays independently.  

Be sure to provide words (even ones you’d prefer he not say) for activities rather than what you’d probably normally say.  For example, if he’s trying to refuse an activity, model, “No” or “Don’t like it.”  If a sibling or peer is taking a toy, help your child learn to say, “Stop,” or “Mine.”  Many parents don’t like the idea of “teaching” their children these unpleasant, impolite words, but then again, I’d rather hear a word rather than a scream, or deal with a child who’s been bitten or hit (or is the biter or hitter), all because we failed to teach an appropriate response.         

When you’re reading books (often a favorite activity for this kind of kid because they like visual, repetitive, and predictable information), point to and label the pictures using single words at first and then short descriptive comments as his comprehension skills improve.  If he doesn’t name the pictures as you’re naming, take his finger and pause to give him a chance to “echo” what you’ve taught him previously.  While many experts recommend this is a great way to increase vocabulary initially, don’t over-use books and pictures.  Be sure to play with toys MOST OF THE TIME since children like this generally need more help learning to use language during everyday activities.  Reading books, looking at flashcards, and naming pictures from videos are NOT functional or useful skills when your toddler is in the kitchen and can’t figure out how to tell you he’s thirsty and wants milk!                    

2.   Don’t ask your child “Do you want……” questions since he will initiate his requests by saying, “Do you want …..?”  In this kind of situation model what he should say if you know what he wants.  For example, if he’s reaching for an object, say the item’s name or model, “I want the ________.”  If you’ve already messed this up and your child is doing this, model his name as you give it to him and say, “_____ wants the _________.” 

One thing I do is respond to a question like this literally by saying, “No, Laura doesn’t want the _________, but _child’s name does.”  Then model, “I want ________.”  Wait until she repeats this phrase as the request before giving him the item.    

Once a child’s language has become more advanced, ask the question, but offer responses at the end.  ”Do you want ice cream, yes or no?”  Again watch your tone so that you’re not modeling the question inflection for the yes/no response part of the question.  

3.  When offering choices, also drop the “Do you want   _____ or _______?”  Model the names without the question tone at the end and holding each one forward when offering the choices.  If your child is reaching for one, again model the objects’ name and withhold until he repeats you. 

One expert suggested using a fill-in-the-blank format.  Offer the choices by modeling the words in a statement tone of voice (not a questioning intonation) and then adding, ”Child’s name wants…..”  Wait for him to complete the phrase, then give the object.  

4.  Stop asking other questions like, “Do you need some help?” or “Should I hold you?”  Model what your child should say before and while you’re doing what he needs.  Try, “Help,” or “Hold me.”  Also drop the question tone since your child may also imitate this voice pattern.  Later you can start to wait a while and expectantly look at him for his “echoed” request. 

5.  Be careful how you respond to requests.  If you’re saying, “Okay” habitually after a request, your child may also incorporate this into his script saying something like, “Help you?  Okay.”  To avoid this, either perform the request without a verbal response, or vary what you say so that he’s not “locked in” to a particular pattern.          

6.  Avoid using praise such as, “Good job ______” or the more stupid phrase, ”Good talking __________” with the child’s name since she will often imitate this.  If you can’t stop yourself, at least don’t use her name.  I try to use lots of hugs, smiles, and cheer, “Yay” to replace this habit.  It sounds less abnormal when a child cheers to congratulate himself when he’s not using his own name.     

7.  Avoid greeting or closing using the child’s name since he will always repeat the way you’ve said it instead of using your name.  (By the way - I screw this up regularly!)  Use just, “Hi” and “Bye.”  Hard to remember!  You may also try other good-byes such as, “See you later!” or “Be right back,” since it’s okay if a child echoes these.

Several sources recommended using a verbal cue such as calling the child’s name first or touching him and then using your greeting or closing. 

8.  When you notice your child echoing, look at this as an opportunity to teach him what he needs to know.  Model the way he should say something and wait.  

9.  Sometimes echolalia is a child’s response when his system is overstimulated.  Children who are tired, hungry, scared, sick, extremely bored, or overwhelmed often lapse into echolalia as a way to self-calm.  Analyze the situation and see what kind of support you can provide to them environmentally before you begin to look for ways to eliminate the echolalia.    

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In closing, let me remind you again of the bright side of echolalia.  He’s talking!  He’s trying!  He is working on learning to communicate.  You can see it right before your very eyes!  It may be frustrating for you, even for a looooooooooong time, but remember that it’s better than the alternative of being silent and not showing any evidence of learning language.   The positive qualities of echolalia, having strong memory skills and learning from predictable patterns, CAN and SHOULD be used to help your child learn to communicate.  Use these suggestions and ask your SLP to help you figure out how to do this for your child.

I welcome your comments to this and all articles on this site! 

Laura                                     

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There Are 58 Responses So Far. »

  1. You just made my day! Your experience was very helpful. Thanks a lot!

  2. I have just spent hours trying to find out what I am supposed to do with the child I work with with echolalia. I will now have information to tell the parent. I feel like I have a much better understanding of echolalia and have something to work with.

    Thanks!

  3. Its great to have the information in a user friendly format. Just one suggestion…you didn’t mention the importance of visual strategies to help children (ASD) learn those appropriate phrases.(For example using a Boardmaker picture/word sentence strip in play routines to teach a scripted sentence.) Its much easier to fade that visual prompt than a verbal model!

  4. MSLP - Good idea! Thanks for the reminder! Laura

  5. Thanks for the great info! I’m gonna try some of this in therapy tomorrow and share this site with my co-workers.

  6. Dot - Glad to help! Echolalia is tough to treat, but I just keep reminding myself - at least this child can talk! Laura

  7. use tact correction procedures and teach the response “I don’t know”

  8. Very helpful information here! Thanks so much!

  9. I searched online, couldn’t find much info on how to help my echolalic son.Thanks for the examples.That would help us a lot.Please continue posting more info.You are doing wonderful job.

  10. Thanks Laura for your specific suggestions. How could I model a response when “can I play?” is asked by another child? The child with the echolalia (I’ll call him David) appears not to hear the question so I get his attention and have the child repeat his question. Of course I’m learning that David repeats the question and then I model “yes”. I’m stuck and would appreciate any suggestions to be effective.
    Thanks
    Joy

  11. Joy - I would model, “What?” or “What did you say?” when he appears not to understand/process/hear the original question so he learns this very functional sentence to help him learn to ask for clarification when he needs it. Also try the “Yes or no?” technique so that you’re still having him be a little more independent in answering since he chooses which answer to respond with. If he’s more confused by this, try just shaking your head “yes” to see if this will cue the word rather than direct imitation. Treating echolalia is hard!! I can still work myself into a tizzy doing this! Hang in there!! Laura

  12. Thanks so much for this article. My little one is probably on the spectrum though not officially diagnosed. He is 2 yrs 8 mos. he has come a long way. He is receiving services from school and clinic with therapy for improving language and apraxia and social/functional language. He has sensory issues and is getting help with that too. The problem is that four out of five days he will get stuck on routines where his mother needs to repeat what he has said before he goes on. This includes a whole conversation on a topic…albeit the same conversation always. For example. “The sun comes up. (Wait for rep.) The sun goes down. (Wait for rep) “Papa said that’s ok. Rep. It’s night. rep. It’s daytime.” His mom is adept at giving him greater amounts of knowledge about the topic, trying to shift him into saying other things about the topic, shifting the topic, but he keeps coming back over and over all day long. she is about going crazy as you can imagine. He also often seems anxious, wakes during the night and seems like he is a little sick during these days. On his good days he can use 5-8 word sentences and carry on other types of conversations for several turns. He has several routines that he gets stuck on. Have you ever heard of this? If his mother refuses, he doesn’t get upset, but he keeps coming back to it and trying to get her into the routine, by taking her hand and saying “come”. Any suggestions or thoughts?

  13. Heather - These kinds of behaviors are pretty typical in children with autism and are one of the diagnostic characteristics. It sounds like you guys are doing all of the right things and all of the strategies I usually suggest to moms to work to help him expand these exchanges. The encouraging part of this that he has “good days.” He can use longer novel sentences and carry on conversations about other things, so he IS making progress with language. I’ll continue to think about this and add more to this response if I come up with any new ideas.

    You said that he’s getting therapy thru school and a clinic. Is anyone on the team helping mom with the sleep issues and anxiety, perhaps a psychologist? His OT should also have some insights to share with her to address both of these issues as well.

    Thanks so much for your post, and I’ll let you know if I come up with some other ideas. Laura

  14. I have a 30 month girl who has hit all her verbal milestones late but following the “normal” path. She is repeating alot of words, but she is having a hard time with spontaneous lanuguage. She was mildly behind in receptive language as well (She had ear infections which lead to tubes and severe reflux as an infant.) For instance, if I ask her “Go get your backpack” She will go in another room to get it, then say “backpack” as she hands it to me. But, if I just take ehr backpack and ask “What is this?” she won’t or can’t tell me. She does this with many many words. I feel confident she knows what the words mean, but can’t produce them until she hears it from me. (She has been in speech therapy since 20 months of age).

  15. Laura - It sounds like she’s having some word retrieval issues, and this is very common for a new talker. On-demand naming is difficult for many late-talking children. Sometimes a simple cue such as you saying, “It’s a ______,” and then waiting for her to “fill-in” the word will cue her when, “What’s that?” is still too difficult.

    You can also work on naming common objects using game-like activities too. In play or in a daily routine gather up 3 or 4 objects, hold them in your arms, and then name them as you make a big deal about setting them down one-by-one. Or hide them under your shirt and make a big deal about naming them as you pull them out. Again, the cue, “What’s that?” can be worked in later as she improves, but you may just skip that for now and work on naming them without that added “pressure” of answering the question.

    By the way - the most important thing is that she UNDERSTANDS you when you say, “Go get your backback,” so good job there!!

    Also ask your SLP for ideas to use to target this. Some SLPs like pictures or flashcards for targeting this kind of thing, but I don’t like those as much for young children. I prefer REAL objects and situations. However, do ask your SLP since she may have a different take on this since she’s actually worked with her and I haven’t.

    Great question! Thanks so much! Laura

  16. Hi,there. A big relief! I was so worried when I ask the speech therapist regarding the progress of my 4 year old daughter. She said that my daughter is keep on repeating all the question they are asking and that is their big problem after my daughter was talking. After I read your article I can say that I am not ALONE in this battle! Thanks a lot for this very helpful suggestion. Please keep on posting. Thanks. More power.

  17. Thanks May! Keep reading! Laura

  18. Laura,
    Thanks for the great ideas. Can you give me ideas to help a sudent understand they are using bad language. They do this usally when upset and transtion times.
    Thanks

  19. Pam - Fortunately I have very little personal experience with this (just one 2 year old several years ago who was not on the spectrum, but who lived in a chaotic home with older siblings where cursing seemed to be the 1st response to being upset!), but what I would do is try to give them a new script. Model what they should say using vocabulary that’s developmentally appropriate, a functioinal phrase that “fits” the situation, and something you can live with hearing them say!

    You do want to teach emotion words, “I’m upset,” or “I’m mad,” and that’s a “real” way to give these difficult-to-learn words meaning. Some parents don’t like that we’re teaching these kinds of words, but again, when you’re looking at the alternative, I’d rather than this kind of phrase than cursing or physical aggression.

    I did work with one little boy whose mom taught him to say, “One more minute” during transitions so that he could learn to negotiate for more time, but he still got upset when we’d counter with “No more minutes” after a few extra turns to reward his request. However, dealing with this is likely much better than what I suspect the kids you’re talking about are saying.

    Hope this helps! If anyone else has a better idea, please add it! Laura

  20. Hi there, This information is wonderful! I really look forward to trying to impliment this at home with my daughter. She is going to be 5 soon and has Optic Nerve Hypoplasia. I have just spoke to an O.T that told me echolalia is typically in children with a syndrom and that I should have her checked again….is this true? I provide my daughter with yes/no opportuities now. For example I will say “do you want a drink yes or no? and she will say no if she does not but if she does she repeats want a drink rather then saying yes? Any further suggestions of what I may be able to try with her? I am getting concerned because she is hitting now and I really believe its because she does not have the vocabulary to express what she really wants. Are there any books out there you would recommend Laura?
    Thanks for your time!
    A concerned Mom

  21. Dear Concerned Mom - I’d recommend a speech eval if you’re not seeing an SLP already. She should not be using echolalia at 5, so she is likely experiencing communication difficulty. Has someone previously told you she doesn’t need speech therapy or that she doesn’t have another diagnosis?

    If you are currently seeing an SLP, then ask for her advice. I love the OTs I work with, but this sounds like an area you should be addressing with an SLP.

    I think your interpretation of her recent increase in aggression is correct. Many children hit, bite, and throw tantrums because they can’t adequately communicate.

    Keep reading ideas here on the website for ways to work with her at home.

    You can also write back in and tell me where she’s functioning communicatively and then maybe I can recommend some additional reading for you. Laura

  22. Laura,

    Your information has been very helpful to me in understanding my son’s echolalia. It seems like his speech is becoming more echolalic recently(I’m not sure why)so I was glad to finally find some useful tools.
    Blake is 9 years old and has Down Syndrome. He is an excellent reader and speller. He also seems to have good receptive language but his expressive language is very delayed.
    When doing cognitive work such as catagorizing animals, adding, telling time,etc. he does well but we use a lot of visual aids.
    I’m starting to wonder if I should start using sign language with him along with the suggestions you have mentioned to see if he starts having more spontaneous speech. We stopped using the sign language after he started to talk.
    Any suggestions would be greatly appreciated.
    Thanks again!

  23. Jennifer - You could certainly try it, and if it’s not successful, at least you’ll know you gave it your best shot. What does his SLP think? Children with Down Syndrome have low muscle tone which makes it more difficult to talk, but many children with Down Syndrome also have apraxia, or verbal motor planning problems. Using signs for children with apraxia also helps them verbally motor plan since you’re giving them an additional way to access the word. Targeting easier verbal things like animal sounds and other play sounds may also be more fun for him too to do spontaneously, and then work your way toward spontaneous words, phrases, and sentences. You’ll have to goofy and playful while you’re doing this, even with a 9 year old, so he drops any inhibitions he’s acquired and “goes for it” with his speech. I hope these ideas are helpful. Let me know how he does with them! Thanks for your questions! Laura

  24. My 11 year old son has echolalia issues that are different than what you mentioned in the article and I need some help. He will repeat lines from movies/TV shows/video games VERY dramatically (loudly, pointing, etc). I’m not worried about this when we are at home because it’s just what he does but I have concerns when we are out in public. He usually does this when he is looking directly at someone (although, I’m not really sure he is seeing the person) and I’m afraid people will think he’s yelling at them, acting aggressive, etc. I know this is a self calming thing for him so I’m not sure how I should handle it. Should I ask him not to do it (because, technically, he really can’t help it) or is there some other thing I can have him do that will help with the self stimming? Any help you can give me will be appreciated. Thank you

  25. Dan’s Mom - What does his SLP recommend he do? I specialize in treating infants and toddlers, so a child who is 11 is like geriatrics to me!! But I’ll tell you what my instinct would be.

    Is he able to respond to behavioral redirection such as, “You can do this at home, but not when we are away from home.” If he can understand and follow through with these kinds of redirections or “rules,” I’d go ahead and implement those so that he doesn’t isolate himself socially. Can you find another less dramatic way to help him self-calm? His OT and/or SLP should be able to help you find other things that work for him. Does he calm to deep pressure or any kind of tactile stimulation, or does it always seem to be loud talking that calms him? You may have to help him find another substitute for the loud quoting first such as squeezing his hands or handling a fidget toy, but if doesn’t respond to the tactile feedback like he does his loud talking, you may have to teach him to excuse himself to a restroom or outside to do the yelling and pointing. This is a tough issue which may need lots of trial and error for you to find a solution that works. Good luck and let me know how he does! Laura

  26. Hi Laura,

    I have a 34 month old son who repeats 85% of the time. He can answer questions like “What color is this” or answer “What is this” and he can communicate what he wants with 2-3 word sentences. He is very smart but he seems to echo too much. He has a large vocabulary but seems to just not be able to put it together. I did have him evaluated for early intervention services (in NYC) but they said that he is where he should be and to just monitor him. I am hoping that your advice on this website will help me as I plan to implement the advice you give and I also bought your DVDs. I am just very worried. Any advice you can give would be greatly appreciated.

  27. Worried Mom - As you know, just because he can say it, doesn’t mean it understands it! Echolalia occurs when there’s also an underlying auditory processing/receptive language problem. Work on helping him learn to understand more and his spontaneous language should increase. The DVDs will help you learn what kinds of things you can work on during play.

    Use the ideas here in this article on the website to help him learn to understand questions.

    Since you’re still worried about him, I’d recommend that pursue a private speech-language evaluation, even if you have to pay out-of-pocket for these servicves. Many times children don’t qualify for services from early intervention programs because they don’t meet eligibility requirements which are very, very low. Children usually have to be functioning in the bottom 1-5% when compared to other children their same age, so even children who are only in the 10th percentile won’t qualify for services, and many times therapists don’t explain that clearly enough to parents. There’s a big difference between typically developing and “eligibile for services.” Typically developing 34 month olds certainly don’t echo 85% of the time and are talking in longer sentences.

    Hope this info helps.

    Laura

  28. Worried Mom - Your 34 month old sounds very similar to mine!

    Laura, would you say I’m wasting my time by pursuing only the EI evaluation at this point? I feel like this whole process is going to take forever and we are losing precious time where he could be getting help.

  29. Krista - Get the EI eval for the primary purpose of someone helping you through the transition process and to get recommendations for what services would be helpful for him, even if he doesn’t qualify for therapy or there’s little time to get started. You’ll still know more about him than you would have without the information. Laura

  30. Hi Laura.
    I’m starting to suspect that my son (21 mo.) might be echolalic. He began talking kind of late? (15 1/2 months) and now has a broad vocabulary. He began by repeating EVERYTHING, which to us, was fantastic considering we’d been waiting for him to speak at all. Now he is starting (trying) to put two words together. He has absolutely no concept of pronouns yet and will often say things like “Help you” or “good job,____”, etc - phrases that obviously I say BUT they do seem to fit the situation at the moment. There is a definite routine going on as well. For example everytime we get into an elevator he will say “door shut” and “door open” because I pointed it out to him before- but now he says it EVERY TIME with little/no variance. I guess my main question is at what age would you expect a child who is definitely self aware to use/understand using pronouns?

  31. Shannon - The milestone for children with typically developing language is mastering early pronouns me, my, mine, I and you by 30 months, so he’s still a little young to have fully gotten the hang of those by now.

    Since you know this pattern is his learning profile, follow the recommendations listed in the above article to avoid problems. Model phrases exactly as he should say it. Point to who you’re talking about as you say the correct pronoun to help him understand. Avoid names if he tends to repeat those. Those are all recommendations that are easy to say (or type), but much harder to actually carry out!

    I’m glad he’s now talking all the time, but redirect your focus on language comprehension with him to be sure he understands what he’s repeating. Following directions is CRITICAL. Give him oppportunities to demonstrate that he comprehends language all day long. If you need some more specific ideas, take a look at my DVD Teach Me to Listen and Obey 2.

    Thanks for your question! Laura

  32. I spent the last hour and a half reading the material on this website. I was searching for information on Autism but more specifically Echolalia. This site is so informative. My son who is 35 months was recently diagnosed with an ASD. He memorizes everything and repeats it back. He can quote DVDs from beginning to end. Each question I ask him, he repeats it back to me. I desperately want to give him all the help that I possibly can. I was told to get him speech therapy. Can you please provide me with a guide as to what I can do? I am so scared right now. This is all new for me and I have read so much in the past few days since his diagnosis but I am still so confused.

  33. Hi Laura. My son is 38 months and I am very worried that he could be autistic on some level. He displays some of the symptoms like memorizing books, singing complete songs and he LOVES puzzles. He can complete puzzles designed for 4 year olds. He started preschool in March and is currently attending summer camp at the same school. While he likes to play with his cousins, he tends to be a loner at school. He loves music and was receiving services form our states early childhood until the age of three. At tthat time, they told me that they didn’t feel he needed any more services from the school’s child find program.

    He repeats alot of what I say, including voice inflection. He is learning to answer his name when asked and knows that he is “3 years old”. When he wants something, he pulls me by the hand and says “come with me” or “help” and then he points at what he wants.He knows the alphabet song and can recognize all individual letters when asked. He can also recognize and count numbers up to twenty. Please advise.

  34. Thank you, Laura, for such a great article. My son is 26 months old. After reading your article I realized that he is learning lsnguage through some form of eholalia. For instance, he learned to say lots of phrases from his favorite TV shows. He will point at something interesting to him and say:”Look at that!” Even though he is repeating, he is using it appropriately. One time, he said: “Look at the mommy!” when he saw me. It doesn’t count as a sentence though since he didn’t form it completely on his own. Am I right? He says: “Here you go” when he hands me something and “I got it” or “You did it” when he grabs something. I have noticed that when I say “Hi, Mitchell”, he repeats the phrase. He doesn’t understand the concept of “I and me” yet and I am having a hard time teaching it to him.

  35. Hi Laura,

    Great article, gave me a lot of comfort level as a dad of 3 year old child. I do have a question though, what we have observed is that our child is generally pretty smart, he asks for things he need, like water, milk etc. Like he’s good with identifying objects and action-based conversation (don’t know any better way of saying that) anything that we ask him to do he will do it…or understand to do it..like get me the TV remote…etc..also, if we ask him (by showing the object), what is that…he’ll answer correctly (obviously whatever he knows)..and similarly if we ask him what color is that..he will correctly answer..however, anything that doesn’t require him to take any action, or when we are not showing him anything to answer..then he repeats the question (with an exception of some questions that he has understood well..like where did you go..he will say..I went to mall…or park…and also would respond to what he ate..he would say chocolate, rice etc)…like for good amount of months…I ask him..what were you doing..he keeps answering with what were you doing…so, the thing is..he never initiates the conversation..(unless it’s an action he wants us to perform) and rarely will NOT repeat questions that he cannot relate to anything..like I have been trying to teach him..How are you, I’m fine..type…he will memorize it and at times..he would just say..How are you, I’m fine..but that’s not two-way conversation…I am going to try to utilize your suggested methodologies..but any particular comment/suggestion will be much appreciated.

  36. Hi David. Thanks for your questions. What I gather from your comments about your son’s learning style is that he has to DO something before it makes sense to him so that he can talk about it. So that means for everything he’s NOT answering, or answering with an echoed question, he’s not able to process. You’ll have to figure out a way to make those concepts/ideas more real or concrete for him. Some things in life that we routinely talk about are pretty abstract - like “How are you?” Emotion words in general are pretty difficult for many kids who are on the spectrum to understand. You’ll have to think of very REAL ways to teach these. For example, labeling, “I feel happy/sad/sleepy/hungry etc…” These are probably better targets and more easily understood than “fine” for right now - although there is value in learning to respond with a nice, expected answer in social situations!

    For teaching the response to “What are you doing?” use action games. Model common actions that you know he understands like jumping, running, singing, sleeping, eating, etc… and have someone else ask you, “What are you doing?” You reply, “I’m jumping.” Then have him join in (by making him jump/run wtih you) and have the other person ask both of you, “What are you doing?” Encourage him to repeat your “I’m ______.” Over time work toward modeling actions he’d be doing as you ask these kinds of questions during your daily routines such as playing with cars or drawing, etc… Because he’s echolalic, you’ll always want to model answers in the way he would say it since he’ll initially be repeating you and you want it to make sense in context.

    Echolalia should diminish as his language processing and comprehension and vocabulary improve. Right now he’s repeating because he doesn’t understand the question or know how to respond correctly - or perhaps both. Use these as opportunities to know what he needs help to learn. Does that make sense to you?

    Is he in speech therapy with a great therapist? If so, talk to her about any ideas. Since she can see you, she may be able to provide specific instructions that I can’t since I don’t know you guys. If he’s not, then I’d highly encourage you to get this service going. It is as important for you as it is for him.

    Thanks so much for your question. I love to hear from hands-on Dads!! Laura

  37. Many thanks Laura for your comments…I appreciate it. I will work on the ideas provided by you. However, no he’s not doing a speech therapy at the moment, we did have his speech therapy done when he was 2 and he was able to successfully meet all the goals set forth..and since then we have seen lot of progress, but then this repetition of questions started…I will look into speech therapy too..but we were planning have him start the pre-school soon…hoping he may be able to make some good progress by watching other kids…he’s the only child we have…that has also probably contributed to some of the issues we have run into..

  38. Hi Laura,my son is turning 3 next month,but he isn’t fond of talking at all.He doesn’t answer when we call him or when we ask him question.But he knows all my directions well.I’m a working mom,so I use nanny to babysit him.But I don’t expect that she doesn’t communicate with him at all.Everyday they just sit beside the window,watching the cars go by.When I have no nanny after that,I just let him sit infront of the tv.He is a really adorable little boy,smile to everyone,easy to manage,self feeding from 1,5 year old,and likes to play with everyone.Because of that,I feel comfortable to just let him sit watching tv,so I can work without being disturb.But later,I found out that he can pick other disc that was full of violent(robots,kungfu,and mostly in Japanese language).He got it from his brother’s desk,and he did change the disc by himself.and later,he did a lot of movement like somebody is fighting,doing kungfu,and imitate how the robots act,with the nasal sounds like it’s really the background sound of the movie.Now he babbles a lot.When I ask him,he does echolalia.Sometimes he would answer question with no no,with his head saying no.When asking for food,in the past he would say am,but now,he just pick his plate and bowl,then send them to us.This 2 months,I have spent a lot of time with him,and I just realized that I had made a lot of mistakes by not spending time with him,and his development problem is caused by me.He only knows abcd and 1-10.And that because no one has ever teach him about that.But this 2 months,I know he progress a lot,know my directions.I am very afraid that he is autistic,cause he only says about 10 words.He says and know the meaning of mama,papa,grandma,sister,brother,go forward,broken,go,beware,milk,eat.Other words,he can say them,but not by his own.He is just echoing.He has 1 brother,and 1 sister,11 and 8 years old.Both of them are bright.But have no time to play with him.I notice that his brother made a monster voice everytime they met,and now he is imitating the voice too.Oh yes,he has no odd movements,loves to wave bye bye and says dada,even with a toy if the toy is moving away.Now he makes the movement of the arms as if he wears a Ben- 10 wrist watch(he watch Ben -10 several times,and make kungfu movement.He makes eye contact when he wants.When he is busy,I have to call 3 times until he comes.He loves kiss and hug.May I have advice from you,please?I live in Indonesia,and the info about Autist is very rare here.Thx a lot.

  39. Oh yes,when we tell him to pee,he will pull off his pants,and then go to the toioet and manage it himself.When he wants to poo,he won’t tell,but he will run to the toilet and pull off his pants.I feel that his little mouth is very lazy to say things.But he will say it correctly when echoing,after we repeatedly asking him to repeat them.He isna thumb sucker since he was born.thx Laura…I’m awiting for your response.I’m not getting any well sleep these days,afraid that my boy is really an autistic person.We don’t have very well experience about it here…….God bless u!

  40. I forgot to tell,we use 3 different languages at home,but this 2 months I only use 1 language with him.He is a food lover,he eats everything.thx

  41. David - I’d pursue speech therapy again to specifically help with these issues. Good luck to you! Laura

  42. Hi Jeannie - Since I can’t see him, I don’t really know what’s going on with him other than what you’ve reported. Based on that information, I would be concerned. He does need to see a speech-language pathologist to jump start his language development. I’m glad you’re figuring out ways to spend more time with him. Since he’s understanding more of your words, you know this is what he needs to learn. I’d also decrease the amount of time he spends watching TV. He needs interaction from real people for most of his day. When you’re at home working, have him in the same room and chat with him about what he’s doing as you accomplish your tasks. If this is a real issue, maybe you could pursue a quality or preschool program for him or hire a sitter with playing with him and teaching him new things as her primary responsibility. For ideas on how to teach him language in play, check out my DVD Teach Me To Talk. It often helps to SEE those strategies to know how to work with him. We ship to Indonesia frequently, so moms have told me that access to therapy services is difficult, but not impossible. Talk to his doctor about a developmental evaluation for him to rule out any issue. Good luck! Laura

  43. Ok,thx a lot Laura,for all your suggestions.We really appreciate it

  44. This is a great article. Thanks for the info. We have a 4.5 year old son who is not currently diagnosed on the spectrum, but is receiving services for language delays. He has been using echolalia for the past year or so, but it’s changed. he now only repeats his favorite movie lines (he’s never repeated what we say) when he’s stressed or anxious or excited - like as we arrive at school, which he loves. Sometimes he’ll use echolalia as he narrates his own play - although he’s also doing much more creative play these days. He’s becoming much better at articulating his wants or needs. He can tell you that he’s hungry for a cracker, for instance, or that he needs help with his tinkertoys. He’ll ask me to play with a specific toy or game quite clearly. He’s also starting to synthesize his own (sometimes complex) sentences.

    My question is about the echolalia that remains. Should we do something about this? If so, what?

  45. Kyle - Thanks for your comment. I’m glad your son is making such great progress! Congratulations! The way he is using echolalia is pretty common. He says those passages to help himself calm down and regulate, when he’s excited for both good and bad reasons. As his language skills and coping skills improve, echolalia should diminish IF he can learn some other ways to compensate when he’s stressed. Is he receiving OT? If so, talk with his OT about other calming strategies you can introduce. He may have to pair those with the echolalia for a while, but hopefully, it will decrease in time as he matures. If he doesn’t have any other sensory issues that require treatment, talk with your SLP or perhaps a psychologist for more strategies for helping him regulate without the echolalia. Remember that he’ll need something to replace it, and it may not necessarily be easy or happen as soon as you’d like. Hang in there! Laura

  46. Many thanks for your kind words and comments.

    He is receiving OT at school, although I don’t think they work directly on the echolalia. I think it occurs mostly when we drop him off from school and sometimes at recess, so it doesn’t seem to interfere with learning. My sense is that teachers and therapists are currently just pushing him towards productive speech and not so much away from the repetitive language. We do notice that he uses echolalia more after watching his favorite movies, so we’ve restricted that significantly. We’ll chat about coping mechanisms with teachers in the next few weeks, but do you have ideas of what we might try at home? I’m also a bit confused about the sensory component - he has some food texture issues, but is otherwise not greatly affected by his environment. What’s the connection here?

    He’s beginning to exhibit palilalia. I did this as a kid, too, and sometimes catch myself doing it as an adult. Interestingly, he seems to do this mostly with his own phrases and sentences. It’s almost like it’s practicing. I’m not sure if I should, but I take this as an encouraging sign.

  47. Kyle - The sensory connection is that the situations you described make him overwhelmed or overstimulated (even excited can be overstimulated), and that IS a sensory reaction to his environment. Please talk with his OT about this so that she (or he) can give you specific examples or explain why this isn’t related. Since I can’t see your child, so I could be wrong about my take on this. I’m just responding based on my previous experiences with children with echolalia.

    It’s fine for his team to work on productive speech because it will replace the echolalia except for what he uses in the previous contexts we described with sensory reactions.

    Echolalia is closely linked to palilalia, especially in toddlers and preschoolers who are on the spectrum. However, I would not rule out “practicing” in the case of any child with language delay since practice is required to improve! When it interferes with other activities, it is problematic. Professionals may even refer to that as perseverative speech.

    Thanks again for your comments. I hope your team can shed light on questions specific to your little boy. Good luck to you both! Laura

  48. I have been so worried about my son to a point where I often wonder if he is autistic despite the fact that he does not show other symptoms other than the language delays. Your articles on Echolalia shed so much light on this subject for us. thank you so much!

  49. You’re welcome Carla. I hope you’re getting him the help you need. Have you checked out my DVDs - especially the receptive language DVDs Teach Me To Listen and Obey 2? Kids with echolalia do often exhibit underlying issues with comprehension. Check that out if it seems appropriate for your situation. Laura

  50. My sister is 21 years old and is still echolalic. She doesn’t repeat things said to her, but will repeat things said to a third party by someone else in the room. For instance, I’ll say, “I’m going to work.” and my mother will reply, “have a nice day.” My sister will instantly jump in with “Have a nice day.” the same thing happens when someone is telling a story about something that happened, even if she wasn’t there! She has aged out of speech therapy, but my whole family is being driven crazy by the echoing. Thoughts??

  51. Hi MT. Echolalia can last a lifetime, particularly when the person has a hard time generating new, novel sentences, but still wants to take a turn during conversation. You could try to teach her some other “general” or “filler” phrases to use rather than copying what she heard another person say which may sound more conversational. Try, “That’s a good idea,” or “How about that!” or “You don’t say…” Those are my initial thoughts and what I’d do, but please know that I specialize in working with toddlers. You may also continue to search for ideas from someone who works with adults. Laura

  52. Hello Laura,

    I am a speech and language therapist and have recently started seeing a little 3 year old boy. He does not have a diagnosis as yet but there are few characteristics of echolalia/processing difficulties. He tends to repeat sentences a few times. If they are instructions, then he will repeat them, think for a while and then carry out the instruction (it may have to be repeated for him). There is one area that I am a little but confused about. His mother has reported that if he comments on something, he expects his mother to repeat it back to him and if she does not he gets really frustrated. Any suggestions/tips on what this may be and how we can provide therapy?

  53. hi Laura
    my almost 3 year old daughter just started a daycare and on the very first day, the teacher noticed she repeated alot of her commands. I never thought this was an issue until now having looked it up online. we only speak to my daughter in Spanish and have placed her in the school so she can learn English. She was an early talker, at 10 months having about 10 vocbulary words. at the age of 12 months, we had her with a Nanny who spoke to her in Arabic and from there, she stopped speaking for a few months. i thought she was trying to process the new language. after several months, we let go of the nanny and so concentrated again on Spanish, with her only listening to English on Sesame Street. and soon after, she began talking again and really being able to hold conversations while at the same time retaining some of the Arabic (she knows her letters and numbers in Spanish, English, Arabic). so that when they told us about this issue in school, it caught me by some surprise. she understands and instantly does anything that i ask of her, will generate her own conversation “look mama, the butterfly is flying into the tree” and things to that affect. at times, i’ll exit my car horse from answering her questions and talking with her. she will say ”
    Sumi wants a cracker” vs i want a cracker. but i also think that’s because we haven’t taught her the I, me, mine part of language. we always sort of went with what she said. we’re trying to correct that now by trying to teach her that. at times she’ll ignore what we ask of her but i’m unsure of this has anything to do with her just being independent and testing limits. but we now definitely notice she will repeat what you ask her or the last word of the sentence rather than respond at times. i’m going to keep a journal as to when it happens most (tired, etc) we’re going to have her evaluated for speech as well as any autism or spectrum issues. she has no issues with eye contact or eratic behavior, loves to play, go to the park and go to the school (today was her second day and she greeted the teacher and responded to the Spanish speaking adjunct). she seems to have problems with transitioning without preparation but yesterday i explained she was going to school, what the teacher would ask her, what her reponse was going to be, and that we’d pick her up later. and when my husband picked her up, the teacher said she had a great day, easily did what she was told and even asked a little boy she was playing with to come home with her. she reponds to jokes or funny situations as well. if and when she does have a tantrum (because she doesn’t want to leave the park), i let her cry and then explain why we’re leaving and what is going to happen next. she seems to calm down after. from the little that i have said, what are your recommendations in how we should speak to her to get her to not repeat as much, to express more of what she wants and any other advice. how should our questions sound, should we mimick what we want her to say, etc? also, do u recommend any play activities that mite help.

  54. Hi Shinoa. Without seeing her I have no idea exactly what’s going on with her. That being said, I do have some advice.

    Based on what you said it doesn’t seem to be a receptive language problem BUT I would go ahead and pursue a speech-language evaluation and SPECIFICALLY get them to test her receptive language skills to be sure that any language processing/comprehension issues haven’t been missed. Echolalia is usually seen when a child isn’t truly understanding what’s been said, so you’ll want a thorough assessment to rule that out.

    Generally, the more language she truly understands, the less she’ll repeat you and the more conversational she’ll become.

    I’m glad you’re going to follow up with ruling out autism as well. Children with high functioning autism often aren’t diagnosed until much older because they CAN talk, but the other problems are overlooked, so again, get it ruled out. She is displaying some red flags that would make me a little concerned about her.

    There are TONS of articles here on the website about eliciting language and teaching a child to request, so take a look at those. If you’re not sure how your play with her should look, I’d recommend my DVD Teach Me To Talk, but it sounds like she may be further along developmentally than most of the kids in the therapy clips, but the high energy playbased activities would still be my preference for teaching her what she doesn’t understand or say on her own. Good luck to you! Laura

  55. Dear Laura, I understand how busy you are and how many comments you probably receive, but I still hope to get some feedback on my post about my 28-month old daughter Anna sent a couple of days ago…I am very concerned about her language development and would like to order some books and a DVD, so I would appreciate your feedback a lot. Thank you!

  56. Dear Laura,
    I am trying to post here my question and all about the problem, but the web-site doesn’t publish anything. I’ve managed to post a short question above, but not everything. Is there any e-mail I can try? Thank you.

  57. Hi Laura,
    I feel that i found a perfect site for my problems.My son will turn 4yr this nov.He is taking the speech therapy services from the early intervention from february’12.Previously he was not using two words put together.Now he has improved a lot.Also i used to repeat the sentences for him at home like “i wan’t juice”,then slowly he started repeating that.Now he tells what he wants and where he wants to go.But if i ask him what he did in school or how you got hurt in school ,like fell down?he is not able to answer.If i ask him what he ate for lunch,sometimes he says breakfast.One day i asked him what you did in school,as usual he didn’t say a word.Then i told him”U played with your friends?”The next time i asked him the same question he said “played with friends”.Is he echolastic?Also how shall improve in making him respond to questions?the things which i can do at home.

    Also we speak 2 languages at home(only 1 language with kid and we talk in another language with each other) ,other than english.Since the therapy is in english we thought we will talk to him in english also.Also he replies back in english and he understands english better.Am i doing correctly?Should i stop talking to my husband in a different language than we use with the kid?should i use english only for him?

    So far i have not done any test for him for autism.I feel that i should wait for some more time.Previously he used to be so cranky,now he has changed a lot better.Low eye contact,stubborness,lack of speech etc.But he is doing far better now.He used to play alone till he was 3.Now he likes to play with kids and requests me to take him to his friends houses.
    I donno whether i should take the evaluation or wait for few more days.When i talked to my speech therapist she said she was little concerned about his attentiveness.But then she said may be you can wait.We are living in US now,will be moving back to our own country this year.I am sure that i will not get good resources and services like how i get here back in my hometown.But still feel that should wait as i don’t wan’t him to be labelled so soon.I will be in US only for two months.What is your opinion regarding this?Awaiting your reply.sorry for a long post

    Thanks
    Divya

  58. Hi Laura,

    I have a 5 year old daughter who was diagnosed with ASD when she was almost 4 years old. Since her diagnosis we placed her in a therapeutic pre-school where she received speech, occupational, music and dance therapy. She has done remarkably well. We never suspected ASD because Olivia met all her developmental milestones appropriately and she communicated using words and gestures. We did find it peculiar that she would repeat things we said and that she heard on TV. Olivia has delayed echolalia. When she repeats something from a book or TV show, she will do it like 20 times in a row almost in a trance until I say “One time Olivia, one time.” then she repeats the phrase one more time and stops. I don’t know if that’s the right thing to do. I also ask her questions about what she is saying. For example if she says “I can swing right over the world” I will ask her, “Who says that?” or “where did you hear that?” and she will say “In my book MY WORLD.” Is there anything else I should be doing when she displays this behavior? Should I continue what I have been doing? If this serves some purpose for her, I don’t know if it is the right thing to try refocus her and stop the echolalia. Any advise would be appreciated.

    Thanks,

    Karina

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