Home »
Echolalia……..What To Do About It
Echolalia…What To Do About It
This is a follow-up article to my recent post “Echolalia…What It Is and What It Means.”
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 five minutes or two lines are spent offering recommendations for intervention. In an effort to overcome this irritating trend, I constantly remind myself to spend most of my time on this site writing about the part that most of us seek – the “What To Do About It” part!
I hope that you’ll find these strategies helpful for your child at home, or for 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. I even found a few BETTER strategies as I researched this article that I will share with you.
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, every day! 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 find solace in the same way that 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! 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 while displaying 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,” even though 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 them, 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 to 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 her 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, and 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 “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 herself when she’s not using her own name.
7. Avoid greeting or closing using the child’s name since he will always repeat it 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.
—————————————————————————————————————————-
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 my site!
Remember, you can teach words anywhere, anytime!
Laura
If you’d like more information about echolalia, you can find it in my course Is It Autism? Recognizing and Treating Toddlers and Preschoolers with Red Flags for ASD.
Get My Free eBook
A Parent's Guide to Understanding Speech Language Development
Get real-time clinical coaching and Q&A for professionals and parents who want practical answers, clearer next steps, and direct access to Laura’s expertise.
Recent Posts
Teach Me To Talk Testimonials
Happy Therapists, Teachers, Parents & Children
"Laura, I am a long time follower. You have mentored me from a distance for many years. I've watched many of your courses and purchased 5-6 of your books. I just wanted to take a moment as a sister in Christ to say- --- Thank you!! I'm in my 33rd year as an SLP and still love it! I work in the public schools and have grown my skills along the way with your help. Thank you thank you thank you and, Many blessings to you and your daughter!!!"
Camille, SLP
"Laura,
Three years ago, my then 2year old (adopted) was only saying two words - momma and boat. We had been doing speech therapy for 6 months, and he loved to play, but he was entirely uninterested in talking. A dear friend who is a SLP recommended I look you up online. Since then, I've read your emails, listened to hours of your podcasts, ordered two of your therapy manuals, and watched many of your videos.
My now 5year old tells elaborate stories now, and if you didn't know his background, you would never guess. And thanks to the hours that I have spent with your guidance, when our next son, now a 2.5yr old, didn't talk (after a craniotomy), I had tools to get started with him. His speech has just taken off in the last month or so.
Thank you so much for all that you do to help parents facilitate speech therapy with their kiddos. And thank you for your gentle, confident living of your faith.
God's blessings."
Rachel (mom to 3 boys in a now very noisy house!)
"Hi Laura!
I became an SLP in 2004 and you were my first SLP crush! I was so fortunate to have a supportive school district that allowed me to purchase your videos and the Teach Me to Talk handbook. Not only was the handbook a life saver (I literally called it my Bible lol), but the videos, oh how the videos changed my life, and the lives of the families I worked with! I remember telling my families that they'd love you, not only because you spoke directly to families, jargon free, but also because of your southern dialect. You speak directly and clearly, but never rushed and never over anyone's head, something I highly value. I told families that I could listen to you read the phone book and it would capture my attention. You see, I'm from Ohio where we don't get a whole lot of diversity and cool dialects, so listening to you talk about my favorite topics was a breath of fresh air. So many of us think talking over people's heads makes us more credible or whatever, but now that I've been around over 20 years, I can say you had it right all along. Southern speech included 😊"
Heather Welling, M.A., CCC-SLP, Early Intervention in Summit County, OH
"I found the modality checklists to be invaluable. I had something in hand that I can use right off the printer."
Elizabeth, SLP
"LOVED this program! It was jam-packed with a ton of information that will take time to incorporate into therapy sessions. (Not only is the child learning new skills, so am I as a therapist!) I've known about strength-based therapy and have done it, but not to the extent and to the organization offered in this training. I am looking forward to seeing how my therapy changes and how my little ones progress by using this program."
Leah, SLP
"This program was extremely beneficial for use in my practice. All of the information, handouts and techniques that were presented were amazing. Easy to follow along. I liked that it was broken up into different videos/sections."
Michele, SLP
"Thank you for including real-life stories and anecdotes from your own practice. Very helpful."
Ellen, SLP
"I loved the clear strengths guidance, and the reminder not to push too hard in therapy!"
Elizabeth, SLP
"The course was very helpful and practical. I will certainly apply this approach to children on my caseload. I kept thinking about children that already "graduated" from EI and wish I had this knowledge when I still had them on my caseload. (Although I did put a lot of other Teach Me to Talk information into practice!)"
Heidi, SLP
"I appreciated learning the 7 C's of Communication, which seemed to include, (restated/reorganized/ summarized) information from '11 Skills Toddlers Master Before Words Emerge', which I have successfully used for years now (Thank you so much!!!!). I appreciated the additional information included to better assist toddlers with ASD since that population, unfortunately, continues to rise. I also appreciated the focus on regulating children and the need to keep them regulated, since dysregulation and sensory impairment in toddlers is also rising. These are areas I did not study in grad school. I appreciate the worksheets we can provide for parents to identify strengths and how to use these strengths more effectively in treatment. Thank you again, for your essential contribution to our field. p.s. You and Macy are precious!! God bless you both!"
"I am one of those therapists who you pointed out works on the wrong things. ARH!! What a slap in the face, but in a good way, because it was a much needed wake up call. I've hated my job lately and now I know why. Thank you for the clarity."
Susan, SLP
"Dear Ms. Laura and sweet Macy, I just purchased the new course and wanted to say THANK YOU! I would have definitely expected such cutting-edge information to come from you! I am part of several message boards for parents of autistic children, and we parents are just so tired of being told by professionals what our children can't or will never do. And really, what is the point of doing that? How does that help at all? Except to make the parent miserable and feel like there is no point in trying to help their child?...The tone of the course is great (such positivity), and Macy is such a delight! She is such a wonderful addition to Teach me to Talk."
Ann, SLP
“I loved the handouts to share with parents to help them understand how utilizing their child's strengths and interests is the best way to facilitate their child's communication abilities.”
Colleen, SLP
“The most beneficial part of the program is the strengths survey, as well as the treatment toys and activities that correspond to each strength. There was no part of the program that I did not feel was beneficial.”
Natalie, SLP
"I LOVED the energy of this course! I also appreciated the research facts I learned I can spit out to other professionals and parents. The best part was how characteristics of ASD were divided into strengths and therapy activities... so if I have a visually inspecting kid, I know I can go into my pdf and find out what activities I should target based on that characteristic... this really did improve how I think about therapy."
Kelsey, SLP
"I feel so much more at ease now having a huuuuuge packet of therapy ideas and a framework for organizing my therapy and having an actual PLAN instead of just "following the child's lead" while trying to figure out how to work in the goals. The way the content was explained was easy to follow and the handouts are excellent."
A, SLP
“I found identifying a child's strength helped me to consolidate my previous knowledge and experience. I feel I have a clear method to identify a child's strength and to build their strengths into sessions plans to help achieve their set goals.”
Christine, SLP
"Wow, this course was by far my favorite course I have taken in a long time! I have been lately feeling "stuck" with a few of my autistic toddler clients, and this course provided clear and helpful tools and strategies to best support our clients while also being affirming. I loved all of the ideas that were provided as well as the Strengths Survey – I can't wait to implement all of these wonderful things!"
Isabel, SLP
“The most beneficial part of the course was the handouts to share with parents and ALL the therapy ideas!! I've always felt that we focus on the 10% a kiddo can't do instead of the 90% Can Do. I have always tried to do this in my therapy sessions. Now I have evidenced material for support!!!!!”
Suzanne, SLP
“Liked systematic handouts to use to help with assessment and diagnostic therapy. Enjoyed hearing examples of each strength domain. Great review and great handouts to be able to share with families. The course was well organized and the content is much needed as an EI therapist.”
Terri, SLP
“This was a fresh new philosophy and a comprehensive approach with a new concept for successfully working with children with Autism. Before this ,the very structured, compliance teaching model which has been utilized by many therapists using comply-reward, noncompliance -punish or a with-hold philosophy. Children with Autism became prompt-.dependent with this method. These Children couldn't initiate language or make a plan to move on their own. They had to wait to be prompted to act or to respond and never spoke spontaneously on their own. I and many of my SLP colleagues have always believed in play therapy and giving the child choices to play works best. It is very important that Parents should hear about this strategy! Thank you Laura and Macy for doing the evidence-based research and putting this new concept into words!!”
Teresa, SLP
“This was a wonderful, easy to understand course with lots of great materials. Exactly what the fabulous Laura Mize is known for!”
F, SLP
"I am an autism mom, and I bought your books and listened to several podcast episodes over the last few years. I believe your teach me to talk and autism workbook were one of the number one tools in giving me to guidance to help my son. Thank you!"
Brittni
"I just want to thank you for the invaluable information you’ve given me in helping my grandson to talk (which I have passed on to his parents). We’ve ve learned patience, appropriate expectations, and fun and effective strategies that we had found no where else. He is exploding with conversation! Sometimes I struggle to interpret his articulation, but all I have to do is say, “Show me”, and he’s excited to do so. He and I both want so badly to communicate with each other, and your strategies have made it so much easier and non-threatening. Once again, I thank you from the bottom of my heart."
Stacey
"My little guy is taking off like a rocket!! We’ve been working through your Autism Workbook for a few months and he has had an explosion of skills develop. YOU are AMAZING! THANK YOU!" Laura Q, Mom
"Dear Laura Mize and Team,
Thank you so much for all your hard work and publishing books! Our 17-month-old toddler suddenly exploded into speaking and imitating everybody's gestures and sounds, just a week or two after we 'completed' all activities that are listed under 11 pre-linguistic skills! Your method really works!"
Grateful customer.
"Hi Laura!
I absolutely LOVE all of your workbooks, especially your Autism Workbook. Starting with Social Games has been a game changer for many of my littles with ASD and their families. It's been the best way for them to finally connect and sustain shared attention and engagement, leading to longer social interactions, through play!"
Jodie, Dev, Therapist
"Hi Ms. Laura,
Thank you so much for the videos you have posted on your youtube channel. They are so direct, informative, and helpful. Thank you for being a resource for me to become a better therapist."
Dianne
