Echolalia: Dos and Don’ts

Parents and caregivers are often puzzled by echolalia, which is a repetition of words or sounds that one hears from another person. It is an important step in language development and is usually seen in the first 3 years of life. Children learn to speak by echoing or repeating what they hear adults say. However, when it persists in children beyond the age of 3 years, it is considered as a sign of developmental/communication delay.

Did you know echolalia is often a sign of neurological or psychiatric impairments in adults? Check out our blog on neurological/post stroke rehabilitation and role of caregiver here. For the scope of this article, echolalia will be considered as a characteristic feature of communication delay.

Echolalia can be of 2 types.

  1. Immediate echolalia: Where an individual repeats what they heard right away or with a slight delay.

Mom: “Where is the ball?”

Child: “Where is the ball?”

  1. Delayed echolalia: Where an individual repeats what they have heard, but with a delay, which could be hours, days or weeks. It can be either mitigated (with changes) or unmitigated (exact repetition).

Unmitigated echolalia:

Child holding a ball: “Where is the ball?”

Mitigated echolalia:

Mom: What does a cat say?

Child: “What does a cat say, meow meow, good job!”

Presence of echolalia in a child’s speech can lead to anxiety, irritability and frustration. Let’s learn how to manage/modify echolalia.

  1. Narrate the child’s play or activities, this helps to build vocabulary, which is crucial for enhancing comprehension and reducing echolalia.
  2. When a child echoes, it is often best to break down your utterances to smaller chunks which often facilitates enhanced comprehension.
  3. Limit the number of questions. Instead, model appropriate requests/answers. Example- instead of saying “Do you want crayon?”, say “Crayon, please”.
  4. Offer choices visually. Instead of saying “Do you want truck or ball?” you might hold up both items and model their names, then wait for the child to say the name of the one they want. 
  5. When offering choices, pair a preferred with non-preferred choice. For example-Q1. “Do you want to eat pizza or salad?”, “I want pizza” (pizza-preferred item/salad-non-preferred item) instead of asking “Do you want pizza or pasta?” (Both preferred items)
  6. When you notice breakdown in comprehension, you might want to use visuals and ask the questions/share the information again.
  7. When you anticipate breakdown in comprehension, it is okay to teach/model “I don’t know” as it is a more functional and socially acceptable response. For example- What is the date today?, I don’t know.
  8. When you have a student stuck on a word/phrase for a long time, you may want to respond/model additional ways they may say it. For example- “open door”, you may say- “can I open door?, please open door, I want open door” etc.
  9. When greeting or farewell, it is advisable to use “Hi or Hi friend” or, “good morning teacher” etc. instead of saying Hi Jane, or Good morning Ms. Smith.

For children with significant echolalia, it is okay to use social scripting. Scripting refers to using a series of words that are learnt. It provides kids with responses that are socially acceptable and functional. It is just like teaching typically developing kids to say “I am fine, thank you” when someone asks, “How are you?” This pre-existing script makes the conversation socially more acceptable.

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