Have you encountered this?

Adult asks, “Do you need help?”
Child responds, “Do you need help?”

When your child on the autism spectrum repeats yours or others’ words, or even phrases and sentences from their favourite shows, he is using echolalia. Why does your child with ASD use echolalia? First, let’s understand the two different types of echolalia:

1. Immediate echolalia

When your child immediately repeats words or sentences after he hears them.

For example, a parent asking her child, “Do you want ice-cream?” and her child responds, “Do you want ice-cream?”

2. Delayed echolalia

When words or phrases that were heard are repeated at a later time and may sometimes appear to be used out of context.

For example, a student once stood up in class and bowed as she said, “Thank you everybody!” 

She had repeated this from a video of her favourite singer’s concert to let us know that she had completed her work.

From the examples above, it is clear that echolalia has a communicative function. From responding affirmatively to the offer of ice-cream to informing the class teacher that one has completed her work, echolalia serves various communicative purposes while the child with ASD is still developing language. 

This brings us back to the question - why do some of our children with ASD use echolalia? Unlike how children typically learn language by first understanding and using single words, then gradually acquiring two-word phrases and short sentences, some children with ASD acquire language differently. This can be attributed to their difficulties with language processing. Therefore, they may memorise and use “chunks” of sentences that they have heard, without understanding the meaning of each individual word. Instead, these echolalic phrases were used by associating them with specific actions or situations during which it was first heard. For example, a child might say, “The doors are closing!” whenever she experiences anxiety as this was an emotional association with the sentence when she first felt the same emotion.

However, let’s not be too quick to judge echolalia as bad news. It is actually a positive development as it is evidence of language imitation and demonstrates the early stages of communication development. With support, echolalia can progress to flexible language use, although your child may still revert to echolalia when he is emotionally dysregulated. In the study of echolalia, the following stages of progression have been identified:

(i) Gestalt use of language - repetition of what was heard in its entirety (i.e. “chunks” of language), without understanding

(ii) Mitigated echolalia – modified chunks of language. Words and phrases are starting to get mixed and recombined

For example, chunks such as “Come on, let’s go!” and “Quick, let’s run!” being recombined to “Come on, let’s run!”

(iii) Use of single words and beginning to generate original two-word phrases

(iv) Development of more spontaneous and flexible language

What can we do to support our children’s language development? 

• Acknowledge and interpret your child’s communication attempts. 
  
  It may be echolalia, but it is your child’s means to communicate with the world around him while his vocabulary is still limited. This enables your child to know that he is heard and learn that it is an effective form of communication.
  
  
•  Understand how we communicate. 
  
  As our children’s communication partners, the way we communicate has a direct impact on our children’s language development. For example, are we often too quick to interrupt or ask too many questions? Are we always in a hurry to move our children from one activity to the next? Do we need to put aside a special time to interact with our children?
  
  Recognising how we communicate and making appropriate changes is critical to supporting our children’s language and communication development. 
  
  
•  Provide language learning opportunities through routines.
  
  Routines are the best way to embed language opportunities as it allows for daily and repeated practice. From the moment your child wakes up, he learns to greet “Good morning!”. When getting ready for school, he learns what “put on your shoes” means as he engages in the action.
  
  
• Patience
  
  Be kind to yourself and allow time for your child to go through the stages of language and communication development. As your child learns to communicate his basic needs and wants, he is also building his self-esteem and forming an emotional experience with the world around him. Take time to understand how your child uses different phrases for various purposes, and seek support when necessary to develop your child’s language development. 

References:

Notbohm, E. (2005). Ten things every child with autism wishes you knew. Future Horizons.
Sussman, F. (2012). More than words. The Hanen Centre.
Twachtman-Cullen, D. (2014). Symbolic communication: Common pathways and points of departure. In K. Dunn Buron and P. Wolfberg (Eds.), Learners on the autism spectrum: Preparing highly qualified educators and related practitioners (pp. 106 - 131). AAPC Publishing.