Echolalia Autism (Repetitive Speech)-Causes, Symptoms and Treatment
- Last Updated: Feb 2nd, 2019
- Posted by: admin
- Category: Speech Therapy
Have you ever heard the person repeating the same words or phrases you ask? Well, its a natural phenomena of children speech. But if it persists in adulthood, you need to think about this problem as it may become a disorder in upcoming periods. You may refer this problem as repetitive speech. In scientific words, this repetitive speech is known as “Echolalia“.
Echolalia is the natural occurrence which is a part of language acquisition in infants. “It’s a bread!” said the mother, to this, the child repeated, “It’s a bread!”
Ever thought what does Echolalia means? Why does this happen? What are its different types? Does echolalia always mean Autism? Is it associated with any other disorders such as Tourette’s, dementia, etc?
In this article, you will read everything you should know about echolalia. It’s types, purposes, happenings in the brain, symptoms, treatment and much more.
Echolalia(echologia or echophrasia) is the condition which is interpreted as people unsolicitedly repeating noises and phrases that they hear. The word “echolalia” comes from the Greek which was first recorded in the year 1880-85.
The meaning of “echo” is “to repeat”, and laliá means “speech” or “talk”. It is a type of echo phenomena, which is related to echopraxia, i.e. automatic mimicry of movements done by another person.
Both of them are referred to as the subsets of imitative behavior. Whereas sounds or actions are imitated being unaware. They might not be able to communicate effectively as they might struggle while expressing their thoughts.
In a single sentence, we can say that:
“Echolalia is the situation in which the person repeats the phrases or sound or whatever they hear.”
Is Echolalia Normal?
Yes, Sometimes Echolalia is normal, as it is a very normal part of language development. Small children who just start to speak use this constantly. If you will ask any question to them mostly they will repeat the last word of the question, instead of answering it. But children come out of this problem when they grew up.
In some cases, children don’t move past this echolalia stage and continue to repeat the words and phrases. These children only repeat what others have said and very rarely come up with their own thoughts.
For example, A person having echolalia might repeat the question rather than answering it. In many cases, echolalia is also designated as an attempt to communicate, learn, or practice the language. In the extreme form, it is automatic as well as effortless.
People may get demented between Echolalia and Tourette Syndrome. But the reality says both of them are different from each other. Where the speaker suddenly starts yelling or blabbering random things as part of their twitch. In such cases, the speaker loses his control over what or when they say it. Echolalia sometimes considered as a sign of autism, any other neurological condition, visual impairment or even a developmental disability.
The chances of having echolalia further into childhood are common for children with autism or any other developmental delays. Especially if the child is experiencing delayed speech. One needs to identify why and how the child may be using echolalia. It will help in created a custom treatment plan for the child. Consulting an expert Speech-language-pathologist can be helpful to pinpoint the cause and treat the language delay.
What does it mean when this stage surpasses toddler years? How does it function?
When Echolalia Stops?
Children between the age of 1-2 years are most founded on this problem. There is nothing wrong in it as this is the way they are learning. When they grow up to age 2, you will found them using their own utterances. At this age they will continue to imitate you when you ask a complex question to them, they will also use their own utterances.
At the age of 3 years, only pretty minimal echolalia is seen. Children at this age start creating their own simple sentences to communicate. While they repeat some words in their sentences. You will still see a little echolalia but the child speech contains their own thoughts and sentences.
Delayed Echolalia is the disorder in speech when the children start quoting the movies and TV Shows. It is very normal but relying on it too heavily can be a problem. This is most common because the children try to do acting like them. Or rehearsing certain scenes that they liked. But if the children are stuck on one scene or quote and repeat it over and over again then there may be a problem.
Difference Between Echolalia and Echopraxia
Echolalia is the condition in which a person repeats the words or phrases that others had said. Echopraxia is also similar to the echolalia but the only and the major difference is that in echopraxia people repeat the actions of another person.
Echopraxia is the involuntary repetition of another person actions. It is recognized as a core feature of Tourette syndrome and is considered as a complex tic.
Echolalia in Children
Repetition of other people’s words, phrases or complete sentences is echolalia. Children begin to reprimand in two age periods from 6 months to 1 year and from 3 years to 4. If the verbal disorder persists in older children, this indicates echolalia. The degree of severity of echolalia may differ. Therefore, the sooner it is diagnosed, the better and fast it can be treated.
A case study of a six-year-old child (by Semantic Scholar) shows that echo may serve interaction goals. They examined how social interaction organizes autism echolalia and how repetitive speech responds to the detectable interactional route. They offer an interpretive framework that helps them to understand the complex interactions that children with autism can engage in by using echoes.
Echolalia in adults
In adults, its symptoms appear in personality disorders, various brain lesions, neurological and mental illnesses. They find difficulties in communicating with outsiders, inability to express their own emotions and conducting work. Patients are not able to understand the elementary rules and norms, do not understand their behavior and the intention of others. This makes impossible for them to build friendly and romantic relationships. They may attach to a particular situation of the day and the slightest changes can cause serious experiences and hysterical fits.
Causes & Risk Factors for Echolalia in adults
Echolalia is experienced by every child as they learn a spoken language. Most children develop their own independent thoughts as they age. But some of them continue to repeat words or phrases they hear. If the child is having some communication disabilities, they hold on to mimic what they hear for much longer. Autistic children are more susceptible to echolalia.
Some people may experience this issue if they are distressed or anxious. While others experience it every time. This may cause them to remain mute as they are unable to express their thoughts.
This disorder may be experienced by those adults suffering from severe amnesia or head trauma, as they try to regain their speaking abilities after that trauma.
Echolalia along with other neuropsychiatric diseases leads to various complications and consequences related to health. A person with echolalia may experience the following complications-
- Difficulties with the process of socialization, training, work, the opportunity to make friends or start a family.
- The speech defect persists for life, even after proper treatment.
- If Echolalia occurs against the background of autism, then such patients experience an increased threshold of pain sensitivity.
- Sometimes children engage in self-torture, which leads to various injuries of the body.
Two basic forms or types of echolalia are Immediate and delayed Echolalia. Their presence tells something about the child trying to process language.
This type refers to repeating the words, phrase or an entire sentences immediately after someone has just said. For example, If someone asks a child “Are you thirsty” the child might answer “thirsty” however the possibility is that the child may be really thirsty or not. Frustration, as well as meltdowns, can often be the outcomes of Immediate echolalia. The reason being the inability of the child to convey his needs and desires.
Functional categories of Immediate Echolalia-
- Turn-taking: Words used as turn-fillers in an alternating verbal exchange.
- Declarative: Words used to demonstrate objects, actions, or location along with gestures.
- Request: Words used to request objects or others’ actions.
- Yes-answer: Words used to indicate affirmation.
- Rehearsal: Words used with no apparent intent.
- Non-focused: Words used as a processing aid.
- Self-regulatory: Actions or expressions which serve one’s own actions.
This type refers to repeating the words, phrase or entire sentences after a certain time passes, which varies from hours to years later. Diagnosing this type is really difficult as it happens after a certain time passes. The listener might be unaware of the original words or sentences uttered. The listener may not even notice the delayed echolalia, unless the speaker’s syntax, vocabulary, and the message is different than the normal.
Functional categories of Delayed Echolalia
- Turn Taking
- Providing information: Words offering new information not apparent from the situational context.
- Protest: Words used to prohibit or protest other’s actions.
- Directive: Words used to direct other’s actions.
- Self-directive: Words which serve to regulate one’s own actions.
- Rehearsal: Words produced with low volume followed by a louder interactive production.
- Label: Words to label objects or actions in the environment with no apparent communicative intent.
Symptoms of Echolalia
Repeating the phrases and noises heard before are the main symptoms of echolalia. The symptoms can be either immediate, i.e repeating words or phrases right away after hearing them. Whereas it can also be delayed, i.e. repeating words or phrases hours or days after hearing them.
Some other signs are:
- Mitigated Echolalia: It is the echoed speech which is produced with the change in wording or intonation made by the speaker. He/she changes the syntax of the sentence and the pronouns.
- Ambient Echolalia: Repetition of environmental stimuli such as a television program running in the background.
- Frustration during conversations
- Unusually irritable, especially if asked questions.
Diagnosis of Echolalia
Echolalia can be diagnosed by a professional while conversing with the person with echolalia. If that person struggles to do anything other than repeating what they have been asked to, then they may have echolalia. Some autistic children are regularly tested for this as they go for speech lessons.
Diagnosis of echolalia involves the following procedure-
- Collection of anamnesis- This is the survey of the mother of the baby about the course of pregnancy and the study of heredity.
- Neurological examination to detect abnormalities.
- Examination of speech- Speech therapist evaluates the speech of the baby, confusion of syllables, improper pronunciation, the frequency of repetition.
- Instrumental and laboratory studies.
Echolalia varies from being minor to severe on the basis of professional diagnosis. After identification of its stage and appropriate treatment will be prescribed.
Treatments for Echolalia
There are certain options available for Echolalia treatment. It may be treated using any of the method or the combination of the available methods:
Some people with echolalia attend regular speech therapy sessions. So that they can learn how to express their own thoughts in front of people.
For intermediate echolalia, a behavioral intervention called “cues-pause-point” is often used. In this treatment, the speech therapist asks the echolalic person to answer some questions correctly. Tells them to answer if they’ll point to them on time. Then, the questionnaire starts, such as “What’s your age?” After a pause, the speaker is prompted to answer. A cue card will be there having the correct answer.
Antidepressants or anxiety medications can be prescribed by a professional to combat the side effects of echolalia. These are only meant to calm the patient, doesn’t treat echolalia. Since the symptoms may increase due to stress or anxiety, the calming effect will be helpful to reduce the severity of the condition.
Family members may help people with echolalia to develop their communication skills. Many texts and online training programs are available for helping parents to get positive responses from their echolalic child. Encourage the child to use their limited vocabulary. This may help them to learn to communicate more effectively.
You may be aware of the different types of disorders which are alike Echolalia. Lets have a look on such diorders which are related with Echolalia.
Associated Disorders of Echolalia
What is Echolalia in Autism?
Echolalia and Autism are directly connected. Echolalia is the repetition of words, phrases, and sentences when the person repeats the phrases he heard before is called as echolalia. It may also be a sign of Autism, a neurological condition, visual impairment or a developmental disability. It is a unique form of speech, and if any children are autistic it may be one of the first ways the child will use speech to communicate.
People with Autism are often Echolalic.
Many Children with Autism use complex and adult words, but these words are said in the same tone and in the same order as they have heard in the TV shows, movies, books, or from another source.
Echolalia as a self-Simulation
When the children imitate the sound of human speech without knowing the meaning of those words or sentences. They use echolalia to calm themselves when they are anxious or cope with overwhelming sensory challenges.
Memorized phrases can also be used as the tool for self-talk, let us take an example, a child might talk himself using phrases which he/she heard from parents, teachers or from any other source.
Some people also use prefabricated phrases while communicating. People use this when it is difficult for them to formulate their own speech patterns. For a number of children with autism, echolalia is the first step toward more typical forms of spoken communication.
On the contrary, autistic children use the delayed type for other purposes, which are:
Autistic children tend to use echolalia to entertain themselves with things they are interested in. It also serves a purpose of keeping them from social interactions. This can be used by caretakers to redirect their behavior into a constructive one.
Communicating the Mood
Since spontaneous language hasn’t developed yet in an autistic child. They associate language given to them with emotions at certain times. They later use these phrases or words to express their emotion. He is trying to communicate his sadness that his father is going even though he can’t use the correct words. They associate certain words with the feelings and later repeat them to express their emotion. If it happens, try to redirect their emotions. For example, “I know your sadness but daddy will be back soon.” Children tend to become more echolalic due to the pressure to communicate their feelings, which leads to stress.
It refers to the use of echolalia in order to process the memories which comes to the surface of their mind. For example, a child may remember something said by their teacher after school and repeat it to organize and manage the memories.
Aphasia is related to brain damage due to which the person’s ability to understand spoken or written speech and language function deteriorate rapidly. Due to these symptoms, the person gets the tendency to repeat everything he hears. In transcortical aphasias, echolalia is very common when deterioration starts happening. After stroke echolalia tends to recover in perisylvian aphasias. It may have a similar function as in infant learning to speak.
Dementia may be one of the consequences of a brain injury or brain disease. It is a chronic mental process disorder including memory. They have the tendency for impaired reasoning. They can no longer produce spontaneous speech, leading to echolalia due to memory loss and comprehensive loss capacity.
Read more – Why Dementia and Hearing Loss are linked?
Distinguishing twitches for Tourette syndrome (TS) are Echolalia and echopraxia. The echolalic repetitions of people with TS are basically echoes from within their own “twitch repertoire”. The inadequate imitation-control mechanism makes a healthy mirror neuron system (MNS) vulnerable to interferences”, as pointed by evidence.
Tourette’s is another common syndrome with echo phenomena (echolalia and echopraxia). The person has the tendency to repeat involuntarily whatever they listen. It becomes frustrating due to the inability of the person to control what they say and when they say it.
Epilepsy is characterized by seizures (is a sudden surge of electrical activity in the brain usually affects how a person appears or acts for a short time). Occasionally, epileptic people after losing consciousness can wake up having echolalia.
Epilepsy is the fourth most common neurological disorder and affects people of all ages.
A person is diagnosed with epilepsy if they have two unprovoked seizures (or one unprovoked seizure with the likelihood of more) that were not caused by some known and reversible medical condition like alcohol withdrawal or extremely low blood sugar.
Echolalia and Schizophrenia
Schizophrenia is characterized by a chronic and severe mental disorder. It has psychotic symptoms. Due to these symptoms, differentiation between reality and delusions/hallucinations disappears. Delayed echolalia may be there in people, from things they hear, hours, days or even years later.
Outlook and Prevention
Echolalia is considered a natural part of language development in infants. It’s not favorable to prevent it completely. To do so, parents must encourage their children to use other forms of communication. Exposure to a wide variety of words and phrases will be beneficial for the child. Most children overcome their echolalia naturally.
You may make your child practising the conversation in this way.
Ask the question and then immediately say the answer with a single word (without pausing). It sounds like this “Do you want it? Yes.” Ideally, the child will just imitate the “yes” part of it. If not, encourage the child to imitate “yes” (or whatever the answer is). Keep doing this until the child is consistently repeating just the one-word answer.
Therefore these general therapies will help your child to come out of this disorder and make normal conversation.
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