This month I would like to present some resources on echolalia. This is due, in part, to a dispute on a social media page related to autism and early intervention. One side proposed that echolalia was a restrictive and repetitive behavior that should be extinguished. The other side asserted that it was a functional mode of communication.
On a personal note, I spoke in movie quotes and song snippits when I was younger; and even now, often a quote from a blog, movie, song, or other social media source will be the first thing that pops into my mind. For those who live with me, or are close to me, I can just sing the song snippit or share the quote and they understand me. It is not just the words or lyrics that they understand; but also the emotion, or memories associated with the bit I quote. For example, if I were to quote Miguel from the animated film The Road to Eldorado (2000) when he says, “Stars. Can’t do it. Not today,” in the company of my children, all of whom are grown up and have their own homes, then they would understand that I miss them, that procrastination is a family trait that we all share and that I’m ok with them being late with things, that I love them, and a whole host of things it would take so many more words to describe. As an adult and a professional, I often suppress these urges in certain situations and instead translate what the thought means to me into words that other adults would understand.
From a more professional and research-based note, I have several professional resources that happen to support echolalia as a functional mode of communication.
The first is an article from the American Speech and Hearing Association’s ASHA Leader Magazine titled Echoes of Language Development: 7 Facts About Echolalia for SLPs written by Kylie Davis (posted on) 9, May 2017. This article emphasizes that imitation and repetition are important parts of speech and language development; and that “Echolalia, a verbal form of imitation, is one of the most common characteristics of communication in autistic individuals.” It further states that though it was once viewed as a maladaptive behavior, “an increasing body of evidence has lead most experts to recognize echolalia as a bridge to meaningful, self-generated speech with communicative intent.” Davis goes on to list, with full explanations, 7 important facts about echolalia for SLPs to know and share:
- Echolalia represents a gestalt language processing style. Meaning individuals assign meaning to longer segments of spoken language. (e.g. “comesitatthetable” may just mean “table” to them) and that these children have a top-down rather than bottom up style of learning.
- Echolalia can be immediate or delayed. Immediate happens within 2 conversational turns, delayed is more than 2 turns. “Though delayed echoic responses may not fit current conversational context to an unfamiliar listener, they often relate personally to the child. For example, a repeated sentence or phrase can represent a significant memory, emotion or area of interest.”
- Echolalia is a verbal behavior, not a vocal stereotype. “Echolalia always involves repetition of verbalizations in some form—not vocalizations. SLPs can help distinguish true echolalia from non-speech vocalizations such as vocal stereotypy.”
- Echolalia supports relationship-building and social closeness. It creates opportunities for interaction and engagement through conversational turn taking.
- Echolalia serves a variety of communicative purposes. It “provides a way for people with autism to affirm, call, request, label, protest, relate information, complete verbal routines and give directives.”
- Echolalia aids self-regulation. “Even when a child’s echoes seem out of context, for example, echolalia still supports important aspects of cognitive functioning including rehearsal, learning and self-regulation.”
- SLPs can support language learning through interaction. “Following a child’s lead by using low-constraint language models—like comments, affirmations and reflective questions—can support natural language development in children with ASD who demonstrate echolalia.”
Davis closes with “By recognizing differences in language learning styles, defining echolalia, and embracing its social, communicative and cognitive functionalities, we can positively influence the way echolalia is perceived and treated. Widening our scope of treatment options helps increase language-learning opportunities for people with autism.”
Another wonderful resource on echolalia is Barry Prizant, PhD, SLP. He has researched echolalia since the 1980s, and some of my colleagues have been following his work for the last 20 years. The link will take you to his website where his research is available for free download as PDFs. As this post is longer than originally planned, I am not going to do a review of all of his articles, but they are easy to get to, free, and valuable. The Available Titles are:
- The Functions of Immediate Echolalia in Autistic Children
- Language Acquisition and Communicative behavior in Autism: Toward an Understanding of the “Whole” It
- Echolalia in Autism: Assessment and Intervention
- Analysis of the Functions of Delayed Echolalia in Autistic Children
Further, I recommend Echolalia on the Spectrum: The Natural Path to Self-Generated Language by Marge Blanc, M.A., CCC-SLP (appeared in Autism Asperger’s Digest, March/April 2013), as it is also a helpful read.
This month, I would also like to review a video by Agony Autie. You can find her information in my resources tab. Her pages are created and managed by a 31 year old autistic who also happens to have Ehlers Danlos Syndrome. Agony Autie is very active in the adult advocate community and is located, I believe, in the United Kingdom. She has a great many comprehensive and compassionate videos on a lot of topics that are important to the adult advocate community. Her style of presenting makes things clear to those who may not completely comprehend where the autistic adult community stands or why they need to.
I would recommend the following, as time permits (Click on links to do so):
However, I want to review the video “What is Autism to You?” (Link in video name) because it has had a really profound effect on me, personally.
This is a video letter to parents and loved ones with autistic individuals in their family. Agony Autie shows several clips in the beginning that show the dominant, scary narrative surrounding autism. She goes on to discuss the current diagnostic criteria, and how these sensory processing differences can make things difficult when interacting with non-autistic individuals. Agony Autie does a very good job of describing what the sensory processing differences feel like to autistic individuals in a neurotypical environment and what some typical autistic behaviors are trying to communicate:
- Stimming: physical, vocal, visual etc. is a way to control excitement.
- Emotional dysregulation: Autistic people feel things very strongly many time we cannot feel emotions without a physical response.
- Self-harming: A clear sign of distress, because the autistic individual can feel the emotion in the body, what better way to stop the emotion than to make the pain more physical than emotional? She also states that it is important to try to replace self-harming with safer stims to keep autistic individuals from harming themselves.
- Demand Avoidance: When an autistic person avoids a certain situation or demand because they are unable to process, deal with and function in a situation.
- Echolalia: This IS a communication behavior, it is an attempt at communication with you.
She describes how these behaviors are all interconnected, and instead of trying to extinguish, eradicate or cure these behaviors that professionals should try to help the individual function as they are and can in the world they live in. She reframes these presumed negatives as positives. Autistics have the ability to notice details others miss, sustain focus on one specific thing for long periods of time, that there can be enormous opportunities with our unique perspectives. “Just because a computer is not running Windows does not mean that it’s broken.” She asks parents and professionals to stop trying to cure people of autism, to rethink what is considered “normal,” and to listen to people who are advocating for themselves.
The video style may seem uncomfortable to non-autistic individuals (as reported to me by my neurotypical friends who have watched this) but, please, try not to let that bother you. If I can sit in an office with florescent lights and look you in the eyes and still manage to have a functional conversation with you, I would ask that you give this an honest chance for me. Shifting from a purely classical, clinical, old school paradigm to a more accepting, inclusive, neurodiverse model does not mean that autistic people do not need help or therapy. It only means that we would like to have a voice and say about what is actually going on in our world and what we need help with. If, after all of that, you still find yourself on YouTube with some ‘extra time’ there are some other great videos about neurodiversity you might want to explore. I also like Amazing Things Happen.
Well, I think I have rattled on enough for this month. Like I always say, I don’t have all of the answers; I’m not even sure I know all the questions. But let’s keep exploring shall we?