Why Does My Child With Autism Echo Words and Sounds?

Echolalia can be an important first step toward spoken language.

mom and son reading
mom and son reading

Echolalia describes the precise repetition, or echoing, of words and sounds. Echolalia can be a symptom of various disorders including aphasia, dementia, traumatic brain injury, and schizophrenia, but it is most often associated with autism. 

Echolalia is a unique form of speech, and if your child is autistic it may be one of the first ways in which your child uses speech to communicate. Thus, while it can be described as a symptom of autism, it can also be a great place for a parent or speech-language therapist to start working with your child. On the other hand, in some cases, echolalia really has no communicative meaning at all; it may simply be a self-calming tool that your child is using in the same way as he may use hand-flapping or rocking. 

Echolalia in Normal Child Development

Echolalia is actually a normal part of child development: as toddler learn to speak, they imitate the sounds they hear. Over time, however, a typically developing child will start to use language to communicate their wants, needs, and ideas by stringing together sounds and words in novel ways.

By the time they are three years old, most children (even if they have memorized bits and pieces from TV shows) communicate with others by selecting words or crafting phrases using their own unique voices and intonation. By the time they are four or five, they are able to ask and answer questions, carry on conversations, and otherwise use language in their own way to communicate with others.

Why People with Autism Are Often Echolalic

Many children with autism do use words (sometimes very complex and adult words)—but their words are said in the same order, and usually in the same tone, as those they've heard on a TV show, in a book, from their teacher, or from some other source. Echolalia in autism can have one of several purposes, or its purpose can change over time. It's also possible for a person to use echolalia for multiple purposes at the same time.

  • Some children (and adults as well) imitate the sounds of human speech without grasping the meaning behind those sounds. They may use echolalia as a sensory outlet: a way to calm themselves when they're anxious or cope with overwhelming sensory challenges. When this is the case, echolalia can be thought of a form of self-stimulation or "stimming."
  • Others people on the spectrum use "prefabricated" phrases and scripts to communicate ideas when it is too difficult for them to formulate their own novel speech patterns. For many children with autism, echolalia is an important first step toward more typical forms of spoken communication. For example, a child with autism may repeat a teacher's phrase ("say thank you," for example), in exactly the same way that the teacher says it, rather than actually saying "thank you."
  • Memorized phrases can also be a tool for "self-talk." For example, a child might talk himself through a difficult process using phrases she's heard from parents, teachers, or television. 

    Immediate and Delayed Echolalia

    Sometimes echolalia is an immediate echo. For example, mom says "Johnny, do you want a drink?" and Johnny responds "You want a drink." In this case, Johnny may actually be responding appropriately to mom's question, and may very well want a drink. But rather than using a novel phrase such as "yes please," or "I'd like lemonade," he is echoing her precise language. 

    Just as often echolalia is delayed. A child watches an episode of Sesame Street and, later that day, is heard reciting interactions between Bert and Ernie or singing a snatch of the theme song. Children with autism may have extraordinary aural memories, and in some cases can actually recite large portions of favorite movies complete with intonation and accents. Sometimes an autistic child may use Ernie's words for a useful purpose of his own; sometimes the words are just repeated sounds.

    Functional and Non-Functional Echolalia

    For some autistic children, echolalia is simply the reiteration of meaningless sounds. This non-functional echoing of real words in logical order can be very misleading to parents, as it sounds like their child is using meaningful language when that is not actually the case. A child may be able to recite the entire script of a Sponge Bob episode but have no understanding of who the characters are, what they're saying, or what the story means. It may be the case that the reiteration of memorized sounds has a calming effect on some children on the spectrum.

    Functional echolalia, however, is the appropriate use of memorized phrases for a real purpose. For example, a child hears a line on TV such as "got milk?" and later, when he's thirsty, may say "got milk?" in exactly the same tone and accent as the ad on TV. Again, in this case, the child is using the memorized or repeated phrase, but this time he is using it in a functional manner. He is asking for a drink, and his request is understood—but he is not coming up with his own phraseology.

    It can be difficult to identify functional versus non-functional echolalia, because memorized phrases may sound appropriate or correct when they aren't (and vice versa). For example, a child might reply "peanut butter and jelly" to the question "what did you have for lunch?" even if he actually had a ham sandwich—not out of a desire to mislead, but because he has memorized "peanut butter and jelly" as the appropriate response to a particular question.

    Similarly, a child might use an inappropriate phrase such as "back off Lieutenant" when angry because he heard it used by an angry character in a movie; in this case, he is using the phrase functionally to express an idea but is using it in the wrong context.

    What to Do About Echolalia

    People who wander around repeating words and phrases are often the subject of whispers and stares; as a result, it may seem reasonable to try to limit your child's echolalia. But the reality is that echolalia can serve a valuable function and may be a very positive behavior in the right circumstances. Trying to "extinguish" echolalia is almost always a bad idea.

    When echolalia is functional, it's a cause for celebration: your child has developed a tool for communicating his wants and needs, verbally. The fact that he has done so means that he is able to do much more, with the help of a speech therapist.

    Even when echolalia is less functional it's usually a good starting point for speech and/or play therapy. For example, a child might memorize entire segments of a favorite video, and recite them over and over. The child's purpose in reciting may be to calm himself or reduce anxiety - but the recitation may also indicate a real fascination for aspects of the video.

    In either case, play therapy such as Floortime and speech therapy with a therapist familiar with pragmatic speech therapy can help your child to use her language skills more and more appropriately. In the long run, your child's echolalic speech will almost certainly become more typical and functional. Even if your child never develops typical communication skills, using words to self-calm is always better than aggressive behavior.

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    Article Sources
    • Sterponi, L. and Shankey, J. Rethinking echolalia: repetition as interactional resource in the communication of a child with autism. Journal of Child Language, Volume 41, Issue 2. March 2014, pp. 275-304.
    • Steigler, LN. Examining the echolalia literature: where do speech-language pathologists stand? ​Am J Speech Lang Pathol. 2015 Nov;24(4):750-62. 
    • Van Santen, Jan P. H., et al. Quantifying repetitive speech in autism spectrum disorders and language impairment.” Autism research : official journal of the International Society for Autism Research 6.5 (2013): 10.1002/aur.1301. PMC. Web. 16 July 2017.