Why Your Child With Autism Echoes Words and Sounds

Echolalia describes the precise repetition, or echoing aloud, 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 not always a self-calming tool, like rocking or hand-flapping. It has its own patterns and may be how your autistic child first uses speech to communicate. Thus, while it can be described as a symptom of autism, it's also a point of entry for a parent or speech-language therapist to start working with your child.

This article explores how echolalia emerges in children (whether on the autism spectrum or not), the types of echolalia you may encounter, and how to best help an autistic child with echolalia.

Echolalia in Child Development

Echolalia is actually a normal part of child development: As toddlers learn to speak, they imitate the sounds they hear. Over time, however, a typically developing child learns language, and uses it to communicate their needs and ideas by connecting new words together.

By the time they are 3 years old, most children communicate with others by selecting words or crafting phrases using their own unique voices and intonation.

By the time they are 4 or 5, they are able to ask and answer questions, carry on conversations, and otherwise use language in their own way to communicate with others.

Echolalia in Autism

One of the difficulties in understanding echolalia in autistic children is that the repetitive echolalia speech patterns may be used for different reasons. Those purposes can change over time, and it's also possible for a person to use echolalia for multiple purposes at the same time.

Many children with autism do use words, sometimes very complex "adult" words. Yet their words are, in a sense, not their own. They're said in the same order, and usually in the same tone, as those they've heard on a TV show, in a book, or from their teacher and other people.

Reasons why autistic children use echolalia in speech patterns include:

• Self-stimulation: Often called "stimming," this use of echolalia speech patterns is meant as a calming strategy. The repetition is used to cope with overwhelming sensory challenges.
• Prefabrication: The use of repeated phrases and scripts helps to communicate when it is too difficult or stressful for the speaker to form their own original words.
• Self-talk: Memorized phrases may help a child to talk themselves through a difficult process using phrases heard from parents, teachers, or television.

For many children with autism, echolalia is a key first step toward more typical forms of spoken communication. For example, a child with autism may repeat a teacher's phrase, like "say thank you," exactly as the teacher said it rather than actually saying the intended "thank you" in response.

Types of Echolalia

There are different kinds of echolalia, and the terms can be a bit confusing if you're new to hearing them. That's partly because the understanding of echolalia changes over time. What was once considered a problem to "fix," for example, is now viewed as a possible pathway for speech development. In the same way, "functional echolalia" is often called "interactive echolalia."

Other types may be described as "non-interactive" or "mitigated," when talking about how the autistic speaker is using the pattern. "Immediate" and "delayed" describe the timing of the repetitive words.

Interactive and Non-Interactive

Some autistic children have extraordinary aural memories, meaning they remember what they hear. They use snippets they've learned from teachers or TV shows to communicate ideas and thoughts, but the way these phrases are used seems unconventional. For others, echolalia sounds seem to be meaningless. Researchers believe both styles have a purpose.

It's one reason why "functional" autism may be called "interactive," following the logic that both styles actually are functional but for different reasons. Children speaking in an interactive way are trying to communicate with another person and are using memorized phrases for a real purpose. The challenge is figuring out the meaning.

For example, a child hears a line on TV such as "got milk?" and later, when thirsty, may say "got milk?" in exactly the same tone and accent as the ad on TV, instead of directly asking for a drink.

Similarly, a child might say "Back off, lieutenant!" when angry, because they saw an angry character say that in a movie. The child has connected the words with the emotion of anger and is using the phrase to say so.

It's confusing until you understand how the child has "wired" these words to their ideas, in much the same way that idiom (descriptive turns of phrase) gets lost between languages: No one literally means “It’s raining cats and dogs,” but we know what that is.

In non-interactive echolalia, the child isn't trying to speak to anyone else. They may be repeating words or phrases to themselves for their own purposes, perhaps to "practice" an idea or as a calming mechanism.

It may be stimming. It also may have no meaning at all, because it's not always clear if the child is choosing intentional words or repeating words they don't understand.

What's important is that, either way, the autistic child is borrowing the words of others and still needs help finding their own. Tapping into these echolalia patterns may offer a window for parents and speech pathologists to build on the child's unique style and work toward original language use.

That's especially true of mitigated echolalia, in which the child makes small changes to the original phrasing: a "yes" added in response to a question, or a new pronoun to correctly identify a speaker.

Immediate and Delayed

Sometimes echolalia is an immediate echo of words that a child hears. For example, a parent or caregiver asks "Do you want a drink?" and the child responds with "You want a drink."

This inability to switch pronouns is common, and the child may be responding appropriately and may very well want a drink. But rather than using an original phrase in the flow of normal conversation, such as "yes, please," or "I'd like lemonade," the child echoes the 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. Sometimes a child may use Ernie's words intentionally; sometimes the words are just repeated sounds. In delayed echolalia, there's distance between hearing and using the words.

Is Echolalia Different From Palilalia?

Palilalia is a speech disorder marked by the involuntary repetition of words and phrases. In that sense, it is much like echolalia but there are differences. One difference is that in echolalia, the repetition or echoing is focused on other people's words, received when the child hears them.

Another difference is that palilalia often involves increasingly rapid speech with the same repeated sounds. It's not limited to people on the autism spectrum (neither is echolalia) but is associated more with Tourette syndrome, Parkinson's disease, seizure disorders, and even drug side effects.

Treatment

Much as you may wish to limit your child's echolalia, especially in public, the reality is that echolalia can serve a valuable function and may be a very positive behavior in the right circumstances.

Even when echolalia is less functional, it's usually a good starting point for speech and 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 themselves or reduce anxiety, but the recitation may also indicate a real fascination for aspects of the video, just as it does in typical children.

When echolalia is functional, it's a cause for celebration: Your child has developed a tool for verbally communicating their wants and needs. This means the child may do much more with the help of a speech therapist and caring adults who are intentional about words when talking with them.

Summary

Echolalia in your autistic child happens for different reasons, and everyone on the autism spectrum has a unique experience. Understanding the forms of echolalia, and why your child uses them in different contexts, will help you to make sense of your child's language development.

A Word From Verywell

People with autistic children, and the professionals who support them, already know how challenging echolalia can be. You likely have stories of your own conversations that range from the upsetting, like an embarrassing public episode, to the cute and amusing anecdote about the "odd" way your child sees and describes the world.

Nearly all parents do. It helps to know there is plenty of support, and to remember that echolalia itself is an encouraging sign that your child may grow into more typical language use.