Where There's Echolalia, There's Hope!

By Shoshana Levin Fox, EdD

“Do you want more carrots?” Ben’s mother asks, as she reaches across the table to serve him.

“Do you want more carrots?” Ben echoes back to his mother.

“Do you want to play ball?” Jonah’s father asks. But instead of answering “yes” or “no,” Jonah repeats, “Do you want to play ball?”

child’s echoing of words, phrases or sentences is known as ‘echolalia,’ and it is considered a feature of

autism. With ‘immediate echolalia,’ the child parrots back what he or she has just heard. In situations of ‘delayed echolalia,’ there is a varying time lag between what the child hears and what is repeated.

Some methods of intervention consider echolalia undesirable communication. These methods may simply ignore the echolalia or otherwise attempt to train the child not to speak in that way.

By contrast, Professor Reuven Feuerstein, my late mentor, often quipped, “Where there’s echolalia, there’s hope!”

How so? First of all, the child’s echoed language indicates that the child, fortunately, is hearing language accurately. What is being said to the child is indeed registering on the auditory channel.

Secondly, echolalia tells us that the child is capable of actual speech production, and that is important developmental information.

Thirdly, keep in mind that all of us, from babies to adult learners of a foreign language, achieve our language learning by hearing and, then, by imitating or echoing what we have heard.

What is missing with echolalic speech is the sense that ‘aural (heard) language’ is actually being processed and comprehended within the child’s mind. Missing, also, is that vital sense of connection between speakers, the sense that you and I are communicating. A child’s echolalic speech can be extremely frustrating for parents and others in the child’s life, because echolalia is essentially language without communication.

Fortunately, there are developmentally based methods that, rather than trying to eliminate the echolalia, strive to gradually transform the child’s echolalia into more meaningful, interactive communication.

How can this be done? If you are attuned to the implicit intent in the child’s echolalia, you can follow certain guidelines when speaking to an echolalic child.

Most developmental models encourage parents to begin by being detective-like in figuring out communicative intent; that is, how do the echoed words serve the child? Does echolalia calm and sooth the child, or does it communicate anxiety or distress? Is the echolalia helping the child concentrate during play? Does echolalia indicate the child’s understanding of a situation? Does it reflect an emotional or physical need?

Trying to decipher the emotional and/ or communicative intent behind the echolalia is that critical first step toward knowing how to respond.

The adult’s responses will vary according to the perceived communicative intent. So, responses to the communicative intent of echolalia might range from “you want to know when Daddy will be home” to “you love pounding those nails” to “I think you’ll feel better sitting on my lap” to “you’re really hungry!” If you have a sense of the child’s intent, you can respond in a way which meets the child where he or she is emotionally as well as deepen a sense of

shared meaning.

Although it is important to relate to the child’s intended meaning, the process of transforming rote, echoed speech to non-echoed intentional communication requires patience and attention to detail in how you respond verbally to the child’s echolalia.

Here are a few specific pointers:

• Make eye contact with your child — but not by pulling the child’s face toward you. Crouch down and position yourself in the line of the child’s gaze.

• Avoid using questions, as the wording and intonation of questions are likely to trigger the child to echo.

• Slow it down and speak in a soft tone of voice. Your soft and gentle tone of voice, with words spoken very slowly and well-spaced, can increase the likelihood that your child is processing the language and, therefore, can help reduce your child’s automatic echolalic response. In my work, I have found it helpful to speak quietly and slowly as I address what I

call “the child behind the symptoms.”

• Words spoken to an echolalic child that are too fast, too loud, too insistent, or structured as a direct question are almost certain to trigger an echoed response.

• While still avoiding questions, select your wording for your child in such a way that if he or she does echo your words, the child will be using correct phrases. For example, instead of asking “Do you want chocolate milk?” which will likely elicit a full sentence echo, use a slow, gently worded brief descriptive phrase such as “yummy chocolate milk” or “want yummy chocolate milk.” Since echolalic children often confuse the pronouns “you” and “I,” this kind of ‘neutral wording’ (without the pronoun), helps children express themselves in correct language without that pronoun confusion. Precise pronoun usage can be worked on at a later

developmental stage.

• Experiment with the pitch and tone of your voice as you address or respond to your child. When does your child appear to be understanding the meaning of your words, not just hearing their sounds? Experts recommend using a matter-of-fact tone with no pressure for the child to respond.

Living with an echolalic child can present built-in challenges and frustration at times, but, by modifying one’s way of speaking to the child, an echolalic child can gradually be helped to

move toward improved communication. Of course, always supplement your efforts at home by seeking the advice and support of an expert Speech and Language Pathologist, someone with a proven track record of helping echolalic children. 

Shoshana Levin Fox, EdD, is a child

psychologist, play therapist -supervisor, autism specialist and the author of the parent-friendly

An Autism Casebook for Parents and Practitioners: The Child Behind the Symptoms.

Shoshana shares her wealth of experience in numerous worldwide conference presentations and professional publications based on her work using play-based methods to assess and treat young autistic children.

Acknowledged with gratitude: The above compilation of guidelines is drawn from print, digital and recorded resources of the Hanen Center, the Watson Institute, DIR Floortime practice, expert practitioners Sima Gerber and Betsey Field, Reuven Feuerstein, and my own experience of over thirty years working with autism-diagnosed children.