Echolalia: Types, Causes and Treatments

The Involuntary repetition of words or phrases, known as echolalia, is a language disorder that, if properly treated, can be somewhat cured Learn how.

Echolalia (from Greek ἠχώ, “echo” and from λαλιά, “speech” or “talk”) is a speech disorder that causes the child to unconsciously and involuntarily repeat words, phrases, songs, and conversations heard from other people, from the radio, or from the television. It’s common in cases of autism, when there’s language delay or hearing impairment.

Of course, children naturally learn by repeating, but if they’re more than two and a half years old, it’s a warning sign. Those who suffer from it speak in a monotonous, somewhat mechanical way, with the same rhythm. The sounds may appear suddenly and without context.

Types of echolalia

The classification of echolalia responds to temporal, structural, or functional criteria. In terms of time, it’s classified as immediate or delayed. If it refers to the structure, we speak of exact, reduced, amplified, mitigated, or expanded echo. Echolalia can be relatively functional or non-functional.

It manifests with pronominal inversion or with difficulties in the use of personal pronouns, and is characterized by the non-creation of formal syntagms and sentences, or with neologisms or words that only the child knows or manages.

When conversing, the child doesn’t find the topic or adapt to the conversational situation, no reciprocity or exchange is generated, and the conversation may end abruptly or inappropriately.

Let’s have a look at all the types of echolalia in detail:

Immediate

Immediate echolalia occurs when the child repeats the last syllable or word heard. If we ask “do you want to eat?” and the child repeats “do you want to eat” without answering the question, we’re dealing with this degree of echolalia. If the child repeats the phrases, but also adds elements, words, or phrases, it’s called nuanced echolalia.

Delayed

In this case, the child may repeat phrases, words, songs, or conversations hours, or even days, later. This is a more complex type, because it involves the use of a non-relative and inactive memory, but one that’s capable of reproducing sound traces.

Functional

When it’s functional, the repetition of echolalia occurs in a context that confers meaning. It either has communicative or self-regulatory intent.

Parents or caregivers who are aware of the child’s likes or dislikes can elicit the functionality, anticipating that the echo will progress to an effective response. For example, if the child likes to paint, presenting sentences accompanied by painting materials would give the repeating sentences referential objects and actions. The point is to get the child to repeat less and less.

Mitigated or expanded

This type of repetition involves the possibility of the child introducing new or non-repeated items. It has been suggested that this variety marks the beginning of a more functional use of language.

Indeed, as comprehension skills increase, echolalia decreases. In that proportion, the mitigated form increases.

What are the causes of echolalia?

This syndrome can have endocrine, environmental, or psychosomatic causes. In the case of endocrine glands, there’s an intrinsic relationship between these and psychomotor development, which acts on growth and language. The endocrine system excites or inhibits the production of words.

Environmental causes include the child’s family, and social and cultural environment. Given certain circumstances, it can affect their normal development.

As for psychosomatic causes, echolalia can be observed in catatonic, stuporous patients and in some with organic brain diseases. We’re talking here about decreased mental function due to an illness.

Disorders associated with echolalia

Echolalia is a symptom of major pathologies, such as autism spectrum disorder or ASD. Aphasia, schizophrenia, epilepsy, and Tourette syndrome are also associated.

Autism spectrum disorder

ASD includes neurodevelopmental disorders observable in communication, interest, and behavioral disturbances. Repetitions are not only recorded in speech, but also in movements and with regard to manipulation of objects.

Aphasias

Aphasias are language disorders due to brain lesions. In cases of mixed transcortical aphasias, the patient with echolalia cannot name images, but can repeat, recite, complete words and sentences.

Schizophrenia

People with catatonic schizophrenia, in addition to remaining in fixed positions, indulging in excessive activity or opposing themselves by adopting a rigid posture, often present echolalia. Accordingly, they repeat or imitate words or the movements of others, which is known as echolalia.

Epilepsy

In epilepsy, echolalia accompanied by sluggishness and dysphagia is observed. It’s also associated with automatisms of sucking, subtle eye or facial movements or ocular deviation with nystagmus. The latter is when the eyes move in a rapid and uncontrolled manner.

Tourette syndrome

Tourette syndrome causes sudden, repetitive muscle movements and tic-like sounds. The latter are echolalia responses, accompanied by shouting or swearing, which is known as coprolalia.

How can echolalia be treated?

As it’s a language disorder, results will be obtained by working with professional speech therapists, and a lot of patience. It’s important to determine the linguistic level and what instructions the child can carry out.

The person should be asked clear sentences and direct questions in order to leave no room for doubt or delay in understanding the meaning. On the other hand, parents should try to rely on echolalia to reinforce the meaning of what they are asking the child.

For example, you should avoid yes or no answers and try saying statements like “I am thirsty, I want milk”. The child with echolalia can then respond not with the typical yes, but with the complete word or phrase containing the modulated action.

Simple words and short sentences should be used. Sayings, puns, or phrases with a double meaning will not be understood or interpreted.

Echolalia can be functional

The repetition of words or phrases forms the basis of the beginning of language learning. However, once echolalia is diagnosed, parents, caregivers, and teachers must act together so that the repetition helps the child to integrate into communicative environments.

According to psychologist Ana Zaragoza, the opposite of echolalia without logic is functional echolalia. The child has heard a word and rephrases it in an appropriate context. This is a fact to be commended (…) so that the child feels good about their progress and repeats it.”

If there are siblings at home, this is a huge advantage, because they will contribute or give the necessary meanings to the words in context. And, if you need extra resources, cryptograms are very useful. Representing actions with pictures and images that explain the words will provide answers that pave the way for communicative interaction.