What is Echolalia?
A portmanteau of the Greek words “Echo” and “Lalia”, echolalia is the repeating of others’ words and sentences [1]. It most commonly presents as a symptom of Autism Spectrum Disorder (ASD) in children [2]. In such cases, children tend to repeat the words and sentences of people they are familiar with, such as parents or teachers.
Note that this condition may also be present in healthy children. The repetition of words is a step in the language-learning process, and may just represent a child’s attempt to grasp a language in their foundational years. You should only be concerned about echolalia if a mental health professional diagnoses your child with ASD.
Adults may present this condition as well, but for more variable causes.
Types of Echolalia
There are two ways of categorising echolalia.
Immediate vs Delayed
Immediate echolalia is the repeating of verbalisations right after one has heard it. Conversely, delayed echolalia occurs when one repeats words and sentences some time after hearing it. For others, this may be confusing as the repeated words are not appropriate for the current context [3].
Interactive vs Non-interactive
Interactive echolalia represents a person’s attempt to communicate with others. For example, a child with ASD may echo a question from his parents, “Do you want to watch TV?”, back to them to indicate that he wants to watch television.
On the other hand, non-interactive echolalia does not represent an attempt at communication, and may be performed for personal uses. This could be linked to the need for self-stimulation often seen in children with ASD. For example, a child at home may repeat words or phrases from his teacher at school as a means of self-stimulation [2].
Hence, this condition may present itself as one of four possible types in a person. At the same time, it is possible for a person to suffer from more than one type of echolalia.
Causes of Echolalia
In Children With ASD
Similar to ASD, there is no single identified cause of echolalia. Children with ASD tend to develop the condition as they learn languages differently from healthy children. Healthy children learn languages by first picking up single words before stringing together sentences. Conversely, children with ASD pick up and attempt to understand entire blocks of words and thus may get stuck on certain ones.
In Adults
Echolalia in adults may be attributed to a variety of causes. Adults may present it due to [4]:
- Head injuries
- Tourette’s syndrome
- Intellectual disabilities
- Schizophrenia
- Epileptic seizures
- Neurodegenerative disorders
This list is non-exhaustive; there are many other disorders or scenarios where adults may repeat words or phrases as a symptom. For example, some people tend to repeat words when they are nervous. This does not necessarily suggest the presence of a mental disorder, unless the the person’s standard of day-to-day living is compromised.
Diagnosis of Echolalia
Presently, there is no one sure-fire test for echolalia. Mental health professionals can typically diagnose the condition through conversations with a client as it is fairly easy to identify. Additionally, mental health professionals will also look out for the aforementioned causes of echolalia in the client. For example, if a child has ASD, professionals will pay special attention to if he/she presents echolalia in his/her speech.
Treatment of Echolalia
Typically, mental health professionals utilise speech therapy and medication to treat echolalia.
Speech Therapy
Firstly, mental health professionals, such as speech therapists, will attempt to identify the words commonly repeated by someone and what triggers the repeating. Afterwards, they will use methods such as positive reinforcement and behavioural techniques to resolve this. For example, a commonly used behavioural intervention is the “cues-pause-point” practice. Therapists will give patients a cue, such as the question “Where are you now?”, before asking them to pause. The therapist will then point to the patient, which then serves as his/her cue to answer. This intervention serves to break the unconscious and automatic repeating of words in the patient [2].
Therapy mostly applies to younger patients as mental health professionals generally avoid medicating them.
Medication
There is no medication that directly cures echolalia. Instead, mental health professionals usually dispense medication to address underlying causes [5]. Due to the large variety of causes, a range of medications may be prescribed.
More commonly, for adult cases that arise due to stress or anxiety, prescribed medication include antidepressants and selective serotonin reuptake inhibitors (SSRIs) [3].
FAQ
1. How old must my child be for echolalia to become a source of concern?
As mentioned, echolalia is a natural part of language learning in young children. Most healthy children should outgrow their echolalia by three years of age [6]. If your child is older than that but still exhibits echolalia, bring him/her to a mental health professional to identify the root cause of this symptom.
2. How can I support a loved one with echolalia?
- Remain patient: Understand that your loved one does not intend to be irritating or annoying by repeating their words. Attempt to understand that this is their method of communicating and functioning.
- Learn more about echolalia: Understanding the different causes of echolalia can help you support your loved one in a way that is more specific to their condition. For example, if your loved one exhibits echolalia due to schizophrenia, you can then infer that their echolalia could stem from the hallucinations common to the condition. Hence, you can attempt to support him/her through these hallucinations and, by extension, their echolalia.
3. If my child repeats his own words instead of others’, does he/she still have echolalia?
No. The repetition of one’s own words and sentences is commonly referred to as palilalia, an entirely different symptom [7].
