Practical Tips for How to Deal With Echolalia
Echolalia in autism is a unique disorder to treat. It also can be frustrating to work on or to live with. It definitely helps to have some basic information. Then, read on for some practical tips on how to deal with echolalia.
Basic Types of Echolalia
Immediate echolalia is when a child with autism answers your question by repeating the question or echoes whatever you just said.
Delayed echolalia happens when a child with autism repeats something that was said earlier in time, often a statement that has been heard frequently or even sections of a favorite TV show or movie.
Echolalic statements may or may not have communicative functions. What is that?
Communicative Functions of Echolalia
It is no wonder that echolalia can be confusing to the treating SLP! It is helpful to read the research by Dr. Barry Prizant. This tells us that echolalia can occur for a variety of communicative, interactive and non-communicative functions.
In easy terms for parents reading this, communicative functions means that the child echoes what you said to try to tell you something. For example, you say, “Do you want a cookie?” Your child says back the whole question, or maybe just the word cookie. But you know it means your child wants the cookie.
Interactive communication functions occur when children don’t know what to say, but want to be able to talk to you. They know they need to respond, but it is difficult. So they just repeat what you said.
Noncommunicative functions are repeating what was said without tring to tell you anything. One example is repeating sounds over and over for an unknown reason. Another is saying sentences from a TV show that don’t have any meaning in the situation.
Helpful Links For Echolalia
Here is a free download of Barry Prizant’s original research.
If you’d like a more reader-friendly version, there’s a great condensed version at Indiana University Bloomington.
My Success Story
Visuals are the best strategy I know for working with students on the autism spectrum. Did you figure out the statement in my picture, courtesy of Smarty Symbols? A picture is worth a 1,000 words!
I’ve been personally successful in treating young children with immediate, communicative echolalia. The only method these children had was to echo the question instead of answering it.
This was positive since it showed that the children actually understood that they were being asked a question. Echolalia did not occur when they were given a simple direction that was understood or asked a question that they knew the answer to.
I felt that the echolalia meant they couldn’t process the question. Or they were having problems formulating a response. But they understood that a response was required and filled in the gap with echolalia.
Activity Tips for Echolalia
Visual supports are a vital piece of the strategy. How to model is also very important.
Have your child look directly at what is happening (joint attention). Then use simple language that tells about what is being done.
If your child doesn’t have joint attention skills, be sure to talk about what they are attending to. Also work on increasing joint attention.
Make sure that the language you use literally and directly relates to the ongoing activity.
Model the language many times. Point at the visual symbol or sentence script and say it out loud more than once before expecting a correct response.
Repeat the action, providing a model yet again. Then ask a question. Immediately give the answer verbally and visually by pointing at the words or word symbols. Then ask tthe question again and pause.
If your child still echoes the question, say the language with a little more emphasis and stop doing the action. Pause and ask the question again. Wait to see if your child echoes the question or gives the answer.
Help your child point at the pictured words or symbols if they are still echoing the question. Then you start doing the action again.
Ask the question and say the response as you start the action again. This time, put more emphasis on the answer than on the question.
Practice and repeat as needed!
Literacy Tips for Echolalia
Actions in the environment can be fleeting. There can also be many distractions that keep the child from connecting language with the activity. This is where literacy comes in. If your student isn’t making progress in the real life situation, try books.
Use simple pictures with plain backgrounds in your book activities. This is very helpful since pictures last in time. The student can look at the picture as long as needed to process the language.
Make sure that the language matches exactly with the picture. If you aren’t making your own books or using already adapted books, then change the text of the picture book to tell the story, matching the pictures.
Find or make a book with repetitive text that models the same language you are using in your activity.
Use pictures that show different ways to do the activity, keeping the language the same. It is great to use photos of your child doing that activity!
Start with something fun for your child. Later you can make books about regular events, like getting ready for bed.
Be sure to include symbols, words, or drawings, for the language. Even for young non-verbal students! Children with autism who are nonverbal can be hyperlexic, learning to read very early. They may learn to read before they can talk. Then they use their reading skills to help them understand the spoken words.
I made a personal homework book for a 2 year old student I had. He answered “What is it?” by labeling nouns, but had no other functional language. He answered with immediate echolalia to everything else someone said to him.
Every day at the end of the therapy session, I put a picture in his book that showed the major activity we did that day. His parents were amazing. They read that book from start to finish with him every day.
The related question was on the left-hand side of the page. The pictured activity and a phrase or sentence was written under it on the right side of the page.
This book became his bedtime story every night. The parents used the tips in this post at first, but by the end of the year, my hyperlexic two year old read the entire book himself. Along the way, he also earned to use that same language functionally.
Involve parents! It is worth repeating. They know their child best and, together, you will accomplish more.
How to Use Visuals and Scripts
Read the list of possible functions for echolalia from Dr. Prizant. Then use your data to make a hypothesis about what the child is using the echolalia for. This helps you figure out what language to model.
Model visually as well as verbally! Use pictures that SHOW the language and symbols that show the words.
Use scripted words, phrases or sentences. This means to use symbols, draw pictures, or write the language your student needs.
The ‘script’ can be a word, a phrase, or a short sentence that you are going to practice over and over. Symbols are great for nonverbal students. Read more here about how to choose symbols.
Make the ‘script’ as short as the student needs to communicate well in the situation.
Choose a situation that is functional. We want to improve communication in daily life.
Teach the language for situations where the student gets frustrated or acts out. With visual symbols, you can help the student point to communicate. This helps the student get needs met before frustration and acting out behaviors occur. Behavioral problems often decrease when the student can communicate what is wanted.
If the student is not using echolalia for any communicative purpose, it is still important to expand communicative and interactive social skills. There is research currently being done on the most effective way to deal with this type of echolalia, also called ‘verbal stereotypy.’
If there is a communicative function in the way the child is using the echolalic utterances, do the same thing we do for all of our students with language needs. Set up the situation, model the desired response, pause, model again, and wait for a response. Provide a visual way to respond using pictures, symbols or written words to match the verbal words you are modeling. Then, practice, practice, practice!
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