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How to Treat Vocal Stereotypy in Autistic Children

written by: Keren Perles • edited by: Paul Arnold • updated: 1/19/2011

Does your child seem to exhibit signs of vocal stereotypy, such as echolalic speech, noncontextual giggling, or production of random words or sounds? If so, read on for information about how you can minimize their production of vocal stereotypes.

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    Definition of Vocal Stereotypy

    Vocal stereotypy is the use of nonproductive sounds or words. Many children with autism use vocal stereotypes, and so do those with other developmental disorders or medical conditions. In addition there are also children who use vocal stereotypes but do not suffer from any disorders or medical conditions that could cause them.

    Examples of stereotypical vocalizations include laughing or giggling when the situation does not call for it (such as during a religious ceremony at church), repeating words or phrases out of context, saying nonsense "words" over and over again, or echolalic speech. (Echolalic speech is the repetition of a phrase that the child has heard spoken before, such as the phrase that another speaker has just said.)

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    Teaching Alternatives

    One way to cut down on the vocal stereotypy displayed by children is to teach them socially acceptable alternatives. For example, some children begin to laugh uncontrollably when in an unfamiliar social situation. Teaching them how to react appropriately (e.g., saying "hello," asking to join a game) can minimize the need that they have for the vocal stereotypes. Children may also begin to exhibit stereotypes when they feel pressured to answer a question in class. You can teach children to say "I don't know" in a comfortable voice, as an alternative to resorting to stereotypic behavior. And practice this frequently with them.

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    Response Interruption and Redirection (RIRD)

    The main therapeutic technique used to treat vocal stereotypy is Response Interruption and Redirection (RIRD). RIRD is a practice that can be helpful in decreasing behaviors that interfere with normal social interaction, which is why it works well in treating vocal stereotypes. It has been found effective in studies done with children ages 3 to 21.

    As the acronym suggests, there are two main components to RIRD: response interruption, and redirection. During response interruption, the therapist interrupts the child during the verbal stereotypy by using any of the following methods: saying the child's name calmly, looking directly into the child's eyes, or asking a nonrelated question such as "What is your younger sister's name?" or "What color is your hat?" This stops the child from actually engaging in the verbal stereotypy. During the redirection component, the therapist encourages the child to use alternatives (such as those discussed in the previous section).

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    SSRIs

    Selective Serotonin Reuptake Inhibitors (SSRIs) can be helpful in controlling vocal stereotypy as well. These medications, which must be tailored to the child's needs, are helpful in treating depression, OCD, and similar problems. Your medical practitioner will be able to advise you. Their use, either alone or combined with RIRD, can help the child minimize the number of vocal stereotypes used throughout the day.

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    References

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1885411/

    http://autism.healingthresholds.com/research/assessing-and-treating-vocal-stereotypy-children-autism

    http://www.necc.org/research/newsletter_may_june_2003.asp

    http://autismpdc.fpg.unc.edu/content/response-interruptionredirection

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