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What Techniques Can Help Children with Echolalia

written by: Paula Davis • edited by: Elizabeth Wistrom • updated: 9/14/2010

It can be difficult to carry on a conversation with a child that repeats words or phrases instead of initiating a dialect. Here, we discuss techniques to use with echolalia children.

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    What is Echolalia?

    What is Echolalia? Echolalia is where a person automatically repeats things that are said by another person. There is no thinking about what the person is saying - just repetition. This gives the person time to think and process what has been said.

    Echolalia is very common in people with Asperger and PDD (Pervasive Developmental Disorder – not otherwise specified) and is shown in development disabilities along with several other disorders. Echolalia is more commonly noticed in children. Sometimes children do not learn how to speak naturally and have difficulties expressing themselves, at which point there are several various techniques to use. With Echolalia children, many of these techniques may serve as a beneficial way to help get a more natural conversation started and thus help to account for the problem.

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    Screening for Echolalia

    When learning to talk, the child with Echolalia cannot speak properly and sometimes appears to just be saying nothing but a mixture of different words. (Babbling) Due to the difficulty of the thought process, they will make gestures such as pointing at what is wanted, and they automatically go to repeating what a person has just said.

    A example of Echolalia would be if you ask a child “Do you want some water?" and the child would respond using the entire sentence or just the word water because that is what the child really wants. He/she may repeat the word “water" several times. If you notice any unnatural speaking/communication with your child you should have the child examined for speech difficulties so that speech treatment can begin. The earlier Echolalia is noticed and diagnosed the better the outcome. Echolalia is treatable.

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    Treatment for Echolalia

    Treatment involves speech therapy and can be time consuming. Early intervention is made with intense language/speech training. The habit established with a person interferes with social interaction and learning skills. Echolalia means that the person has not learned the appropriate response to a question or a command. One of the techniques to use with Echolalia children is to prompt the person with the correct answer to the question as soon as you ask it, and then reinforce the answer again until the individual knows the answer. This method is not always best because it teaches Echolalia for a time and you would have to answer every question that you are presenting to that individual. However, teaching the individual the correct responses is good because a lot of the simple questions that you would start out with are common questions with common answers. (e.g. What is your name?, How old are you? Are you hungry?) This method is known as Cues-Pause-Point method.

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    Cues-Pause-Point Method

    To use the Cues-Pause-Point Method, ask each of the questions, record the answers, and score the person's answers using the following categories: Echolalia (when one or more of the words in the question were repeated even if other verbalizations follow); incorrect (when the response contains an irrelevant word even if the correct response was also given); or correct (when the answer is appropriate to the question or matches the trained response).

    Show the individual “Cue" cards so that the picture and the words relate. What is your name? You would have a “Cue" card with the individual’s name. Dog, picture of a dog. I am sure you get the point. Have the person repeat the correct answer to the question to reinforce the reply and give them praise, points, some type of behavior modification for the correct reply. This would be repetitive training until the person correctly replies to the questions and appropriate card a minimum of three times.

    A place must be a quiet place with no distractions. Sit in front of the person and command eye contact. You then hold your index finger up midway between you and the person to indicate quite. This is the “Pause" prompt. Then you advise the person you are going to ask them questions and to answer them the best they can. If you are interrupted then you hold your index finger out again and say “Shh".

    After you give the “cue" and the “pause" you then ask a question. (You have a card showing the correct answer). After a few seconds you point to the card and ask what is on the card. Make sure that you give praise and acknowledge the correct reply. Reinforce the correct reply once again. In order for this method to work you have to do it consistently.

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    Success and Benefits

    After being successful with the aforementioned, ask each of the 10 questions in different training sessions. Always provide positive feedback and reinforcement for the correct replies. More simply put is that in order for the person with echolalia to understand and respond correctly to a question or command they have to be taught the correct reply.

    This is a learned behavior. However, with a lot of practice, the person with Echolalia is more confident. He/she will be more comfortable replying to a question or command because they will know the correct response and it will be easier for them to reply. Asperger, Autism and Related Disorders (based on McMorrow & Foxx, 1986)