“And I am not ~ repeat not ~”
– The Suite Life of Zack and Cody
Echolalia is when someone repeats noises and phrases they hear. This can include not only the words spoken, but the exact imitation of a person’s inflection, tone of voice, and volume. Now it probably makes sense to you why I titled this post “Human Mockingjay.” (It doesn’t have a thing to do with the Hunger Games; yes, I used the word “mockingjay” just to play with some of you.) Echolalia can be classified into two types: immediate echolalia, which occurs immediately or soon after the original words are spoken; and delayed echolalia, which happens hours, days, weeks, or months after the fact.
Echolalia is in fact a natural part of language learning and development. All children experience it at some point in their lives, generally most around 2 ½ years of age. It usually declines significantly by the time the child turns three years old. Those who have been around children probably have noticed how boys in particular tend to deliver long, blurry, dramatic monologues that don’t make a lot of sense to the rest of us. In time, this shifts into a more specific and understandable style of speaking. This is the way language skills develop, which I will describe in four stages: First, the child learns to talk. This develops into communication through use of words. Then the child learns to take the phrases they know, take them apart in chunks, and recombine them into new phrases. After that, they break it down even further to where they’re putting together single words and creating two-word phrases. Finally, the child begins to create more complex sentences and independent thought. However, some children continue to repeat what they hear as they age. They hold on to echoed expressions much longer, and though they can say lots of words, they don’t seem to completely understand what they’re saying. This is echolalia.
Autistic children are particularly susceptible to echolalia. They typically progress slower than “normal” ~ or “neurotypical,” as they are sometimes referred to ~ children. (I don’t like to use the words “normal” and “neurotypical.” I think I would prefer “ordinary.” Have you met any autistic children? They are far more interesting than other children. Watch Mercury Rising.) Apparently researchers have found that up to 85% of autistic people who speak exhibit echolalia in some form, but I’m not certain yet if I believe this. I think I’ll need to do more research of my own before I take that as fact.
Children with apraxia ~ motor planning issues ~ can also get stuck in this phase. They begin speech therapy with very poor imitation skills, and once they learn to repeat what they’ve heard, they seem to want to hang on to it for a long time. This could be because repeating may become the “motor plan” they learn best, and it might be easier for them to use a rehearsed message rather than come up with a new one. Although it is true that apraxia children can come up with spontaneous utterances better than imitated ones, this is not usually the case if they have been in therapy for a while.
Although most children grow out of echolalia as they get older, some simply don’t. As a result, they may not be able to communicate effectively because they struggle to express their own thoughts. This may eventually cause them to go mute, and if asked a question, they may only repeat the question instead of answering it. You can see how this could cause them to lead very frustrating lives.
Adults who suffer from severe amnesia or head trauma may also experience echolalia as they try to regain their speaking abilities.
Symptoms of echolalia include repetition of phrases and noises, frustration during conversations, depression, muteness, and unusual irritability, especially when asked questions. Sometimes echolalia only appears when the person is distressed or anxious.
Doctors diagnose echolalia by having a conversation with the suspected patient. If the patient struggles to do anything other than repeat, he may have echolalia. However, some patients can combine phrases to make new ones, which makes it more difficult to determine if they have echolalia or not. The key to discerning this is noticing whether or not the answer actually reflects the question, or if it’s slightly off.
Doctors generally give antidepressants or anxiety medication to the echolalic person, which won’t treat the condition, but it will keep the patient calm. They are then expected to work with people at home to develop their conversation skills. There are also texts and online training programs that help parents get positive responses from their children. Some echolalics attend regular speech therapy sessions to help them learn to say what they are thinking.
Although echolalia can be difficult to conquer, it’s not a good idea to try to prevent your child from experiencing it completely. It IS a natural part of developing language skills, after all. Rather, a parent should encourage other forms of communication and expose their child to a wide variety of words and phrases. It’s also important to remain patient while your child is having echolalic “episodes.”
I don’t really have an ending to this post. But then, I’ve posted many a post without a proper ending. So I guess I will just leave off with this encouragement: echolalia is not permanent. Everyone seems to get over it eventually, even if it takes a really long time.