Understanding Echolalia: Presentations And Mental Health Connections
Speech is often complex, and people tend to communicate in multiple ways. Echolalia, a common pattern in early childhood, generally involves the repetition of words and sounds. Some children and adults may be more likely to experience echolalia past typical developmental milestones. Understanding the signs of echolalia may be helpful for those experiencing it and their loved ones. If this speech pattern is accompanied by mental health challenges, speaking to a therapist may be helpful.
What is echolalia?
This response is often involuntary or compulsive. Echolalia is commonly seen in children with typical language development before the age of three and can serve as a way for them to learn to communicate and understand speech.
For some, echolalia persists or begins after the toddler years, sometimes occurring in adulthood. This speech pattern can contribute to relationship challenges and may lead to difficulty being understood by others. Echolalia can occur for many reasons, including neurodevelopmental disorders, language disorders, and stroke.
Types of echolalia: Delayed echolalia and other types
Echolalia can vary depending on its cause and the environment in which it occurs.
Immediate or delayed echolalia
Immediate echolalia typically refers to the immediate repetition of sounds. For example, a child might hear the sound “meow” from a cartoon cat and immediately repeat it.
Meanwhile, delayed echolalia usually occurs much later after initially hearing a sound or word. For instance, a person might remember a word they heard earlier in the day and begin to repeat it out loud.
Unmitigated or mitigated echolalia
Unmitigated echolalia normally occurs when a person repeats a word, sound, or phrase exactly as it was expressed by someone else.
Mitigated echolalia generally refers to altering the speech one repeats or only using parts of the original phrase in their repetition. For example, a person repeating a company jingle they heard on the TV might only sing part of the phrase or repeat certain words from it.
Communicative or semi-communicative echolalia
Communicative echolalia may occur when a person repeats a sound, phrase, or word with the intent to communicate or create meaning in a social context. For example, a child who often hears their parent saying “good job” in reference to good behavior might say “good job” to themselves or others in similar situations.
Non-communicative echolalia can take place when a person repeats sounds or words with no communicative intent. Discerning between these two types of echolalia may be difficult for parents of children who only communicate by repeating others or through limited verbal speech. These parents may be concerned that they don’t fully understand what their child is trying to communicate to them.
Ambient or echoing approval
Ambient echolalia typically refers to someone repeating sounds, words, or phrases from their environment. For example, a person might start making the same sounds as an animal they hear outside or repeat words they’ve heard on TV.
Echoing approval usually happens when a person repeats words from a question to respond to the person who asked. For example, a parent might ask their child if they want juice. The child might say “juice” in a happy tone to indicate they want juice. They may cry and say “juice” angrily if they don’t want juice.
Examples of echolalia
Echolalia can have a variety of presentations. Below are several examples:
- A child hears the word “Tupperware” on TV and repeats the word compulsively throughout the day (delayed and ambient echolalia)
- A parent asks their toddler if they want a stuffed monkey, and the child responds with “monkey, monkey!” (echoing approval and immediate echolalia)
- An Autistic adult repeats a certain sound they heard a few days ago to self-soothe, such as a beep, hum, or melody (delayed and non-communicative echolalia)
- A person says “It’s okay, it’s okay” to calm someone down, as this is a phrase they’ve often heard and repeated with the intent to calm others (communicative and delayed echolalia)
- A person states, “I’m so happy!” hours after they initially felt the emotion and told someone about it (delayed echolalia)
- A mother tells her child, “Don’t do that,” and the child repeats, “Don’t do that,” over and over, including in situations where they make the same mistake in the future (immediate and delayed echolalia)
- A person hears one word from a phrase on TV and repeats it with no communicative purpose (immediate, ambient, and non-communicative echolalia)
What causes echolalia?
There can be many causes of echolalia, and this behavior is not necessarily a sign of a mental or physical health condition. Echolalia is often a part of language development, as toddlers and some babies may naturally use echolalia as they learn to communicate.
However, echolalia is often more common in children with autism spectrum disorder, as children with autism tend to be more likely to experience verbal challenges as their language skills develop.
The most common causes of a prolonged pattern of echolalia or echolalia in adults include the following:
- Neurodevelopmental disorders like autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD)
- Traumatic brain injury (TBI)
- Language disorders like aphasia
- Paralysis
- Stroke
- Epilepsy
- Seizure disorders
- Delirium
- Speech disorders
- Dementia
- Tourette syndrome
- Schizophrenia and other psychotic disorders
- Learning disabilities
- Brain inflammation
If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Should echolalia be treated? Echolalia in children with autism and other speech challenges
Echolalia is not a medical or mental health condition in itself, and this speech pattern is not necessarily harmful, although it may lead to frustration, irritability, and relationship conflict for some.
If a child is not distressed by this form of communication or uses it for self-soothing purposes, attempting to “treat” or change this speech pattern may lead to further frustration and distress.
In autism, echolalia is often considered a vocal stim or form of self-stimulation, which means a person may use vocal sounds and sensations to self-soothe or due to an urge to produce spontaneous speech.
For example, an Autistic child might repeat the word “cow” over and over if the sound of the word is enjoyable to them. The connection between the word and its ability to soothe the individual might not be apparent to others but can be evident to the person repeating it.
If echolalia is unwanted by the person experiencing it, several treatment options may be helpful, such as speech therapy, occupational therapy, mental health support, or medical care to address the physical cause of the symptom (if applicable).
For instance, in the case of someone who experienced a stroke, echolalia might be their only way of communicating. They might work with a doctor and speech therapist to learn more expanded ways of communicating their needs.
Tips for communicating with someone with echolalia or repetitive speech
If you are the parent or loved one of someone with echolalia, try the following communication strategies.
Be patient and understand the different types of echolalia that can cause repetitive speech
Be patient with your child or loved one when they communicate using echolalia. This form of communication can be different than one is used to, but it often serves a purpose.
For those who struggle to express words or phrases independently, repeating words or sentiments can be a way of showing that they understand. For example, when a child says “toy” in response to their parent asking if they want a toy, the child is likely trying to communicate in the best way they know how. Becoming frustrated and asking them to “use their words” or communicate differently can lead to the child believing they’ve made a mistake, and this may further hinder communication.
Use other communication cues to understand, especially with children with autism and other speech-impacting disorders
If you aren’t sure what someone with echolalia is trying to communicate, use other communication cues to attempt to connect. For example, you might focus on their body language, intonation, or the potential messages behind the word or phrase they are repeating.
While not all echolalia has an underlying meaning, some might use the repetition of sounds to attempt to connect. Look at the person’s expressions. Do they seem happy? Distressed? The nonverbal cues they share could indicate whether they are pleased about a certain request or situation.
Mental health support options
Echolalia is not necessarily distressing for the person experiencing it, and many people with echolalia can also communicate in other ways. However, if this style of communication negatively impacts you or a loved one, or if you’re living with a mental health condition causing it to occur, you might benefit from talking to a therapist. If communication barriers cause difficulty with seeking in-person support, online therapy through a platform like BetterHelp is also an option.
Through an online platform, clients can choose between phone, video, or live chat sessions, which may be helpful for those who have unique communication needs. In addition, online platforms offer access to group sessions and other resources that may be hard to find in one’s community.
Studies generally support the effectiveness of online therapy, reporting that it can be more cost-effective and may lead to a higher quality of life than in-person therapy for some people.
Takeaway
- Previous Article
- Next Article