What Is Echolalia? Definition, Causes, & Treatment

What Is Echolalia?

Echolalia includes the repetition of words, phrases, or other sounds the person hears, and is thought to be present in about 75% of autistic individuals during childhood.⁵ Echolalia can sometimes be a means of communication; an aid in processing, learning or absorbing new information; or a stim to meet sensory needs and help to reduce overwhelm within complex sensory environments.¹

Echolalia might include the repetition of the following:

• Single words, sometimes the last word of a sentence spoken by someone else
• Phrases heard in conversation
• Sentences spoken by another person
• Song lyrics
• Lines from movie or television
• Non-word noises or sounds

Echolalia in Child Development

Echolalia is actually a typical part of the language development of young children, and can be found in autistic and non-autistic children alike. Repetition is one way that kids learn and develop language, particularly between the ages of one and two. After this stage, non-autistic children typically begin to move on from echolalia and toward building their own sentences to express themselves. By the time most children reach age three, use of echolalia will likely reduce, and become replaced with simple sentences and phrases. Although some echolalia or repetition may continue, it will be utilized only on occasion, with self-created sentences becoming the predominant means of communication in neurotypical children.²

Echolalia in Autism

In autistic children, echolalia is more likely to remain a primary and instrumental form of communication, which is often an indicator that the child is a gestalt language processor.³ While analytic language processors learn and build language in smaller “building blocks,” such as words, gestalt language processors learn, process, and build language in larger “chunks,” such as sentences or phrases.⁴

Autistic people may use echolalia for different purposes. The use of echolalia in its scripting form is particularly common among gestalt language processors, and scripting may be a primary form of communication and expression for some autistic individuals throughout adulthood.

Types of Echolalia

While the main characteristics of echolalia remain the same, there are a few ways in which it may be exhibited.

The types of echolalia are:

• Immediate Echolalia: Immediate echolalia is the reciting of words right after they are heard. It might include the repetition of an entire sentence, phrase, or a single word.
• Delayed Echolalia: Delayed echolalia occurs at a later time than the original sound was heard.
• Interactive Echolalia: Interactive echolalia is the use of echolalia as a means of intentional communication, or for the purposes of interacting with another person. It might be used to express a need, thought, or feeling that the individual would like to convey.
• Non-Interactive Echolalia: Non-interactive echolalia is employed by an autistic individual in a way that doesn’t seem to be intentional communication. Sometimes, when non-interactive echolalia is being used, the individual may be repeating the word or phrase because they enjoy speaking the words, or hearing the sounds that they make. If echolalia is being used to gain a type of sensory input, this would be considered a form of a “stim,” or self-stimulatory behavior. Some autistic folks find the use of non-interactive echolalia to be enjoyable, to be helpful for self-soothing when overwhelmed, or to manage anxiety.
• Scripting: Scripting is the repetition of sentences or phrases heard from television, movies, or the speech of others. It is typically a form of delayed echolalia, as the repetition of the phrases or sentences often occur later on. It is important to remember that scripting is a valid form of communication in itself.⁴ Scripting is also referred to as “TV Talk” or “Movie Talk”. Many autistic individuals–while scripting or repeating lines from movies or television–will also adopt or imitate the mannerisms, accent, speech patterns, or persona of the character they are copying.⁷

Echolalia Examples

Sometimes echolalia is used as a way of processing and integrating the information that was just heard, as part of the learning process. For example, if an individual hears, “The store will close at 6 o’clock”, and they immediately repeat the information, this may be their way of integrating, absorbing, and reinforcing that new information into their minds.

Another possible purpose of repeating this phrase immediately is to serve as one’s acknowledgement of having heard it. For some, repeating a phrase immediately after hearing it is like a way of saying “Ok!” or “I heard you.” One benefit of utilizing echolalia in this particular way is that it offers an autistic person a way of responding that is relatively quick and doesn’t require a great deal of energy. For many autistic individuals, speaking, or translating thoughts into words may be difficult, consume a large amount of energy, or require more time to respond. This is similar to when we speak a foreign language–there may be a bit of time required to translate our thoughts into spoken speech that the listener will understand. A response utilizing echolalia is a quick and helpful way of providing a response, rather than creating an entirely original sentence structure.

As an example of non-interactive echolalia, a person might choose to say “The store will close at 6 o’clock” simply because they either enjoy the feeling of speaking the words, or they enjoy listening to the sound that the words make after they are spoken. In this case, the words are being spoken only for the enjoyment of the listener, and not as a means of interacting. If the words are being spoken because they meet a sensory need, the echolalia is being used as a stim.

It is important to mention that autistic individuals use stims for different reasons or purposes, and the particular way that they utilize these might change over time, or from one situation to another. It can be helpful to note whether a certain script or word might be repeated during periods of happiness or excitement, or if it is used to indicate pain, distress, or a need for help.

Echolalia & Treatment

Autism doesn’t necessarily require any treatment at all, but there are a few areas where those within the autistic population may benefit from some support. If echolalia is present, this behavior is serving some kind of a purpose, even if that purpose is unknown to the listener. Furthermore, its presence can help provide valuable insight into the needs of the individual. If an autistic person is looking for support, they might go to a speech therapist, an occupational therapist, or a talk therapist for help with co-occurring conditions like anxiety or burnout.

Here are a few ways to support those who utilize echolalia:

Speech Therapy

As there are sometimes challenges related to speech or communication for those among the autistic population, working with a speech and language pathologist can help the individual find ways of communication that are beneficial and comfortable for them. Seeing that many autistic folks are gestalt language processors, it can be instrumental to work with a speech therapist who is familiar with this process, and affirming of neurodivergent styles of communication.⁴

When supporting autistic folks, remind yourself that communication–not necessarily spoken speech–is the primary goal. So, finding a means of communication that works for and is preferred by the individual–whether that may be sign language, typing, or an Augmentative and Alternative Communication Device (AAC)–is critical in helping foster communication, autonomy, and agency.

Occupational Therapy

If an autistic person commonly uses echolalia as a stim, the presence and use of the echolalia can offer helpful insight into the sensory needs of the individual. It may also be an indicator of the presence of unique sensory needs. In these instances, consulting with an occupational therapist (OT) can be helpful to learn more about the sensory profile of a person, and the sensory support that may be most influential for them. Occupational therapists can also offer support in the areas of activities of daily living (ADLs), emotional and self-regulation, and fine motor skills and activities.

Medication

Echolalia does not require medication or medical treatment, but it could be triggered or worsened by co-occurring conditions like anxiety, depression, or ADHD. If someone has a comorbid condition, they may experience symptom improvement from support with medication.⁶

Counseling or Therapy

Sometimes an increase in echolalia or stimming can signify an increase in anxiety or distress. Also, increased sensory discomfort–a more pronounced need for stimming–and a new sense of difficulty managing every day tasks can be a sign of autistic burnout. If echolalia is triggered or worsened by an underlying mental or emotional health issue, then finding support from a neurodivergent or neurodiversity-affirming therapist who can identify any needs that may be present, and offer support that may be helpful.

Final Thoughts

Echolalia is a characteristic common to those on the autism spectrum, and can serve many different useful purposes. The more we understand the needs behind echolalia, and its purpose for being utilized, the better we may support and celebrate the unique needs and strengths of individuals within the autistic community.