My child repeats everything we say? Is he autistic?
This was a question I received from a concerned mom. She believed her son to be a bright child and understood so much. Her only complaint was that he repeated everything. If she said, "*Ben let's go home" he would repeat "go home." She felt he didn't have any real sentences of his own - only words from others that he would repeat.
Before contacting me, she did what most of us do when we have a medical concern- turn to GOOGLE! The proper label for her son's repeating of words is echolalia. If you google echolalia, the first result is "meaningless repetition of another person's spoken words as a symptom of a psychiatric disorder." YIKES!! If that doesn't send you into an immediate panic and you are brave enough to read further, you may see "repetition of a child learning to talk." You may also see definitions linking echolalia to autism spectrum disorders. But what does any of this mean?
Echolalia is a form of verbal imitation. It is one of the most common characteristics of communication in people with autism spectrum disorders (ASHA 2017), but echolalia alone does not mean your child has an ASD.
There are two types of echolalia- immediate and delayed. With immediate echolalia, the child immediately repeats all of the question heard or a segment of what was just said. Here's an example of immediate echolalia
Mom: Do you want juice or milk ?
Son: juice or milk
In this example, the boy has repeated a segment of the question asked by his mother. Some variations may be the son repeating "want juice?" "want milk?" "juice" or "milk." Often the response may be accompanied by a gesture, like pointing or simply taking the beverage of choice. Although it may appear to be simple repetition, it is a response and acknowledgment that the question was heard.
Delayed echolalia refers to the repetition of a message heard previously and is repeated after a time delay. It could have been minutes ago or even years ago. A child may repeat a script from a favorite television show or repeat a directive/ message given by a parent. For example, I have a student who grabs my hand and says "1,2, 3 Go!" when he wants to end an activity or leave the room. Although we initially used 1. 2, 3, go while playing cars, he has assigned the entire phrase a different meaning. This is his way of communicating a desire to move on to something else. Another student would say to himself, "don't make a mess" while washing his hands. He was repeating a directive heard in the past and applying the memory to a current and appropriate experience.
Is echolalia normal? Sometimes. Echolalia is not a maladaptive behavior, but it is a stepping stone to language development and processing language.
Is it associated with autism spectrum? Sometimes, but it can also be apart of normal language learning. An evaluation by a medical doctor is needed to determine whether a child has an autism spectrum disorder.
Is it treatable? Yes! A certified speech language pathologist can assess how and why echolalia is being used. An SLP can develop a treatment plan and give you specific strategies to help your child.
If you have concerns about your child's development, trust your instincts and don't wait! Talk to your pediatrician. He or she can refer you to a team of professionals (including a speech language pathologist) to help.