Echolalia Autism: Repetition Can Lead to Better Language Processing

Echolalia refers to the repetition or echoing of words, phrases or sentences. It can be puzzling to those not in the know.Echolalia is the action of a person repeating something that someone else says. Echolalia autism is somewhat common and the person with these symptoms does not mean to be annoying to others. It’s simply a behavior that’s is automatic and non-voluntary.

While toddlers do this as a way to process language when they are learning to speak, this form of repetitive speech, sometimes referred to as “parroting,” is considered typical and will be outgrown as language develops.

However, if these symptoms of repeating a conversation – often word-for-word and using the same pattern or even inflection – is something that continues, it deserves to be checked out by a physician. Echolalia autism is a symptom that can be pointed to being on the spectrum because it is an indicator of lacking language processing skills that are needed to put a sentence or phrase into the proper communications context.

Repetition of words is not just found in individuals with autism. The symptom is common with other disorders as well, although it may present itself differently.

Understanding Echolalia Autism

Repeating words is a characteristic often associated with individuals diagnosed with autism spectrum disorder (ASD), although like everything else when it comes to autism, it may or may not be co-occurring.

However, the common condition that causes this symptom is autism, and some sources say about 75 percent of individuals with ASD use echolalia at some point in their life. Additionally, Some studies have indicated it is less likely to appear in so-called “high functioning” autism level 1.

Read more about Spotlight on the Spectrum: Understanding 3 Levels of Autism

Echolalia in adults and children alike refers to the repetition or echoing of words, phrases, or sentences just spoken by another person. For others who are unfamiliar with echolalia, it can be puzzling behavior. However, understanding the science behind it can help make sense of this core symptom. 

It doesn’t just appear in autism. Other medical conditions that can cause the symptoms include attention-deficit/hyperactivity disorder, dementia, developmental delay, Tourette syndrome, and schizophrenia, extreme stress, and anxiety, to name a few.  This is by no means an exhaustive list and individuals should consult with their healthcare provider

What Do Symptoms Look Like?

There are a few key features of echolalia that help distinguish it from typical development and behaviors. Individuals exhibiting echolalia may:

  • Instantly repeat or echo words or phrases verbatim after hearing them
  • Use the same tone, rhythm, accent and inflection as the original speaker
  • Repeat lines from favorite movies or stories
  • Repeat phrases out of context
  • Repeat questions rather than answering them

Some individuals with autism engage in continual echoed speech while others may only echo sporadically. Speech may sound robotic and lacks the usual rhythms of back-and-forth conversation. 

Types of Echolalia in Adults and Children

There are two widely recognized types of word repetition often seen in autism:

  1. Immediate echolalia

    This type of echolalia example happens when a person repeats words or phrases instantly after hearing them or within 2-3 seconds. It is thought to be a self-stimulatory behavior because it seems to provide enjoyment for the person.

    They may be focused on the sounds of the words rather than the meaning. However, repetition doesn’t always happen after statements directed at the individual but occurs just as often with ambient speech and sounds. 

  2. Delayed echolalia

    In contrast, an echolalia example of delayed repetition of words, phrases or sentences occurs sometime after hearing them initially. This could be several hours, days or even weeks later.

    Delayed echolalia appears to be used more purposefully. They may repeat a phrase from the past because something in the current environment has triggered that memory. Some professionals consider delayed repetition to be more communicative because previous speech is reproduced to convey meaning relevant to the present situation.

Additionally, the diagnosis may be categorized in four different ways:

  1. Immediate or delayed

    As mentioned above with types, it is categorized if the repeated word or phrase occurs immediately or sometime later.

  2. Communicative or Semi-Communicative

    If the repeated word or phrase has meaning within a conversation, such as answering a question that is asked, it is considered communicative, but if the reason for the repeat isn’t clear then it is semi-communicative.

  1. Mitigated or unmitigated

    If the repetition has changes to the tone or pitch of speech, it’s mitigated, but if it matches exactly to what other person said then it is unmitigated.

  1. Echoing approval or ambient

    If words are repeated in a positive or negative tone in response to a question asked to them or someone else, it is echoing approval. This compares with repeating words from a surrounding environment (an echolalia example could include radio or TV), which is ambient.

Theories Behind the Behavior of Echolalia in Adults and Children

Researchers have offered several theories to explain the mechanisms behind echolalia and why it is so common in autism. Here are 4 common ones.

  • Speech and language processing challenges

    Receptive language difficulties are nearly universal in ASD. Many autistics have trouble understanding complex grammar and multi-step sentences. Echolalia may be a way of responding when individuals do not fully comprehend questions and statements directed at them. An echolalia example is repeating parts they do grasp.  

  • Underdeveloped communication skills

    Around 30% of individuals with autism remain minimally verbal, according to some studies. Those lacking functional spoken language rely on echolalia to interact because they have no other communication tools. They repeat what they hear as a way to connect with the world around them.

  • Comfort with routine

    Many autistics take comfort in repetition and sameness. Predictable routines and consistency is reassuring. Echoed speech as an example is predictable because they’ve heard it before. The familiarity of repeating may be self-soothing.

  • Connection and meaning making

    Even immediate word repetition seems to serve a purpose. Hearing their own voice produces sensory feedback. Delayed echolalia even more clearly helps individuals share observations, make requests, and process information by reproducing stored language.

Treatment Approach for Echolalia Autism

Echolalia autism is thought to help with language processing. Research overwhelmingly recommends that word repetition not be discouraged in all situations. Repetitive speech often serves a functional communicative purpose for an autistic at their stage of development.

However, speech-language therapy is extremely helpful for not echolalia in adults and children alike to: 

  • Replace meaningless repetition with purposeful, spontaneous expressive language
  • Increase receptive language skills so a child understands what is said to them
  • Improve functional communication when echolalia is used to the exclusion of original thoughts
  • Determine contexts where repetition is socially appropriate or not

A speech therapist may first assess why word parroting happens and whether it meets the child’s or adult’s interaction needs. If speech is already functional, the therapist may opt to improve naturalness. But if echolalia prevents clear communication, replacing it would help the person to achieve greater connection and independence. 

Strategies focus on improving language comprehension, play skills, and conversational turn-taking. With support, children and adults alike can learn to generate original words and phrases. Using visual cues, social stories, sensory integration and assistive technology provides other ways to support expressive communication. 

For parents and/or loved ones, the most important thing is to keep the communication channels open. Meet them at their developmental level. With understanding and speech therapy support, an individual with the symptoms can learn to communicate meaningfully. Working closely with an autism specialist ensures you address behaviors like repeating words appropriately. 

Managing Symptoms at Home for Children With Autism

As a parent, you may be wondering what you can do to support your child if they exhibit echolalia. While therapy is invaluable, there are strategies you can implement at home to facilitate communication growth.

Model, Don’t Demand

Instead of insisting your child speaks spontaneously, be an example of appropriate communication. Children learn organic language from exposure, not correction. Narrate your daily activities, keep instructions simple and give them space to insert words. Shape the home environment to elicit speech.

Use Visual Prompts

Visual cues take pressure off verbal interaction. Post schedules, timers, picture exchange cards, and notebooks can provide structure. Visuals allow a child to communicate without speech. They may transition from pointing at a picture to later labeling it.

Provide Alternatives

Redirect echolalia to more functional options. If your child repeats phrases from books verbatim, ask them recall questions to demonstrate comprehension. Have them re-tell stories with visuals. Completing fill-in-the-blank sentences teaches use of language in context.

Shape the Environment

Make adjustments to lessen triggers for incessant word repetition. Some children repeat phrases from electronics or background noise they find distracting. Minimizing competing sensory input encourages social attention. First/then visuals also convey, “We’ll watch your show after we play this game.”

Most importantly, meet your child with empathy. Progress takes time. While the symptom may not make sense to you, it serves a purpose for them. Support your child by consulting speech therapists and autism professionals to ensure their unique needs are understood and met. With compassion and learning, your child can develop communication that allows fuller engagement with the world.

Also, while repeating words and phrases is something that can be managed better with maturity in time in some autistics, while others may struggle with the symptom for their entire lives. The key is changing supports and help in a developmentally and age appropriate fashion, and a therapist can provide guidance in this area.

Repetition word chatter causes distress mostly because of its strangeness and unpredictability. But it’s critical to bring empathy, patience and acceptance to understand why it occurs as well as helping the individual to live their best life while communicating to the best they can.

Repetition provides comfort, connection and meaning for children still learning language rules. Support meets them where they are at and enables progress to richer communication. With development, echolalia in adults usually transitions to more original, spontaneous conversations.

My Personal Perspective on Word Repeating

Echolalia in adults and children is something that can be treated, but it's important to know that the individual is trying to process language.I recently posted some information about echolalia autism, and was surprised that a few of the readers strongly debated whether it was a “condition” or a “symptom.” I’m not a medical expert, but I did look at various health websites, only to derive at the answer is that the terms seemed to be applied differently while essentially describing the same symptoms.

One article shows my case in point by using both terms in the same sentence: “Since echolalia symptoms may increase when a person is stressed or anxious, the calming effect can help lessen the severity of the condition.”  

Another references the symptom as an unconventional verbal behavior, seemingly avoiding the term condition, but referencing it as a symptom. A third suggests an underlying condition can cause the symptom to appear.

I only point out the inconsistent and confusing wording because some individuals on the spectrum or diagnosis may feel strongly about how echolalia is defined, and my role is only to describe it from an autistic point of view and not from an expert opinion.

As with any diagnosis or medical question, I always recommend talking with your preferred medical doctor and/or therapist or counselor to get their professional advice.

Finally, while I don’t have the diagnosis of word repetition, I have noted there are occasions when I do occasionally repeat back phrases, often to myself out loud, but more frequently in the sense of endearment or communications exchange.

An echolalia example is someone telling me “good night, sweet dreams” and me uttering back the same sentiment. I find it sweet when someone does the same with me, and I understand that is not the same. However, it brings me comfort and calmness just the same.

But I do echo the opinions of experts when they suggest that while the chatter of repeating back words someone says may not be the ideal way to communicate, the good news is that it is an outreach of communications processing and shows a desire to connect with others. Who can disagree with that?

Other Common Autistic Behaviors

There are many behaviors associated with having autism. Keep in mind that everyone presents differently, which is why it is caused a spectrum disorder. However, there are common autism behaviors. Learn more about them.