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Echolalia: Is Your Client or Child Repeating Words? Here’s What You Can Do

Dr. Mary Barbera

As both a parent and a professional in the autism world, I’ve seen a lot of echolalia in the past 2 decades. Echolalia is a child with autism repeating what you just said. So if you say, “do you want a cookie,” the child can either say “cookie” or “do you want a cookie?” Either way, we’re talking about the child echoing you without answering your question. So today I’m going to talk all about echolalia.

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What is echolalia?

In my career as a behavior analyst and even before I was a behavior analyst when I just had my son Lucas, I did have some experience with echolalia, both immediate echolalia and delayed echolalia. Several months ago I did do another video blog on delayed echolalia, which is really scripting and stimming. In that blog, I gave an example where when Lucas was young we would take him to the park. My husband and I would read him the signs, “please do not feed the duck, quack, quack.” Then we would go to the next sign, and say the same thing. Then in the middle of the night, he’d wake up and he would start repeating, “please do not feed the duck, quack, quack.” So what he was doing is he was engaging in scripting, which is delayed echolalia. He was remembering what we said and then he was saying it.

A bigger concern for kids with autism and for professionals that’s often confusing is what to do when a child with autism starts repeating what you say. For instance, “touch your head” or “do you want a cookie?” So they’re just reciting back. Some behavior analysts even have a problem if you say, “touch your head” and the child says, “touch your head” while completing the instruction. Many kids with autism as they’re completing the instruction will echo, but I don’t really treat that, and that sometimes will go away on its own. But if you ask “do you want a cookie?” and the child says, “do you want a cookie?” That’s an error.

Or I had a client once who would repeat the “say” part of the instruction. So I would say “say banana” the child would say “say banana.” That’s obviously an error and we need to treat this echolalia to get the child to either answer yes or no or to get the child to respond with at least one word. So if you say “do you want a cookie?” and the child says “cookie” it’s still technically an error but you know if the child’s not ready for yes and no then that’s appropriate. I did do a video blog on teaching yes and no to kids with autism a while back. I developed a procedure on yes and no back when I was trying to help Lucas learn this important skill.

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Echolalia Treatment

To treat the echolalia, the first thing we need to do is an assessment. We need to do an assessment of the whole child. What that echolalia is telling me is that they don’t understand the language and they’re probably not ready for you to be asking them things like that. In my professional career, I have really found the VB-MAPP to be the assessment that I like to use for these kids. I’ve been using the VB-MAPP for kids who are not conversational since 2008. I found it to be a really helpful assessment. And for the VB-MAPP I would recommend not just the milestones, but also the barriers, the transition assessment, and the echoic assessment.

There’s also another really important assessment subtest that was created by Dr. Mark Sundberg with the VB-MAPP, but it’s not actually part of the VB-MAPP; It’s a supplement. This test is called the intraverbal subtest. You can get this online for free. It’s a really helpful tool to begin to assess the child’s ability to answer questions. The child might not be able to answer “what’s something that you eat for breakfast?” But they might be able to answer “you sleep in a” or “what does a cow say?” So maybe for easier questions, they can answer and get the intraverbal response, but when it gets to be harder, that’s where they can’t answer it. So doing a VB-MAPP assessment and doing an intraverbal subtest is great.

Then you need to make a plan, not just to get rid of the echolalia. The echolalia does have some benefits. We know the child can talk and many of our kids that have this echolalia actually have pretty good articulation. So those are all good things. We just have to direct that echolalia to make it more functional and to get the child to the next level. My online courses utilize the VB-MAPP, the intraverbal subtests, the self-care checklist, and all resources from Dr. Mark Sundberg. I’ve also created my own assessments where we basically step back, look at the whole picture, and help both parents and professionals figure out the next step for their own clients and children.

So if you would like to learn more about how to assess the whole picture and how to use the echolalia that we do have as an advantage and not a weakness, I’m going to encourage you to sign up for a free online workshop at marybarbera.com/workshop. If you enjoyed this video/blog, please leave me a comment, give me a thumbs up and share the video/blog with others who might benefit. And I hope to see you right here next week.

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