If a person has the habit of repeating words after his interlocutor, without really understanding the meaning of what was said, this phenomenon may indicate the presence of echolalia. This diagnosis is made for a specific neurological disorder. Although sometimes echolalia can act as a form of natural speech development in a child.
What is echolalia, echophrasia? Definition
Echolalia is characterized by spontaneous, compulsive, meaningless
uncontrolled person automatic repetition of sounds, syllables, words that are heard in the speech of other people. Moreover, even the intonation of the words heard can be preserved. The term echolalia comes from the Greek words “echo,” which means “reflection of sound,” and “lalia,” which means “speech,” or “laleo,” which means “speak.” In ancient Greek mythology, there was a nymph named Echo. She was petrified. All that was left of her was her voice. The voice repeated the endings of words that people uttered in her presence. A synonym is echophrasia .
Methods for correcting echolalia
The presence of echolalia is diagnosed by a specialist during a conversation with a person showing any signs of such a disorder. Along the way, other diagnostic manipulations can be used to accurately make a final diagnosis, identifying the severity of the disease. Usually, to draw up a treatment plan, neuropsychiatrists collaborate with defectologists and speech therapists. An individual correction scheme is always selected taking into account the patient’s age and the level of neglect of the problem. Often, special training programs are prescribed using specially designed manuals.
When does echolalia occur?
In what pathological conditions, diseases, illnesses does echolalia occur? Echolalia can more often be observed in various neurological and mental diseases, such as Tourette's syndrome (Gilles de la Tourette's disease), autism (early childhood autism, autistic behavior, autism spectrum, autistic character traits), Andreas Rett syndrome, schizophrenia (catatonic), mental retardation (dementia, mental retardation, imbecility, debility), dysphasia, damage to the frontal lobes of the brain. Normally, echolalia occurs as a stage of speech development in children aged 6 months to 3 years, when the child repeats the words he hears, thus learning speech. If a child at 3 years of age and later repeats or shouts words, then this is a sign of a serious pathology. In this case, you should immediately consult a doctor.
Diagnostics
Long-term persistence of vocabulary and syllabic speech imitation in childhood or the appearance of this symptom in adults requires contacting a psychiatrist and neurologist. Echolalia is diagnosed during communication with the patient and observation of his speech. Typically, identifying automated repetitions of sentences and words is not difficult. To establish the nature of echolalic symptoms, a comprehensive examination is performed:
- Assessment of psychoneurological status.
Anamnesis collection, a clinical conversation, and a neurological examination allow doctors to assess the patient’s general condition: his ability to establish and maintain contact, navigate in space and time, and think critically about his illness. Neurological disorders and psychopathological symptoms accompanying echolalia are detected. - Speech therapy testing.
The speech therapist examines the speech function, determines the degree of its formation, the presence of pronunciation defects, and the loss of individual links. In conclusion, he notes whether echolalia is the result of speech underdevelopment or speech decay. - Pathopsychological testing.
A study of memory, thinking, attention and intelligence is carried out. The results indicate the presence or absence of signs of organic damage to the central nervous system, intellectual underdevelopment as the cause of echolalic manifestations. - Neuropsychological testing.
Diagnostics by a neuropsychologist is aimed at analyzing higher mental functions. Testing data allows us to determine neuropsychological symptoms (various types of alalia, aphasia) and differentiate neurological diseases.
Types of echolalia: immediate, delayed, true, mitigated
Reflexotherapists, neurologists, and psychiatrists distinguish 2 types of echolalia : immediate echolalia, delayed echolalia (delayed). In immediate echolalia, the child immediately repeats a word after hearing it from a person or any other sound source. With delayed echolalia, children repeat previously heard words after a long period of time. Several minutes or several years may pass after hearing the phrase. Delayed echolalia is common in Tourette syndrome and autism and is a feature of the disorder. True echolalia and mitigated echolalia are also distinguished. With true echolalia, automatic repetition of addressed speech occurs; with mitigated echolalia, the patient repeats words with transformation.
general characteristics
According to clinical manifestations, echolalia is of two types: immediate and delayed.
In the first option, patients unconsciously repeat words and phrases they just heard. For example, a child, when asked: “Will you have an apple or a banana?”, answers: “Banana,” even if he wants an apple (he is unable to choose an answer). In the delayed form of the disorder, information heard some time ago is repeated. Example: Reproducing phrases from dialogue in a movie. Echolalia, as part of normal speech development, can be observed at the age of 1-1.5 years. Gradually the need for them disappears. Pathological echolalia clearly manifests itself after 2-3 years. Children do not master independent speech, but continue to repeat phrases after those around them. Their entire active vocabulary may consist of sentences often repeated by their mother, replicas of cartoon characters, monologues of TV show hosts.
Echolalia is the automatic, but not meaningless, repetition of phrases. It performs several important functions for the patient: it helps to maintain a conversation, understand the interlocutor, and designate objects and phenomena. Patients with autism use automatic repetition of words as a ritual to restore emotional balance or as a tool for self-stimulation (repeating phrases causes arousal).
Causes of echolalia
When and why does echolalia occur? Echolalia in autism can fill a pause, express agreement or disagreement, name surrounding phenomena, people, objects, allows the child to calm down, train, understand someone else's speech, remember the past, share their feelings, have fun, share experiences and feelings. There are various causes of echolalia.
Child's self-stimulating behavior, stimming.
In this version, the child often repeats words read in books or heard on TV. In this case, the boy or girl has associations and emotions about the actions or objects they saw. Moreover, the appearance of images is not related to the current situation. This greatly interferes with the child's ability to communicate with other children or adults.
Communication of mood.
The child can express his mood, and this mood is often associated with a certain phrase that he remembered the day before. Moreover, the phrase may not be related in meaning to the mood that it expresses in the child.
Systematization of the day's results.
In young children, delayed echolalia may express idiosyncratic processing of information they have received throughout the day that keeps them from calming down.
Unfortunately, in older age, echolalia in most cases indicates a serious pathology, Tourette syndrome , autism, which must be treated in a timely manner.
Potential risk of hysteria
It's a fairly common scenario in the autism community where the cause of a tantrum is a misunderstanding due to immediate echolalia. An adult asks a child: “Do you want grapes or apples?” The answer is almost always the last word: “Apples.” The adult decides that the child really wants apples. The child then begins to scream wildly when he is given an apple, because the child answered before he even realized the two options offered, and in fact he wanted grapes. Picture cards or PECS are a great way to offer your child options or prepare them for change, which can help prevent tantrums.
Treatment of echolalia in children and adults in Saratov
Sarklinik (Russia, Saratov) successfully uses hardware and non-hardware methods for treating echolalia in children, adolescents and adults in Saratov. Treatment is carried out on an outpatient basis in courses. The minimum duration of one course of treatment is 10 working days. The total number of courses depends on the severity of the pathology. Sarklinik knows how to treat echolalia in boys and girls, how to get rid of echolalia in boys and girls, what to do with echolalia in men and women.
Sarklinik also provides treatment for delayed speech development, treatment for delayed psycho-speech development, general speech underdevelopment (GSD), treatment for mental retardation, mental retardation, treatment of alalia, dyslalia, and autism in children.
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Treatment
Echolalia can be eliminated with the help of psychocorrective activities. In parallel with them, the underlying disease that caused the symptom is treated. Corrective work can be carried out by a psychologist, defectologist, or speech therapist. Important conditions for obtaining a positive result are the patient’s ability to maintain contact, the absence of pronounced emotional and behavioral disorders, and a sufficient level of intelligence to conduct a conversation.
Visual aids, tables, audio and video materials are actively used in classes. At the initial stage, dialogue exercises are used in which the patient is asked to replace the echolalic “response” with the choice of a visual stimulus - pointing to a picture or an object. Gradually, visual support is replaced by speech utterances, and the duration and complexity of the dialogue increases. After dialogue speech, monologue and communication in a group are mastered.
Prevention
Echolalia is a unique form of communication, that is, it cannot be called a meaningless and aimless repetition of someone else’s words. Prevention of the disease is aimed at normalizing the communication process, turning the disorder into a tool for interaction with others. Do not stop the patient when repeating, since pronouncing words is one of the ways of self-expression in case of problems with oral speech. If this opportunity is not available, the patient will not be able to practice pronunciation, maintain a conversation, and minimize anxiety through verbal communication. Pay attention to all the words spoken, even if they don’t make sense at first glance. This will allow you to study the features of echolalia in more detail and improve the communication process. Try to understand what is being said, intonation and facial expressions of the patient. It is very important to grasp the tone and rhythm of what is said, since the same phrases can convey different information. Join the conversation and recite your child’s favorite speech scripts one by one. Try to form new things, that is, expand the phrases you have memorized, constantly expanding your vocabulary. Only regular exercises in a calm environment will help to establish the communication process and improve the socialization of the patient. [50], [51]
Self-stimulating behavior
Delayed echolalia is sometimes a self-stimulating behavior whose sole purpose is the pleasure of the speaker. My eldest son always likes to repeat sentences he read in books. I realized that he sees the book in his head, and simply entertains himself by “rereading” his favorite passages over and over again. The line "George, what's that smell?" clearly borrowed from the book about the skunk "Curious George", which invariably causes homeric laughter.
He also enjoys repeating clips from his favorite videos as if he were watching them in his head. When delayed echolalia is used as personal entertainment, it can interfere with real communication. An adult can use such echolalia as a hint to gently switch the child to a more constructive activity.
What causes echolalia?
Repeating heard words and imitating them is a natural and necessary way for a small child to develop speech skills that are just beginning to develop. If echolalia remains in the life of a child who has already reached the age of three, this may indicate a disinhibition of the imitative reflex. This symptom is also associated with possible damage to the left hemisphere of the brain. In particular, there is evidence of a connection between mild echolalia and specific damage to the frontal lobe of the left hemisphere.
