WHAT CAUSES ECHOLALIA (ECHOPHRASIA)?
Medically reviewed by Melissa Bronstein, LICSWMedically reviewed by Melissa Bronstein, LICSW
Echolalia, also known as echophrasia, is the act of repeating the words, phrases, or sounds that another person says. It is automatic and non-voluntary. Echolalia is often an attempt to communicate or learn a language.
Echolalia is common in toddlers learning to speak. It is also common in people with autism spectrum disorder (ASD) and certain chronic (long-term) conditions. Up to 75% of people with autism experience echolalia and speech imitation.
In most children, echolalia resolves by age 3. If someone over 3 years old develops echolalia, it could be a sign of a problem with the frontal lobe, the brain area responsible for managing thoughts, memory, and movement. Understanding why a person has echolalia can help a provider develop an effective treatment plan.
What Does Echolalia Sound Like?
Echolalia sounds like speech imitation or repetition. A person with echolalia may repeat words or phrases that another person says. They may also repeat sounds they hear from their environment.
Echolalia is a common way for toddlers to learn language development. They may mix repeated words with their own to communicate with their caregivers.
Here are some types of echolalia:
- Immediate: Occurs right after someone else speaks
- Delayed: Occurs a bit later
- Unmitigated: Repeating words or phrases exactly as they were spoken
- Mitigated: Repeating words or phrases in a different pitch or tone
- Ambient: Repeating sounds from the environment (e.g., sounds from television, cars, fans)
- Echoing approval: Repeating answers to questions, sometimes questions that were directed toward others
Echolalia may be communicative, meaning it helps people communicate with those around them. It may also be semi-communicative, meaning there is no clear reason for the repetition.
Causes of Echolalia
Echolalia is a common way for toddlers to learn how to speak and communicate. After age 3, it may be a sign of a chronic health condition that affects the brain’s frontal lobe.
Typical Development
Echolalia is a common part of speech and language development. As toddlers learn how to communicate with their caregivers and others, they often repeat words, phrases, and sounds.
Toddlers often repeat words and phrases right away. For example, if you ask a toddler a question, they may repeat the question back to you in an attempt to answer it. Toddlers may also exhibit delayed echolalia when they repeat words or phrases they have heard previously.
Most children grow out of echolalia and speech repetition by the time they turn 3 years old. It is not typical or expected to develop echolalia after that.
Autism
Up to 75% of children with autism spectrum disorder experience echolalia at some point. A child with autism may repeat words, phrases, and sounds from people they know or from their favorite shows or videos.
Like toddlers, children with autism exhibit echolalia while learning how to communicate with others. They may also use speech imitation as a way to self-stimulate or soothe themselves during times of stress or anxiety. If a child feels too overwhelmed or stressed to develop their own words, they may use repeated language to communicate.
Children with autism may also use echolalia to process words or phrases they have heard from caregivers, teachers, healthcare providers, and others.
Other Conditions
Developing echolalia after age 3 can be a sign of a serious health condition that affects the brain. Echolalia may be a symptom of the following conditions:
- Attention-deficit/hyperactivity disorder, or ADHD (characterized by inattention, hyperactivity, and impulsivity)
- Aphasia (difficulty understanding and communicating through reading, writing, and/or speaking)
- Head injury
- Dementia (loss of cognitive functions like memory and communication)
- Developmental delay
- Encephalitis (brain inflammation)
- Tourette syndrome (causes unwanted and repeated movements or vocal sounds)
- Schizophrenia (characterized by symptoms like hallucinations, delusions, disordered thoughts, and disorganized speech)
- Stress or anxiety
- Stroke
When To See a Healthcare Provider
Echolalia is often a typical part of language development. Young children ages 1-2 will often use echolalia to communicate. A child’s speech repetition usually slowly goes away with time. Most speech imitation and repetition are resolved by the age of 3.
See a healthcare provider if you or someone in your care experiences echolalia. Echolalia is the practice of automatically repeating words, phrases, and sounds, meaning it is not a conscious choice.
Your healthcare provider may refer you to a specialist, depending on your other symptoms. For example:
- A psychologist or psychiatrist if your speech imitation might be a sign of a mental health disorder
- A neurologist (for testing) if your provider suspects brain damage
- A speech-language pathologist (SLP) who specializes in speech, language, and communication
Echolalia may be a sign of a serious health condition, and it is critical to seek medical care as soon as possible.
Treatments for Echolalia
Echolalia does not always require treatment. Most toddlers with echolalia naturally grow out of it by age 3. When present in toddlers, echolalia is a helpful way to learn how to communicate.
Your healthcare provider may recommend treatment if echolalia is caused by autism or another health condition. After determining the cause, you and your healthcare team can work together to develop a treatment plan. The goal of echolalia treatment is to reduce symptoms and improve communication skills.
A child or adult with autism who exhibits echolalia may benefit from treatment focused on speech development and communication. A team of healthcare providers, including a speech-language pathologist (SLP), can provide treatment options, such as:
- Speech therapy: An SLP can provide several exercises and resources to improve echolalia. For example, a behavioral intervention called “cues-pause-point” involves the therapist asking a question, pausing, and then pointing to the person to signal their turn to answer in their own words.
- Medications: Your healthcare team may recommend an antidepressant such as a selective serotonin reuptake inhibitor (SSRI) if stress or anxiety seem to worsen echolalia.
An SLP is crucial for treating echolalia in children with autism. A healthcare team might also include special educators and neurodevelopmental specialists. Music therapy is another possibly effective option.
Prevention
It may not be possible to prevent echolalia. Allowing young children to repeat words, phrases, and sounds helps them learn how to communicate.
To lower the risk of echolalia in people with autism and other health conditions, seek treatment with healthcare providers as soon as possible after diagnosis. A team of support is often required for the best results.
Complications
Echolalia can be very frustrating for people who are trying to communicate effectively. If left untreated, an older child or adult with echolalia may experience:
- Frustration and anger
- Stress
- Social isolation
- Learning barriers
- Relationship issues
- Anxiety
- Depression
A Quick Review
Echolalia is the act of repeating words, phrases, or sounds. It is automatic and non-voluntary. Echolalia is a common way for toddlers to learn how to speak and communicate. It is also common in people with autism spectrum disorder.
Other health conditions that may cause echolalia include ADHD, aphasia, a head injury, dementia, developmental delays, encephalitis, Tourette syndrome, schizophrenia, anxiety, and stroke.
Most children grow out of echolalia by age 3. See a healthcare provider if you or someone in your care above age 3 develop echolalia. They can help determine the cause and develop a treatment plan.
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2024-09-07T12:34:10Z dg43tfdfdgfd