Speech 2U

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Autism: Echolalia and filling in the blanks {repost}

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I am probably sitting in a hot tub right now surrounded by some elderly people who wish my son would stop talking.  We are visiting my mom in Arizona. While I am away, I thought I would update and repost some of my popular posts related to Autism.
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Echolalia refers to when a child repeats a vocalization or something that has just been said.  Echolalia can be immediate or it can be delayed.   An example of Immediate Echolalia would be:

Me:  Do you want to eat a sandwich?  Tell me yes or no.
Client:  Yes or No.  
 
Delayed echolalia happens when someone repeats something they’ve heard frequently.  Sometimes this will be repeating lines from books or movies, which may be referred to as scripting.  Sometimes it is something that they heard in a certain situation.  An example of delayed echolalia might be:
Me:  Do you want to eat a sandwich?  Tell me yes or no.  
Client:  Presented by Disney Home Studio
 
In the example above, the echolalia does not appear to be functional.  Other times, you may notice that a child is able to use a whole sentence or phrase appropriately.  Sometimes children on the autism spectrum appear to learn language in a more gestalt form.  Their language may appear to be more advanced because they have learned a variety of rote phrases.  But they may struggle to create their own unique utterances.
Sometimes a child may say something that appears to be completely unrelated to a situation but has specific meaning that the child may be trying to communicate.  An example would be the following situation:
Me:  It’s time to go to the dentist.
Client:  I said put your pencils down right now!  

Sometimes, the child will overgeneralize a statement based on a previous situation.  For instance, maybe he got really upset when a teacher yelled at him to put his pencil down when he was drawing one of his favorite characters.  He may overgeneralize the statement that the teacher said to convey his frustration or anxiety.  Sometimes you have to play detective to try to figure out what a child who uses echolalia frequently is really trying to convey.
Teach wh questions to children who exhibit echolalia can be difficult as they tend to repeat the end of the question.  Answering questions is an intra-verbal task.  it requires the child to listen to the question, determine what is being asked, and then formulate a response.  If you have a child who isn’t making progress with WH questions, then it is time to take a few steps back.
Another favorite goal of mine is Fill in the Blank tasks.  It requires the child to listen to what you are saying and respond but it doesn’t require as much formulation which reduces the cognitive load.  I usually follow the following hierarchy:
1.  Fill in the Blank for Common phrases.
Ex.  Ready, set, _______., It’s time to _______.  Sit _______., 
2.  Fill in the Blank for stories, nursery rhymes, and finger plays.
Ex. Brown bear, brown bear what do you _____.  
3.  Fill in the Blank for Object Functions.
I sit in a _________.  ABA programs often use this as a goal and there are some great products which vary the cues (Ex. I sit in a _______, a chair is somewhere I ______.)  One of my favorite card decks for this is:
4.  Fill in the Blank for common questions:
Who questions:
A person who brings the mail is ____________.
Where questions:
The place where you buy groceries is ___________.
When Questions:
I eat breakfast in the _______________.
Why questions:
I eat breakfast because ______________.  

One of my favorite resources is Natural Learning Concepts: Fill in the Blank Cards.

I wish there were a few more basic cards in this set, but I love the size and the fact that they are coated, making them very durable.

You can also check out my Interactive Flash cards: Fill in the Blank/Reversals product.  It is on sale through April 11th.

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Comments

  2. Is a 3 year old who uses echolalia frequently always on the autism spectrum? Or could they just have a language delay? Does language impairment always put a child on the spectrum even if there are no other symptoms of autism!

    • Those are good questions. Echolalia can also occur when children are learning language-or not understanding the question/sentence. I don’t think a child would be diagnosed with autism based on just using echolalia. They psychologist would look at the whole child including eye contact, patterns of interacting, joint attention etc. If there are concerns, I would recommend an assessment. While it is scary to think that a child may get a diagnosis, there are so many things that professionals can do to help and the earlier the intervention, the better the long term outcomes.

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