Echolalia..

What To Do About It
June 2, 2008 by Laura 34 Comments
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EcholaliaWhat To Do About It
This is a follow-up article to my recent post EcholaliaWhat It Is and What It
Means.
I am always so frustrated when I go to a continuing education conference or read an
article by an expert when the bulk of the time is spent addressing the
identification/assessment aspects of an issue, and then five minutes or two lines are
spent offering recommendations for intervention. In an effort to overcome this
irritating trend, I constantly remind myself to spend most of my time on this site
writing about the part that most of us seek the What To Do About It part!
I hope that youll find these strategies helpful for your child at home, or for the
children on your caseload. This list has been compiled from my personal knowledge,
from the tried and true recommendations I use with my own clients. I even found a
few BETTER strategies as I researched this article that I will share with you.
Let me also add that treating echolalia can be very frustrating, not only for a parent,
but for a professional. With a child who is echolalic, your teaching mistakes are often
amplified because he is repeating EXACTLY WHAT and HOW you taught him. I
have one darling little boy on my caseload right now who is making me rethink every
word that comes out of my mouth during his sessions, and I do this language thing
all day, every day! I understand your frustration if you, too, are searching for a better
way to teach language to a child who learns in this way.
However, I hope youll find solace in the same way that I have for my particular little
friend at least hes talking!!! He may be mixing up pronouns, re-asking my poorly-

worded questions, and imitating things I didnt fully intend for him to repeat, BUT
HES TALKING! Compared to nonverbal children whose parents are eagerly
anticipating their first little peeps, this is a huge, dramatic, BIG DEAL! It should not
be viewed as something we need to eliminate.
On the other handit is NOT normal for a child to repeat so many of the phrases
and sentences he hears while displaying an obvious difference in how he
understands and processes language. It is heartbreaking for me when I evaluate a
child and hear from a grandparent, a teacher, or even a parent who is oblivious to
the fact that their childs language is not advanced, even though they are able to
quote large chunks of a Disney movie or know the words to every commercial they
hear on TV. Even when parents have initiated the evaluation on their own, I think
sometimes they still wish Id come in and say that everything really is fine, even
when they know in their heart of hearts that its not. So with that in mind, lets get on
with learning what to do about echolalia.
The KEY to treating echolalia is to model every word, phrase, or sentence in just the
way your echolalic little friend should say it. Easier said than done, right? This can
be hard! Even when I am teaching a parent how to do this and modeling it for them, I
can still screw it up. (As the mother of the little boy I mentioned can attest!)
Initially, this means that you need to stop asking this child so many questions and
giving so many directions and start modeling more requests, labels, and comments.
You need to say things EXACTLY the way you want your child to say it since he
learns by repeating EXACTLY what youve said.
Some parents and professionals balk at this advice saying, Hes got to learn it the
right way. Well that is wrong, at least for now. One thing I try to tell parents is not to
look at echolalia as right orwrong; it just is. This is how he learns. This is what weve
got to work with. Learn to use this heightened skill of imitation to your advantage.
MORE SPECIFIC EXAMPLES

1. Model language from your childs point of view. Model the kinds of words and
phrases he can actually imitate AND understand.
Narrating play with a child who is echolalic is EXCELLENT because he will likely
rehearse this even when he plays independently.
Be sure to provide words (even ones youd prefer he not say) for activities rather
than what youd probably normally say. For example, if hes trying to refuse an
activity, model, No or Dont like it. If a sibling or peer is taking a toy, help your
child learn to say, Stop, or Mine. Many parents dont like the idea of teaching
their children these unpleasant, impolite words, but then again, Id rather hear a
word rather than a scream, or deal with a child whos been bitten or hit (or is the
biter or hitter), all because we failed to teach an appropriate response.
When youre reading books (often a favorite activity for this kind of kid because they
like visual, repetitive, and predictable information), point to and label the pictures
using single words at first, and then short descriptive comments as his
comprehension skills improve. If he doesnt name the pictures as youre naming
them, take his finger and pause to give him a chance to echo what youve taught
him previously. While many experts recommend this is a great way to increase
vocabulary initially, dont over-use books and pictures. Be sure to play with toys
MOST OF THE TIME since children like this generally need more help learning to
use language during everyday activities. Reading books, looking at flashcards, and
naming pictures from videos are NOT functional or useful skills when your toddler is
in the kitchen and cant figure out how to tell you hes thirsty and wants milk!
2. Dont ask your child Do you want? questions since he will initiate his requests
by saying, Do you want ? In this kind of situation, model what he should say if
you know what he wants. For example, if hes reaching for an object, say the items
name or model, I want the ________. If youve already messed this up and your
child is doing this, model his name as you give it to him and say, _____ wants the
_________.

One thing I do is to respond to a question like this literally by saying, No, Laura
doesnt want the _________, but _ (childs name) does. Then model, I want
________. Wait until she repeats this phrase as the request before giving her the
item.
Once a childs language has become more advanced, ask the question, but offer
responses at the end. Do you want ice cream, yes or no? Again watch your tone
so that youre not modeling the question inflection for the yes/no response part of
the question.
3. When offering choices, also drop the Do you want _____ or _______? Model
the names without the question tone at the end and holding each one forward when
offering the choices. If your child is reaching for one, again model the objects name
and withhold until he repeats you.
One expert suggested using a fill-in-the-blank format. Offer the choices by modeling
the words in a statement tone of voice (not a questioning intonation) and then
adding, (Childs name) wants Wait for him to complete the phrase, and then give
the object.
4. Stop asking other questions like, Do you need some help? or Should I hold
you? Model what your child should say before and while youre doing what he
needs. Try, Help, or Hold me. Also drop the question tone since your child may
also imitate this voice pattern. Later, you can start to wait a while and expectantly
look at him for his echoed request.
5. Be careful how you respond to requests. If youre saying, Okay habitually after a
request, your child may also incorporate this into his script saying something like,
Help you? Okay. To avoid this, either perform the request without a verbal
response, or vary what you say so that hes not locked in to a particular pattern.
6. Avoid using praise such as, Good job ______ or Good talking __________
with the childs name since she will often imitate this. If you cant stop yourself, at

least dont use her name. I try to use lots of hugs, smiles, and cheer, Yay to
replace this habit. It sounds less abnormal when a child cheers to congratulate
herself when shes not using her own name.
7. Avoid greeting or closing using the childs name since he will always repeat it the
way youve said it instead of using your name. (By the way, I screw this up
regularly!) Use just, Hi and Bye. Hard to remember! You may also try other goodbyes such as, See you later! or Be right back, since its okay if a child echoes
these.
Several sources recommended using a verbal cue, such as calling the childs name
first or touching him, and then using your greeting or closing.
8. When you notice your child echoing, look at this as an opportunity to teach him
what he needs to know. Model the way he should say something and wait.
9. Sometimes echolalia is a childs response when his system is overstimulated.
Children who are tired, hungry, scared, sick, extremely bored, or overwhelmed often
lapse into echolalia as a way to self-calm. Analyze the situation and see what kind of
support you can provide to them environmentally before you begin to look for ways
to eliminate the echolalia.

In closing, let me remind you again of the bright side of echolalia. Hes talking! Hes
trying! He isworking on learning to communicate. You can see it right before your
very eyes! It may be frustrating for you, even for a looooooooooong time, but
remember that its better than the alternative of being silent and not showing any
evidence of learning language. The positive qualities of echolalia, having strong
memory skills and learning from predictable patterns, CAN and SHOULD be used to
help your child learn to communicate. Use these suggestions and ask your SLP to
help you figure out how to do this for your child.

I welcome your comments to this and all articles on my site!

Remember, you can teach words anywhere, anytime!