Owen is Echolalic: What to do?

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Did you see the last newsletter, where I described Owen, who is autistic, legally blind, and echolalic? I mentioned consulting with his team, some early progress, and a speech and language assessment as he approached age three.

Now, I’ll briefly share my philosophy of echolalia, an overview of the therapy process, and a few specific examples for Owen.

First, I believe Owen’s echolalia comes from his two neurologically based disabilities, autism and septo-optic dysplasia, not from a natural variation of language acquisition or from psychological, behavioral, or parenting issues. He has very strong auditory memory and verbal imitation ability, but significantly compromised understanding of conversation.

Owen is confused by language and his echoing is confusing to others. So, my strategy is to use his memory and imitation strengths while providing meaningful contexts and modifying the language he hears. This will help him develop more conventional language that meets his immediate needs and provides a foundation for further learning. Of course, Owen also has the small repertoire of play behavior and the social interaction limitations that accompany autism, but this therapy process improves those too.

Here is the gist of it: ?(And yes, it is evidence-based. I can send references if you want. Or read Chapter 2 of my next book.)

Start with teaching him more effective ways to say the things that he wants to say and is now trying to express with echoes. These include:

Requests: Owen says, “Do you want a…?” to mean “I want a…”

Directives: He says, “Can I help you?” to mean “I need help”

Protests:? Owen’s, “Say Bye! Say Bye!” really means “Go away!” or “Get me out of here!”

Some other functions young children usually communicate in more predictable ways are comments, choices, and greetings. Despite his clear speech and longer echoed sentences, Owen needs help with all of them. He also needs to learn to call himself “I”, not “you”, and to answer and ask questions, but most of that comes a bit later.

How to begin?

·?????? Start by eliminating some of the confusion:

Avoid using the pronouns “I” and “you.”? If needed, use your names instead.?

Don’t ask questions, especially the “yes-or-no” kind. Owen echoes, but rarely answers, questions. He might confirm or correct your information (You: “Is it a ball?? Owen: “ball” instead of “yes” or “shoe” instead of “No”) but he never says “Yes” and only uses “No!” as a protest.

·?????? Interact through play, but don’t assume you can just follow his lead. Be prepared to initiate some play yourself.

·?????? Interact through play, but don’t assume you can just follow his lead. Be prepared to initiate some play yourself.

·?????? Model language that matches the meaning of his actions, and does not require a response from Owen, but is still accurate if he echoes it. ?It is probably easiest if you start by modeling comments, as that gives you practice in modeling, puts no direct expectation on him, and helps build a comfortable relationship.

Here are some examples:

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1.?????? Owen is spinning the wheels on an inverted toy wagon.? You say (with pauses) “Wheels…wheels are spinning…it’s a wagon…upside down…goes like this” (as you place it upright). He flips it over again to spin the wheels and you repeat, “Wheels…wheels are spinning…it’s a wagon.”? Perhaps he echoes, “Wheels” or “It’s a wagon,” or maybe not. But everything you said is true, even if echoed. You have joined his play, added an idea, and not insisted when he rejected it. The words you said made sense because they matched his actions and still worked if he said the same words. ?There were no questions and no personal pronouns. It’s a good start to teaching and building a relationship at the same time.

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2.?????? You have a puzzle with three shapes. You place it between you and start removing the pieces as you say: “Shape puzzle…circle is out…square is out…triangle is out. Triangle goes here…square goes here… It’s in!... (pushing it closer to Owen and handing him the circle piece) Circle goes…”?? Perhaps he takes it, puts it in and says “here” or “in” and you respond, “It’s in!”? ?Or maybe he walked away before you even got the triangle back in the puzzle. If so, you just finish the puzzle, and your comments, and you try again next time. ?Remember, this was new, and autism often rejects novelty. He may be much more receptive the second or third time he sees it and hears you say the same things.

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3.?????? Owen is repeatedly rolling a ball down the small indoor slide and chasing the ball to do it again. As he runs after it, you say, “The ball! …gotta get the ball…Yeah! got the ball!… ball’s on the slide…on top…whee!...it’s down…gotta get the ball!” ???You have shown interest in what Owen is doing, provided language that matches his experience and which he can use to narrate his play. Since this is repetitive play, you will have several chances to repeat your commentary, increasing the chances that Owen will echo it.

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These are all comments, not questions and answers, and they gradually become more reciprocal as Owen echoes and you add another comment. Comments are an important foundation for conversation and these short ones are much easier to understand, reuse accurately, and modify with different words because Owen is not confused by questions he can’t answer and those pesky “I-you” pronouns.

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But communication has many other functions besides commenting, and next time I’ll have suggestions for teaching Owen about requesting, choosing, and some other uses of language.

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