Echolalia: Causes, Symptoms, Types, Diagnosis, and Treatment

Repetitive speech is an extremely common part of language development, and is commonly seen in young toddlers who are learning to communicate. By the age of 2, most children will start mixing in their own utterances along with repetitions of what they hear. By age 3, most children’s echolalia will be minimal at most. 

The main symptom of echolalia is the repetition of phrases and noises that have been heard. It can be immediate, with the speaker repeating something right away after hearing it. It can also be delayed, with the speaker repeating something hours or days after hearing it. 

Other signs of echolalia may include frustration during conversations, depression, and muteness. A person with echolalia may be unusually irritable, especially when asked questions. 

Functional echolalia is attempted communication intended to be interactional, acting as communication with another person. Examples include:

Turn taking: The person with echolalia uses phrases to fill an alternating verbal exchange.

Verbal completion: Speech is used to complete familiar verbal routines that are initiated by others. For example, if people with echolalia are asked to complete a task, they might say “good job!” while completing it, echoing what they’re used to hearing.

Providing information: Speech may be used to offer new information, but it may be hard to connect the dots. A mother might ask her child what he wants for lunch, for example, and he’ll sing the song from a lunch meat commercial to say he wants a sandwich.

Requests: The person with echolalia may say “Do you want lunch?” to ask for their own lunch.

Non-interactive echolalia is typically not intended as communication and is meant for personal use, like personal labeling or self-stimulation. Examples include:

Non-focused speech: The person with echolalia says something that has no relevance to the situational context, like reciting portions of a TV show while walking around a classroom. This behavior may be stimming.

Situation association: Speech is triggered by a situation, visual, person, or activity, and doesn’t seem to be an attempt at communication. If someone sees a brand-name product in the store, for example, they might sing the ad

Rehearsal: The speaker may utter the same phrase softly to themselves a few times before responding in a normal voice. This may be practice for the coming interaction.

Self-direction: People might use these utterances to walk themselves through a process. If they’re making a sandwich, for example, they might tell themselves to “Turn on water. Use soap. Rinse hands. Turn off water. Dry hands. Get bread. Put bread on plate. Get lunch meat,” and so on until the process is completed.