Repeating purposefully: Empowering educators with functional communication models of echolalia in Autism

Abstract

Background and Aims Echolalia, the repetition of speech, is highly prevalent in school aged children with Autism. Prior research has found that individuals with echolalia use their repetitions to engage in communicatively functional speech, in the absence of self-generated speech. Educators are the natural audience for a wide vary of echoed utterances across environments and in differing contexts. The objectives of this paper were three-fold: (1) to systematically investigate how researchers identify and ascribe communicative function to echoed utterances; (2) to gather and evaluate the evidence that might assist teachers to identify and better understand echoed utterances as being communicatively purposeful; and (3) to provide teachers with evidence-informed response strategies they can use to assist their students on their journey towards more self-generated speech. Main Contribution Prior research in the field of echolalia has generally been segmented into opposing viewpoints. A paucity of work in the echolalia field has meant that there is limited work that has sought to view how a communicative function to echolalia has been ascribed from across multiple disciplines and fields. As such, there is limited literature to guide the practice of classroom educators. This review combines communicative models from across various disciplines with the view to supporting classroom educators by providing guidance on how they might assist their students with echolalia. This review represents the first contribution to the research literature in this area. Conclusions and Implications Research into echolalia did not originally emanate from the field of education; however, anecdotes from classroom educators were cited as the primary impetus for the creation of some of the communicatively functional models. We found that although there are many techniques that researchers have used to attribute a communicative function to echolalia, some of these can be easily employed by educators in their practice. By adopting these techniques, educators are placed in a position that may assist with the identification of communicative echolalia; subsequently they are better placed to acknowledge and respond to their students.

“Can I play ball, too?” Using echolalia for increasing ASD youth verbal/non-verbal expressive/receptive communication through culturally competent action research using play/sensory therapies.

“…For example, this study did not include a communication therapist, as did Breiting and Maas (2021). Nor did this study include teachers, as did Cohn, McVilly, Harrison, and Stiegler (2022). Third, Rossignol and Frye (2021) assessed the utility of vitamin B12, but the current study did not assess any of the five youth Verbal/non-verbal expressive receptive communication 24 for the presence (or absence) of vitamin B12.…”

Echolalia from a transdiagnostic perspective

“…A recent review suggested functions of echolalia have been investigated via multiple methodologies, including looking at surface structure of the repetition, relying on the communicative partner for determining function, evaluating the interaction in the context of the surrounding environment, or evaluating alterations of speech prosody (e.g., tone, volume, inflections, rhythm) as indices of function ( Cohn et al, 2022 ). Although newer conceptualizations consider echolalia as occurring within a communicative context, this was not always how echolalia was conceptualized ( Cohn et al, 2022 ). Early research suggested that presence of echolalia was “auto-erotic and auto-aggressive” ( Buium & Stuecher, 1974 , p. 353).…”

“…During the behaviorism movement, echolalia was reclassified as a self-stimulatory behavior ( Gernsbacher et al, 2016 ). Echolalia has also been described as a lack of inhibitory control, such as the case in GTS ( Ganos et al, 2012 ), and can have some non-communicative functions ( Cohn et al, 2022 ). However, recent evidence suggests that echolalia may have more of an adaptive function instead of being the result of a maladaptive neural function or deficit.…”

“…Echolalia is described as “parroting,” or reproducing previously heard sentences or words, not for the purposes of comprehension, clarification, or reframing (e.g., Cohn et al, 2022 ). Echolalia was first described in verbal and nonverbal (echopraxia) behaviors by Itard in 1825 (Itard, 1825; Roberts, 1989 ), refined by Pick (1924) , and soon thereafter used by Kanner (1943) to describe the tendency of autistic 1 children to repeat, as opposed to respond, when asked a question or provided with a verbal prompt.…”

“…Echolalia can be used as a way for individuals with limited self-generated language to communicate functionally ( Gernsbacher et al, 2016 ); however, echolalia in some forms has been reported to negatively impact one's quality of life, contributing to lower social acceptance and reduced vocational and independent living opportunities ( Paul et al, 2005 ). Despite echolalia being recently reviewed in several diagnostic-specific outlets, including reviews of echolalia in aphasia (e.g., Ota et al, 2020 ; Torres-Prioris & Berthier, 2020 ) and autism (e.g., Cohn et al, 2022 ; Gernsbacher et al, 2016 ; Luyster et al, 2022 ), no research to date has reviewed echolalia from a transdiagnostic perspective. Critically, given the prevalence of echolalia in clinical groups and the number of publications in the past decade exploring echolalia, a literature review that consolidates the findings from a transdiagnostic perspective and provides transdiagnostic clinical recommendations is warranted.…”