Introduction to Echolalia and Autistic Scripting 

In this introductory post, we’re providing you an overview of echolalia and autistic scripting.

What is Echolalia in Autism? What is Autistic Scripting?

Echolalia is the medical term for repeated speech and verbal imitation.

Scripting is a verbal tool used by many autistic people to assist with spoken interactions. Scripting may be considered a type of delayed echolalia, which we’ll look at below.  

Before we look at echolalia as it relates to autistic people, though, it’s important to know that repeating sounds and words is a typical, expected, and necessary phase of language acquisition for young children. When repetition continues after a certain age or stage of development, echolalia may be an indication of a neurodiversity such as autism or Tourette’s Syndrome. There are also instances – such as with some brain injuries or illnesses such as Alzheimer’s – in which echolalia may occur, and are not related to autism. 

For the purposes of this post, we’re looking at echolalia as it relates to autistic children and adults. Much of the older medical literature considered echolalia among autistic people to be meaningless; however, starting with a few researchers in the 1980s, a gradual shift in perception about echolalia has occurred. The medical community in general still categorizes echolalia as a speech disorder, but more recent clinicians and researchers view echolalia as a type of autistic communication: 

Although previously seen by some as maladaptive behavior, an increasing body of evidence led most experts to recognize echolalia as a bridge to meaningful, self-generated speech with communicative intent.
~ Kylie Grace Davis, MS, CCC-SLP

Breaking Down Two Types of Echolalia Used by Autistics

Echolalia is divided into ‘immediate’ and ‘delayed’ types. Immediate echolalia happens within a very short amount of time and delayed echolalia can occur after a significantly longer gap (such as weeks or months). Speech-language-hearing pathologists, such as Kylie Grace Davis, advise that immediate echolalia is within “two conversational turns of [the] original language input, whereas delayed echolalia occurs after more than two conversational turns take place.” (Davis, 2017) Understanding the meaning of the repeated words or phrases can be challenging at times, but keep in mind that the autistic person is communicating, even if the speech doesn’t have apparent meaning to you (the listener).  

One common example of immediate echolalia is when a parent/guardian asks an autistic child a question, such as “what do you want for lunch?” and the child repeats the question back to the adult. The child may be repeating the question as a way of saying “I heard your question and I’m thinking about it,” or because they don’t have (or know) an answer to the question.  

How Is Autistic Scripting Related to Echolalia?

The idea of scripting goes hand in hand with delayed echolalia for autistic people. As Danielle talked about in episode 4 of the Neurodiverging podcast, scripting is a tool autistic people use in several ways.

Having a pre-planned or pre-rehearsed phrase in answer to a common question is one example of scripting. Using a script can give the autistic person time and space to process what was said to them and to come up with a response. Having to generate unique responses for casual comments and questions in a social or workplace setting can be exhausting for autistic people, and/or can lead to a sense of isolation in social situations. As Danielle mentioned in the podcast, she has several standard scripts she uses in social situations – for instance, when talking about the weather – which help her save her processing energy for other things.

In adults, another example is when an autistic person rehearses what they’re going to say prior to making a phone call. This can help the autistic person to organize their thoughts ahead of time as well as reduce anxiety related to making phone calls and/or speaking to strangers who are likely neurotypical.  

Echolalia Is Meaningful Communication

While many medical professionals – not to mention online sources – view echolalia as a disorder that needs to be fixed or cured, it can be more useful to see echolalia and scripting as meaningful, valuable communication by the autistic person. Speech-language-hearing and mental health professionals can assist autistic children, their parents, and autistic adults in understanding echolalia and scripting, and to help communication be a less stressful and more rewarding experience for everyone.  

Sources (open access) 

CDC. (2016, August 18). Early Warning Signs of Autism Spectrum Disorder. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/autism/curriculum/documents/handouts/ews_handouts_508_final.pdf

Charlop, M. H. (1983). The effects of echolalia on acquisition and generalization of receptive labeling in autistic children. Journal of Applied Behavior Analysis, 16(1), 111–126. https://doi.org/10.1901/jaba.1983.16-111 

Davis, K. G. (2017, May 8). Echoes of Language Development: 7 Facts About Echolalia for SLPs. Leader Live. https://leader.pubs.asha.org/do/10.1044/echoes-of-language-development-7-facts-about-echolalia-for-slps/full/ 

Demaine, K. (2012). Musical Echolalia and Non-Verbal Children with Autism. Expressive Therapies Dissertations, 22, 168. https://digitalcommons.lesley.edu/expressive_dissertations/22 

deVries, I. (2022, March 29). How to Help Autistic Children with Echolalia [Informational]. WikiHow. https://www.wikihow.com/Help-Autistic-Children-with-Echolalia 

Echolalia. (2022). In Wikipedia. https://en.wikipedia.org/w/index.php?title=Echolalia&oldid=1091788765 

Echolalia and Its Role in Gestalt Language Acquisition. (n.d.). [Official Association site]. American Speech-Language-Hearing Association; American Speech-Language-Hearing Association. Retrieved May 2, 2022, from https://www.asha.org/practice-portal/clinical-topics/autism/echolalia-and-its-role-in-gestalt-language-acquisition/ 

How to Treat Echolalia in a Child with Autism. (2020, May 21). Otsimo. https://otsimo.com/en/echolalia-autism-spectrum/ 

Hurley, K. & Katie Hurley LCSW. (n.d.). How to Improve Communication with Your ASD Child [Informational]. Psycom.Net – Mental Health Treatment Resource Since 1996. Retrieved May 2, 2022, from https://www.psycom.net/autism-communication 

Kjelgaard, M. M., & Tager-Flusberg, H. (2001). An Investigation of Language Impairment in Autism: Implications for Genetic Subgroups. Language and Cognitive Processes, 16(2–3), 287–308. https://doi.org/10.1080/01690960042000058 

Krantz, P. J., & McClannahan, L. E. (1998). Social interaction skills for children with autism: A script-fading procedure for beginning readers. Journal of Applied Behavior Analysis, 31(2), 191–202. https://doi.org/10.1901/jaba.1998.31-191 

Prizant, B. M. (1983). Echolalia in Autism: Assessment and Intervention. Seminars in Speech and Language, 40(1), 63–77. http://barryprizant.com/wp-content/uploads/2015/07/echolalia_sem_spl_lang_1983.pdf 

Prizant, B. M. (1983). Language Acquisition and Communicative Behavior in Autism. Journal of Speech and Hearing Disorders, 48(3), 296–307. https://doi.org/10.1044/jshd.4803.296
http://barryprizant.com/wp-content/uploads/2015/07/whole_of_it_1983_jshd.pdf  

Prizant, B. M., & Duchan, J. F. (1981). The Functions of Immediate Echolalia in Autistic Children. Journal of Speech and Hearing Disorders, 46(3), 241–249. https://doi.org/10.1044/jshd.4603.241
http://barryprizant.com/wp-content/uploads/2015/07/functions_ie_1981.pdf  

Prizant, B. M., & Rydell, P. J. (1984). Analysis of Functions of Delayed Echolalia in Autistic Children. Journal of Speech, Language, and Hearing Research, 27(2), 183–192. https://doi.org/10.1044/jshr.2702.183
http://barryprizant.com/wp-content/uploads/2015/07/functions_de_1984.pdf  

Reagon, K. A., & Higbee, T. S. (2009). Parent-Implemented Script Fading to Promote Play-Based Verbal Initiations in Children with Autism. Journal of Applied Behavior Analysis, 42(3), 659–664. https://doi.org/10.1901/jaba.2009.42-659 

Schuler, A. L., & Prizant, B. M. (1985). Echolalia. In E. Schopler & G. B. Mesibov (Eds.), Communication Problems in Autism (pp. 163–184). Springer US. https://doi.org/10.1007/978-1-4757-4806-2_10 

Scripting. (2020, September 23). [Governmental Agency]. Autism Hub. https://autismhub.education.qld.gov.au/resources/functional-behaviour-assessment-tool/help/scripting 

Thiemann, K. S., & Goldstein, H. (2001). Social Stories, Written Text Cues, and Video Feedback: Effects on Social Communication of Children with Autism. Journal of Applied Behavior Analysis, 34(4), 425–446. https://doi.org/10.1901/jaba.2001.34-425 

Vicker, B. (1999). Functional Categories of Immediate Echolalia. https://apps.missouristate.edu/education/projectaccess/workshop%20resources/Intro%20to%20Autism%20Resources/Resource_28_Functional_Categories_of_Immediate_Echolalia.pdf 

What Is Echolalia? (n.d.). WebMD. Retrieved May 2, 2022, from https://www.webmd.com/parenting/what-is-echolalia 

Wojcik, M., Eikeseth, S., Eldevik, S., & Budzińska, A. (2020). Teaching children with autism to request items using audio scripts, interrupted chain procedure and sufficient exemplar training. Behavioral Interventions, 36(2), 1–18. https://doi.org/10.1002/bin.1761 

Sources (gated/restricted) 

Dobbinson, S., Perkins, M., & Boucher, J. (2003). The interactional significance of formulas in autistic language. Clinical Linguistics & Phonetics, 17(4–5), 299–307. https://doi.org/10.1080/0269920031000080046 

Grossi, D., Marcone, R., Cinquegrana, T., & Gallucci, M. (2013). On the differential nature of induced and incidental echolalia in autism. Journal of Intellectual Disability Research, 57(10), 903–912. https://doi.org/10.1111/j.1365-2788.2012.01579.x 

Loca, J., & Wootton, T. (1995). Interactional and phonetic aspects of immediate echolalia in autism: A case study. Clinical Linguistics & Phonetics, 9(2), 155–184. https://doi.org/10.3109/02699209508985330 

Rydell, P. J., & Mirenda, P. (1994). Effects of high and low constraint utterances on the production of immediate and delayed echolalia in young children with autism. Journal of Autism and Developmental Disorders, 24(6), 719–735. https://doi.org/10.1007/BF02172282 

Sterponi, L., & Shankey, J. (2014). Rethinking echolalia: Repetition as interactional resource in the communication of a child with autism*. Journal of Child Language, 41(2), 275–304. https://doi.org/10.1017/S0305000912000682 

Stiegler, L. N. (2015). Examining the Echolalia Literature: Where Do Speech-Language Pathologists Stand? American Journal of Speech-Language Pathology, 24(4), 750–762. https://doi.org/10.1044/2015_AJSLP-14-0166 

Stribling, P., Rae, J., & Dickerson, P. (2007). Two Forms Of Spoken Repetition In A Girl With Autism. International Journal of Language & Communication Disorders, 42(4), 427–444. https://doi.org/10.1080/13682820601183659 

Tager-Flusberg, H. (2004). Strategies for Conducting Research on Language in Autism. Journal of Autism and Developmental Disorders, 34(1), 75–80. https://doi.org/10.1023/B:JADD.0000018077.64617.5a 

Tager-Flusberg, H., & Joseph, R. M. (2003). Identifying neurocognitive phenotypes in autism. Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences, 358(1430), 303–314. https://doi.org/10.1098/rstb.2002.1198 

van Santen, J. P. H., Sproat, R. W., & Hill, A. P. (2013). Quantifying Repetitive Speech in Autism Spectrum Disorders and Language Impairment. Autism Research, 6(5), 372–383. https://doi.org/10.1002/aur.1301 

Wootton, A. J. (1999). An investigation of delayed echoing in a child with autism. First Language, 19(57), 359–381. https://doi.org/10.1177/014272379901905704 

Tesni Linden lives in a quiet corner of New England with an amazing, supportive partner and their chatty, exuberant, lovable felines. Tesni has a wide range of interests which, at the moment, include reading, yarn crafts, and learning about the insects, arachnids, and reptiles in the area – and of course, researching and writing for Neurodiverging!