What to know about Echolalia and children with ADHD

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and usually continues into adolescence. People with ADHD show symptoms of hyperactivity and impulsivity, inattention, or both.

echo It is when one person repeats what another person said, either immediately or later. Echolalia is a normal part of language development, but usually stops around age 3 when children acquire more developed language skills. If a person over the age of 3 still has frequent echoes, other reasons may be at play.

Echoes are often associated with autism spectrum disorder (ASD), but some people with ADHD are also involved in echoes. This article will discuss the types of echoes, why they occur in children with ADHD, and treatment options.

What is an echo?

Echolalia described what another said about repetition. This is not a one-off episode or the occasional repetition or quoting of someone to make a point for clarification or other reasons, but an act of repetition, often seemingly meaningless, but believed to serve several purposes.

Echolalia is most associated with ASD, but not exclusively.

Why is my autistic child echoing words and sounds?

type of echo

Echolalia is classified in several ways.

It is characterized by time frames such as:

  • Echo Immediately: A phrase or word repeated immediately or after a short delay
  • Delayed echo: a phrase or word that repeats after a long period of time

It is characterized by purposes such as:

  • Functional/Interactive Echo: Used as a way to communicate with others
  • Non-Interactive Echo: For personal use or benefit, not usually as a means of communicating with others

Echolalia can also be mitigated, which means that people change their wording to some extent when repeating.

“you and me”

It is common for people to mislabel pronouns with echolia. For example, they might say, “Would you like to see a cartoon?” as a way of saying they want to see a cartoon.

Causes and symptoms

Spoken language usually occurs when a person does not or does not use typical language to communicate. This can come from a language delay or a disorder such as ASD.

The symptoms of an echo, or more precisely, how the echo manifests and expresses itself, depends a lot on the purpose behind it.

Examples include:

  • When asked “What did you eat for dinner?” the person may repeat the question and wait for another, more specific question to be asked. Or the person might say, “Don’t sip your pasta,” repeating what was said to them during the meal.
  • The person might sing the jingle of the product to indicate what they want to have for lunch, or ask “Do you want juice?” to indicate that they want juice or are thirsty.
  • When another child does something they don’t like, one child might say to another child, “We don’t take our friend’s toy,” even if it doesn’t match the action. They were repeating a phrase they heard as a warning to behavior. They may also repeat it to themselves to self-direct their behavior.
  • A person can rehearse what they have to say by quietly repeating the phrase before speaking to the other person.

Echoes can also be a form of self-stimulation (called stimulation) or self-soothing. For example, the person might repeat to themselves a phrase they heard in a movie or TV show.

Beyond these examples, Echolalia can manifest in a variety of ways, but usually as a way to communicate with others, record/enhance one’s own message, or self-regulate.

Echoes and Decisions

When asked a question with two options, people using the echo often repeat the second option.

If asked, “Would you like your red jacket or your blue jacket?” they might answer blue.

If asked, “Do you want a blue jacket or a red jacket?” they might say red.

An example can be seen in this video.

This does not mean that people using echolia cannot indicate their preference, but this needs to be considered when asking between options.

children’s spoken language

Echolalia is developmentally suitable for very young children. Young children use echoes as they learn how language works and practice communicating with others.

By about age 3, most children no longer use the echo regularly. They usually have mastered a language complex enough to communicate without it.

If your child is still using the Echo after age 3, it’s worth talking to their healthcare provider.

adult echo

Echolalia is uncommon in adults. Adults with autism may use echo just like children with autism.

People with certain mental illnesses may develop spoken language in adulthood, such as catatonia (psychomotor disturbances in behavior or movement, usually manifested as unresponsiveness), or in the event of head trauma, severe amnesia, or any other condition that requires relearning of language.

Echoes and ADHD

Children with ADHD may experience language delay. While this may not cause echoes, language delay is one cause of echoes.

Echoes are uncommon in children with ADHD, but they can occur. One way it presents in people with ADHD is as a stimulus (self-stimulatory behavior).

Stimulation is common in both ASD and ADHD, although it is expressed differently in the two conditions. For people with ADHD, stimulation is usually used for short periods of time (often less than an hour), and often when trying to concentrate. People with autism may be stimulated for hours at a time.

As evidenced by the recent fidget spinner craze, stimuli associated with ADHD tend to be physical, such as hand/pencil tapping or hair twisting – but stimuli have multiple behaviors, including all senses.

Some people engage in auditory stimulation by reciting songs, phrases, or words from TV, movies, commercials, or elsewhere. Everyone does this from time to time, but with this form of echo/stimulation, it’s done as a form of self-stimulation or self-soothing, and often out of context.

Autism and ADHD

ASD and ADHD are two distinct disorders with different diagnostic criteria, but they exhibit high comorbidity, which means they often occur together.

Some children with ADHD show symptoms of autism and vice versa, even if they don’t meet the full criteria for diagnosing both.

Assessment and Diagnosis

Echolalia is usually diagnosed by a healthcare provider by interacting with the child and listening to the parent or guardian. Echolalia is a clue to further determine why the child is involved and if there are any underlying conditions or language delays.

treat

It is generally not advisable to try to cancel the echo immediately, as it is on purpose. People who use it do so for communication, self-regulation, self-soothing, and other beneficial behaviors.

Treatment usually involves building communication skills that gradually replace echoes. The first step in the process is to determine why the person is using the echo so you can understand what needs must be met and what tools are available to them.

speech therapy

Treatment of echoes usually involves a speech therapist. Speech therapists can use a variety of tools, including play therapy, to assess language skills and facilitate the development of new skills.

Speech therapists can also look for and address other language difficulties that may or may not be echo-related.

If the echo is comforting or purposeful to the person, a speech therapist can teach them the appropriate timing and ways to use it.

drug

There are no specific medications for echoes, but prescriptions can be prescribed to address the cause of the echo.

For example, because echoes are sometimes used when a person is feeling anxious, antidepressants or anti-anxiety medications can be prescribed so that the person feels more relaxed and less likely to feel the need for an echo.

ADHD medications, such as stimulants, can reduce the need for stimuli, including echoes, in people with ADHD.

improve communication

When echoes occur, parents or guardians can help build communication skills by gently redirecting and correcting.

For example, if your child says, “Hold you?” you can imitate the correct sentence, “Will you hold me?” and have the child repeat it to you before you pick it up. After doing this for a while, you can extend it. If your child indicates they want juice by saying, “Do you want juice?” try answering, “No, I don’t want juice, but you do. Say ‘I want juice.'”

If there are echoes such as repeating a phrase from the TV because the child finds it comforting or stimulating, it does not have to change. If it doesn’t interfere with their functioning or disruptive, they can use the tool just like any other stimulus.

If the echoes are happening in a way that is disruptive to themselves or others, try to figure out what makes them feel anxious, upset, or bored while doing it, and try other less disruptive ways to calm them down or engage Way.

Why is my autistic child echoing words and sounds?

generalize

Echolalia is the repetition of a word or phrase, either immediately after the person hears it or at a later time. Echoes are part of early language development but usually stop by age three.

Echoes are a common symptom of ASD, but non-autistic people can also participate in echoes. Some people with ADHD use echo as a stimulating behavior for self-stimulation or self-soothing.

Treatment for echogenicity involves helping patients expand their language skills to communicate in a more varied and direct manner, usually administered by a speech therapist.

VigorTip words

Don’t worry if you notice your child repeating what you or others have said. This is part of typical language development.

If your child still repeats words and phrases a lot, especially if they are not communicating clearly in an age-appropriate way, talk to your healthcare provider. When a child’s development is not typical, there are many reasons why an echo can occur. If needed, your healthcare provider can help evaluate and point you in the right direction for treatment.

Frequently Asked Questions

  • Can ADHD cause speech or communication problems?

    ADHD can cause speech and communication problems, especially dysphonia (inability to pronounce letters in an age-appropriate way).

    People with ADHD can also speak loudly and have great pitch changes. Language delays can also occur with ADHD. These difficulties are usually related to the organizational and distraction challenges that ADHD presents, rather than to specific speech delays.

  • Are echoes a common symptom of ADHD?

    Echoes as a whole are not a common symptom of ADHD, nor are they listed in the Diagnostic Criteria. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for ADHD.

    Stimuli are common in ADHD, and echoes can manifest as a stimulus, usually the repetition of a phrase from a TV show or other form of entertainment.

  • Is there a way to fix the echo?

    Echolalia doesn’t always need to be “fixed”. It depends on the reason behind it and how it manifests itself.

    A person who uses echoes to stimulate in a way that does not disturb them or those around them, and who communicates well in other ways, may not need any intervention.

    If echoes replace higher or clearer communication, speech therapy is a common treatment.