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Echolalia and Visual Impairments
By Natalie J. Dahl, M.S., CCC-SLP
Echolalia occurs when children repeat words, phrases, or sentences they hear other people say. It is sometimes referred to as “parroting” or “echoing,” and is a normal stage of language development in young children. Repeated words or phrases may happen immediately after children hear them or at a later time.
Many children who are blind or visually impaired learn to talk by echoing words, phrases, and sentences, even if they don’t fully understand what they are saying. Up to 80% of blind and visually impaired children demonstrate echolalia in their speech. While it may be seen as different by others, echolalia is often used to fulfill a desire in these children to be included in social situations. It can also serve several other purposes for children who are blind or visually impaired.Many children who are blind or visually impaired learn to talk by echoing words, phrases, and sentences, even if they don’t fully understand what they are saying. Up to 80% of blind and visually impaired children demonstrate echolalia in their speech. While it may be seen as different by others, echolalia is often used to fulfill a desire in these children to be included in social situations. It can also serve several other purposes for children who are blind or visually impaired.
Echolalia can:
  • Help children determine who is in a room. For children who cannot look to see who is in a room, echolalia may serve this purpose before they have the verbal skills to ask for this information in a discreet way. They may repeatedly ask questions that might seem irrelevant to the situation they are in; however, these questions will get a response from others, letting children with visual impairments know who is in the room.
  • Help children greet others & make connections. Children who have visual impairments are not able to use eye contact, but they still have the need to connect with others. They may not understand that speech should be relevant to the situation they are in, but echolalia mimics eliciting glances and making connections with others.
  • Allow children to participate in conversation. Young children who are blind will often have higher receptive than expressive language skills. They likely have a desire to participate in conversations with others, but may not have the expressive language capacity to do so appropriately. Echolalia can give these children opportunities to feel like they are socially involved in conversation, even though eye contact and body language are not being used.
  • Demonstrate communicative intent. Echolalia can help children answer questions, request or reject objects or actions, label objects or actions, and/or protest against things they may not want.
Breaking away from the pattern of using echolalia to participate in social situations can be difficult. Although it starts as a normal developmental stage, it can quickly turn into a difficult-to-break habit for children with visual impairments. Below are some suggestions for working with echolalia:
  • Expose children to as much expressive language as possible. Use descriptive language to describe the world around them, what they are doing, or what they are hearing.
  • Model correct responses to questions. When children with visual impairments are asked questions by others, such as “How are you today?” they may repeat the question back instead of answering the question. They can benefit from modeling and being taught how to respond to questions in an appropriate way.
  • Simplify your speech. Avoid giving verbal directions that will sound abnormal if echoed.
  • Avoid asking unnecessary questions. Instead, replace them with statements that children can imitate appropriately in similar situations.
  • Use echolalia to help children build on their own vocabulary skills. If they are good at repeating words and phrases, take common phrases and slowly phase out your words and let them fill in the blanks.
  • Try to omit pronouns, especially I, you, me, and your. Children who use echolalia have a difficult time shifting their point of reference and using pronouns correctly. Instead, use proper names and introduce pronouns later.
  • Give praise by making comments without the word you. Instead of “Good for you” or “You did it!” use phrases like “Yay!” “Hurray!” “Good job!” or “All done!” These phrases will be more appropriate if repeated later on.
  • A Speech-Language Pathologist can work with children to help increase language production and decrease echolalia.
Echolalia is a normal part of speech and language development. Children who strongly depend on echolalia to communicate, such as children who are blind or who have visual impairments, often have an exceptional memory for what they hear. Unfortunately, repeating words and phrases does not guarantee ability to communicate with others in a functional or appropriate way. If you would like to learn more about echolalia or have children who use echolalia in their speech, please consult with a Speech-Language Pathologist.
Resources
“Handout 1: Suggestions for Caregivers of Children with Echolalia,” Texas School for the Blind and Visually Impaired, accessed December 17, 2018, https://www.tsbvi.edu/197-emergent-literacy/4180-handout-i-session3
“Language Development,” Teaching Students with Visual Impairments, accessed December 17, 2018, https://www.teachingvisuallyimpaired.com/language-development.html
“You Can Say That Again! Echolalia in Visually Impaired Children,” WonderBaby, accessed December 7, 2018, http://www.wonderbaby.org/articles/echolalia
 
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