Wednesday, December 12, 2007

Echolalias

One of the behaviors that got Ben his autism checkmark on the school district's special education eligibility form was echolalia.

Echolalia is the repetition of vocalizations made by another person like so:

Q: What do you want for breakfast?

A: What do you want for breakfast?

This repetition can occur after some lapse of time, too, and this is referred to as delayed echolalia. This phrase is used to describe the seemingly random repetition of TV commercials or overheard conversations common to many individuals with autism.

In Ben’s case, echolalia is not a random tic. Over time, I’ve observed his echolalia having many different functions. In fact, Ben’s echolalia is a kind of Swiss army knife of communicative intent. Here are just a few of the subtypes of echolalia I’ve invented via observation.

Contextual Echolalia

Ben uses other people’s words to communicate when he doesn’t have words of his own. He quotes a story in the appropriate context to communicate something. So appropriate, in fact, that if you don’t know the story, you’d never realize that he has an expressive language delay.

For example, when he has to use the potty these days, he says breathlessly, “I REALLY have to go the bathroom!” It sounds totally appropriate, and is. But what you probably wouldn’t realize if you are anyone other than me or Chris is that he is quoting a Caillou episode. And that up until a few weeks ago he said the line verbatim, which is, “Sarah – I REALLY have to go to the bathroom.”

Now he’s dropped the “Sarah” as if taking training wheels off a bike.

Musical Echolalia

Sometimes, Ben’s delayed echolalia seems like the equivalent of humming a tune. Right now, for example, he’s walking around saying this over and over: “A hot and sunny summer’s day: Click on the clothes you want Elmo to wear for this weather!” This is an audio clip from an online computer game. He’s smiling like crazy and it appears that he just really likes the sound of it.

Humming or singing in the car or the shower is something done for one’s own amusement and pleasure. It makes me wonder: if Ben sang all of his books and stories rather than recited them, would the behavior be viewed as indicative of a disorder? I know people who are constantly singing one song or another at random and it can be charming to mildly annoying, but they don’t get a DSM IV classification for it.

Reverse Echolalia

About nine months ago, Ben was doing this a lot: He would recite a story and after each line he would look at us and prompt us to repeat the line. If we either didn’t repeat it, repeated it incorrectly, or tried to redirect him, he would continue to say it over and over prompting us more urgently, almost obsessively, to repeat after him.

I remember walking around a petting zoo last spring, with him tugging at my pants and insisting that I repeat each line from Dr. Seuss’ ABCs. My attempts at redirecting were met with an almost panicked insistence.

Chris captured a video of this reverse echolalia at the time. Here, Ben is getting me to recite part of Time of Wonder for him. He’s not doing this because he doesn’t know the story and wants to hear me tell it. He clearly knows it better than I do and is correcting me, for example, when I say began instead of begins.

I’m not sure why he used to do this. Was he simply enjoying exerting control? Was he compensating for his poor diction at the time by asking to hear the line as he knew it should sound rather than his own approximate pronunciation? Was he using me as a CD player or an instrument to “play” the sounds he wanted to hear?

This obsessive reverse echolalia continued for some months until he learned how to act out a story. Now rather than just enlisting us to say the lines, he casts us in re-enactments of stories, which, while it appears a more developmentally-appropriate behavior, is no less obsessive or controlling.

Echolalia On-Demand

I admit that as a mom, I’ve used immediate echolalia to my advantage in situations where I want Ben to appear polite. I’ve surreptitiously whispered in his ear at the library check-out counter “Say ‘Thank you for the library books.’” He obliges, and the librarian inevitably says, “My, what a lovely young man!”

I smile smugly, racking up “good mom” points in public – even if it clearly involves cheating.

Echolalia as Laugh Line

Lately, his delayed echolalia seems like a way to engage us and sometimes even make us laugh. He’ll look at us with a mischievous expression and recite some line with a big knowing smile on his face. Then he waits for a reaction in a Buddy Hackett sort of way. It reminds me of how Chris’ high school friends would quote movie lines without explanation or context, knowing that none was needed; that just saying the line would elicit a laugh.

Last night, when I brought him some bread and butter at dinner he said in a British accent, “I do like little bit of buttah for my bread,” a line from the poem, The King’s Breakfast by A. A. Milne.

He was grinning like mad, waiting for me to laugh. I do so hope he never outgrows this.

7 comments:

Anonymous said...

This post reconfirms that we are going to have to find a publisher for this material.
OR: you & ben are going to be a half-hour segment on This American Life.

so brilliant.....

-deirdre.

Christa said...

I'd be up for that!

Who do we know that knows Ira Glass?

Connor's mom said...

My son Connor does the punchlines too. The only problem is that he always expects the same big laugh he got five minutes ago & doesn't understand why the audience starts to stop paying attention to it the fifth, sixth, seventh . . . time he says it!

Chris Ereneta said...

Have to throw in a vote in support of Connor and Ben on this one.

Jokes can definitely get funnier through repetition. After a while, not so funny.

Then funny again.

Then completely hilarious.

Anonymous said...

I've just found this site, going through and reading some of the older posts... I can't believe how much this sounds like my daughter! I never even thought of her doing "reverse echolalia"... she's been driving me nuts lately telling me to say things! I will try to be more understanding...but I do hope she stops sometime soon...

A little boy just 3 years old said...

Just scrolling back through old posts. I can't even believe what I'm reading. You have to be the only person on earth who 150% understands my boy. WOW.

I mean... appropriate echolalia w/training wheels? Got it. Reverse echolalia prompting ad nauseum? Got it.

Twins.

Meredith said...

Holy cow, our sons have the same taste in scripts. My son likes reciting the Elmo getting dressed game (esp the "zip zip zip" part), and sings Dr. Seuss's ABC all the time. Similar uses of echolalia as well. Waaay too familiar...