Echolalia

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Echolalia (also known as echologia or echophrasia[1]) is the automatic repetition of vocalizations made by another person. It is one of the echophenomena, closely related to echopraxia, the automatic repetition of movements made by another person; both are "subsets of imitative behavior" whereby sounds or actions are imitated "without explicit awareness".[1] Echolalia may be an immediate reaction to a stimulus or may be delayed.[1]

The word "echolalia" is derived from the Greek ἠχώ, meaning "echo" or "to repeat",[2] and λαλιά (laliá) meaning "speech" or "talk"[3] (of onomatopoeic origin, from the verb λαλέω (laléo), meaning "to talk").

Associated conditions[edit]

Echolalia is one of the most salient aspects of communication disorders in autism, but is neither unique to nor synonymous with the syndrome.[4] Echophenomena (particularly echolalia and echopraxia) were defining characteristics in the early descriptions of Tourette syndrome (TS).[1] Echolalia also occurs in aphasia, schizophrenia, dementia, catatonia, epilepsy,[1] after cerebral infarction (stroke),[5] closed head injury,[6] in blind children, children with language impairments, as well as certain normally developing children.[4]

Imitation and learning[edit]

Imitation is a useful, normal and necessary component of social learning: imitative learning occurs when the "observer acquires new behaviors through imitation" and mimicry or automatic imitation occurs when a "reenacted behavior is based on previously acquired motor (or vocal) patterns".[1] Ganos et al (2012) define echolalia as an "automatic imitative action without explicit awareness".[1] It is not possible to distinguish imitative learning that occurs as part of normal development from automatic imitation or echolalia until about the age of three, when some ability for self-regulation is developed.[1] A disorder may be suspected if automatic imitation persists beyond the age of three.[1]

Presentation[edit]

Echolalia can be categorized as immediate (occurring immediately after the stimulus) vs. delayed (some time after the occurrence of a stimulus).[1][4] A typical pediatric presentation of echolalia might be as follows: a child is asked "Do you want dinner?"; the child echoes back "Do you want dinner?", followed by a pause, and then a response, "Yes. What's for dinner?"[7]

Mitigated echolalia refers to a repetition in which the original stimulus is somewhat altered,[1] and ambient echolalia refers to the repetition (typically occurring in individuals with dementia) of environmental stimuli such as a television program running in the background.[1]

Function[edit]

In the past, echolalia was regarded as negative, non-functional behavior.[4] However, researchers such as Barry Prizant and colleagues have emphasized the communicative function of echolalia.[4] Among the communicative functions noted are turntaking, requesting, self-regulation and rehearsal to aid comprehension.[4] Echolalia can be categorized as communicative (within context and with "apparent communicative purpose") vs. semicommunicative (an "unclear communicative meaning").[1]

In Tourette syndrome[edit]

Echolalia and echopraxia are distinguishing tics of Tourette syndrome (TS);[1] the echolalic repetitions of individuals with TS are mainly echoes from within their own "tic repertoire".[1] Evidence points to a healthy mirror neuron system (MNS) but "inadequate imitation-control mechanism, which make them vulnerable to interferences".[1]

In autism[edit]

Studies in the 1980s showed that there may be communicative intent with delayed echolalia, "depending on the context in which it occurs";[8] this research on autistic children "raised questions related to behavior modification programs that defended the revocation or replacement of immediate echolalia".[8]

Immediate echolalia results from quick recall of information from the short-term memory and "superficial linguistic processing".[9] In delayed echolalia, a phrase is repeated after a delay, such as an autistic person who repeats TV commercials, favorite movie scripts, or parental reprimands. This delay in speech can be attributed to a deeper level of linguistic processing, including the processing of verbal and contextual information. During delayed echolalia, information is retrieved from the long-term memory as opposed to the short-term.[9]

Uta Frith, Prizant and others have interpreted echolalia as evidence of "gestalt" processing in autistic children, including in the acquisition of language.[4] However, a 1990 study on the acquisition of grammar by Tager-Flusberg and Calkins found that echolalia did not facilitate grammatical development in children with autism.[4]

References[edit]

  1. ^ a b c d e f g h i j k l m n o p Ganos C, Ogrzal T, Schnitzler A, Münchau A (September 2012). "The pathophysiology of echopraxia/echolalia: relevance to Gilles de la Tourette syndrome". Mov. Disord. 27 (10): 1222–9. doi:10.1002/mds.25103. PMID 22807284. 
  2. ^ Liddell HG, Scott R. "ἠχώ". A Greek - English Lexicon, on Perseus. Tufts University. Retrieved October 6, 2013. 
  3. ^ Liddell HG, Scott R. "λαλιά". A Greek - English Lexicon, on Perseus. Tufts University. Retrieved October 6, 2013. 
  4. ^ a b c d e f g h Fred R. Volkmar; Rhea Paul; Ami Klin; Donald J. Cohen (13 May 2005). Handbook of Autism and Pervasive Developmental Disorders, Diagnosis, Development, Neurobiology, and Behavior. John Wiley & Sons. pp. 346–347. ISBN 978-0-471-72110-9. 
  5. ^ Suzuki T, Itoh S, Hayashi M, Kouno M, Takeda K (July 2009). "Hyperlexia and ambient echolalia in a case of cerebral infarction of the left anterior cingulate cortex and corpus callosum". Neurocase 15 (5): 1–6. doi:10.1080/13554790902842037. PMID 19585352. 
  6. ^ Harvey S. Levin (1982). Neurobehavioral Consequences of Closed Head Injury. Oxford University Press. pp. 153–54. ISBN 978-0-19-503008-2. 
  7. ^ Bashe, P. R. The OASIS Guide to Asperger Syndrome; Advice, Support, Insight, and Inspiration. Crown Publishers, 2001, p. 22.
  8. ^ a b Saad AG, Goldfeld M (Jul–Sep 2009). "Echolalia in the language development of autistic individuals: a bibliographical review". Pro Fono 21 (3): 255–60. PMID 9838574. 
  9. ^ a b Rydell PD, Mirenda P (December 1994). "Effects of high and low constraint utterances on the production of immediate and delayed echolalia in young children with autism". J Autism Dev Disord 24 (6): 719–35. PMID 7844096. 

Further reading[edit]