Studies on Autism
Other children have relatively elaborate speech, which does not appear to be echolalic. Instead the speech may be unusual word combinations ("word salads") that do not make any sense, such as "partridge hammock cake down eyelash," or the speech may be meaningful but it occurs out of context. An example of the latter is the case of a child who spends a great deal of his day describing elavators, clocks, or dates and calendars to anyone he meets and independent of what is actually happening at the time. Such inappropriate statements have been called psychotic talk.
Psychotic and echolalic talk directly interfere with the child's ability to generate appropriate speech. This is seen very clearly when you try to teach a child a simple question and in so doing block his opportunity to generate the right response. There will be many other reasons why you will want to help a child overcome echolalic or psychotic talk; for instance, the presence of such speech can delay cognitive development by interfering with learning process. Echolalic and psychotic talk, and procedures to overcome them, are described in more detail below.
Echolalic talk is not restricted to autistic children or to psychotic children, although it is often considered an indication of those conditions. Echolalia occurs in normal language development; it peaks around 30 months of age, then decreases. Echolalic speech can also be observed in children who have experienced recent traumatic brain injury.
The presence of echolalic speech in a child who is beginning therapy gives the child a better prognosis for learning language than if he were mute. Even though the child may not know the meaning of the words and word combinations he is echoing, he knows how to talk. If the child didn't have echolalic speech, then a great deal of time would have to be spent in teaching him to form sounds and words and word combinations. So, for no other reason than that time is saved, the echolalic child is far ahead of his mute peers. Children who are mute, but who later become good at speaking with language training, do so after they have passed through a stage of developing echolalic responding. The previously mute children who do not enter an echolalic stage rarely become good at using language, at least not vocal language. Therefore, it is to the child's advantage to learn to echo, even if he doesn't do so before you begin working with him. The child clearly has to go beyond echolalic (or psychotic) talk in order to function more adequately on an interpersonal level, to problem solve, and otherwise to improve in his cognitive functioning.
Why children echo is hard to say. It is unlikely that they echo because they are rewarded or re-inforced for doing so by people who listen to them. In other words, echolalia is probably not operant behavior based on socially controlled extrinsic reinforcement, but instead it may be operant behavior based on intrinsic reinforcement, like self-stimulatory behavior. The child's reinforcement may consist of his matching what he hears himself say to what he has heard other people say. In other words, the reinforcer is to match, and in that sense the child gives himself his own reinforcement. Notice how closely and how beautifully some children track the nuances of other people's speech; in fact, some children have several voices, imitating their mother's intonations, their father's, and perhaps also their teacher's. Echolalia can be viewed as storing or otherwise preserving in the brain the auditory input from one's surrounding environment. In that sense echolalic speech would be analogous to a visual afterimage. So, it may be useful to retain certain aspects of it, as an "internal" rehearsal. Procedures for helping the child move past overt echolalic responding are described below.
One procedure for stopping echolalic speech to unfamiliar statements (commands, requests) has been provided by Schreibman and Carr (1978). Echolalic children were taught to answer "I don't know," as a general non-echolalic response to questions or statements they did not comprehend. The procedure can be outlined as follows:
You do not want him to echo the question; in fact, you prevent this by rewarding him for being quiet, for withholding his response in the presence of the question. This very promising technique of presenting the cues for the wrong answer at a very low intensity teaches the child to tolerate or not to respond to the presence of the wrong cue.
If you continue this procedure using questions that start with "how," "why," "when," and "where" intermixed with questions to which the child does know the answer, you will find that after a while the child will spontaneously answer, "I don't know" to a question to which he does not know the answer even when you present this question for the first time (that is, without prior training). You may say now that he knows what the "rule" is. In any case, through this procedure you can help a child terminate his echolalic responding in a variety of situations.
Start by giving the child a sharp "No!" (or other kind of disapproval) immediately after his psychotic production. You may want to say, "No, no silly talk," in an attempt to help him discriminate why he is beind admonished. (However, there is no guarantee that he will make the discrimination.) A better way might be to teach a child to talk "silly" (that is, psychotic) on cue. Teach him to talk "silly" or to echo when you say "Talk silly and echo," and reinforce him for talking psychotically or echoing at that time. Then switch and say, "Don't talk silly and don't echo," and reinforce him for withholding his response at that time. The main justification for going through such a procedure is to teach the child to discriminate between appropriate and inappropriate speech. Although we as adults clearly know the discrimination, it is obvious that psychotic and retarded persons do not.
Mar. 1, 1999
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