A systematic review of interventions for echolalia in autistic children

Abstract

IntroductionEcholalia, the repetition of others’ speech, is a common observation in autistic people. Research has established that echolalia is functional and meaningful for many; however, some clinicians and researchers continue to characterise it as pathological and in need of reduction. The aim of this systematic review was to understand the range and impact of interventions for echolalia in autistic children.MethodA systematic search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A total of 15 studies met predetermined inclusion criteria. Screening, data extraction and quality rating using the Scientific Merit Rating Scale (SMRS) were performed in duplicate.ResultsTen interventions across 15 papers were found. Results indicated that interventions generally decreased levels of echolalia. However, there were considerable inconsistencies in the definitions and conceptualisations of echolalia, administration, generalisation techniques and the measures used. The quality of the studies was very low.ConclusionInterventions for echolalia vary widely in terms of administration and measurement. There is limited consensus on the definition of echolalia among the reviewed studies, and no evidence that echolalia is recognised as functional or meaningful to the autistic children. Further, the lack of methodological rigour makes it difficult to draw clinical conclusions about the interventions.WHAT THIS PAPER ADDSWhat is already known Echolalia is the immediate or delayed repetition of others’ speech and is a common observation in autistic children and in some older autistic people. While research and practice has established that echolalia is a functional and meaningful form of communication, particularly for those first developing spoken communication, some clinicians and researchers continue to characterise it as problematic and suggest that echolalia should be reduced or eliminated.What this study adds We systematically searched the literature about echolalia interventions to try to find out about the types of interventions that aim to reduce or eliminate echolalia. We found 15 studies on this topic. The way they defined echolalia was varied, and there was a range of interventions researched. None of the research papers recognised echolalia as functional or meaningful and the quality of the research was very low.What are the potential or actual clinical implications of this work? Clinicians, families and researchers should think carefully and critically about suggesting any programs or supports that aim to reduce echolalia as no recommendations can be drawn from the research we studied. Echolalia should be considered functional, and efforts made to understand the meaning and purpose of echolalic speech.

A look at phonetics and the pragmatic component of language from a speech therapy point of view

“…Se ocupa de las configuraciones del tracto vocal utilizadas para producir los sonidos del habla (fonética articulatoria), de las propiedades acústicas de los sonidos del habla (fonética acústica) y de la forma de combinar los sonidos para formar silabas, palabras y frases (fonética lingüística). (5) Lo antes expresado es conveniente analizar por todo logopeda puesto que se ha hecho referencia a la fonética/ fonología como uno de los componentes estructurales del lenguaje que no se pueden ver de forma aislada sino como una estrecha relación con el componente pragmático del lenguaje, puesto que la fonología y la fonética no son ciencias independientes, ambas se relacionan con el lenguaje, con sus componentes estructurales, (Fonética) ambas se encargan de ayudarnos a identificar porque los sonidos que salen de nuestras bocas son suaves o fuertes y porque cada idioma tiene propios códigos de comunicación (Fonología). (6,7) Las alteraciones fonéticas consisten en la incapacidad de producir (articular) correctamente los sonidos esperados a una determinada edad cronológica.…”

Embracing gestalt language development as a fundamental neurodiversity-affirmative practice

“…A majority of these were behaviourist approaches adopting strategies (e.g. differential reinforcement, tact training, redirection) to actively reduce echolalic utterances, with the explicit premise that gestalt language development is undesirable and interferes with 'normal' language development and social acceptance (Blackburn et al, 2023). More developmentally oriented approaches (e.g.…”

“…The conceptual confusion around gestalt language, combined with neuro-normative frameworks that make assumptions around 'ideal' developmental trajectories and seek to erase autistic characteristics, has led to widespread pathologisation of gestalt language within clinical approaches targeting language development in autistic children. A recent systematic review (Blackburn et al, 2023) identified 15 studies of interventions aiming to reduce or eliminate echolalia. A majority of these were behaviourist approaches adopting strategies (e.g.…”