Palilalia and Echolalia: Verbal Symptoms of Autism and Asperger's Syndrome

 Echolalia is a term that is used to describe a child's nonfunctional repetition of certain phrases such as those heard on television programs or from a parent. For example, when an adult asks, "How are you today?" a child who uses echolalia will respond with, "How are you today?" rather than saying, "I'm fine."

The echoing of a phrase or question that the child is asked directly is known as immediate echolalia, which is a trait that is very common in people with autism and Asperger's syndrome. Delayed echolalia occurs when a child spontaneously repeats a sequence of words that were heard at an earlier time—for example, while watching a movie or TV show—in a manner that is out of context with a typical conversation.

Palilalia is a speech tic that is characterized by a child's instant repetition of words that he or she had used in conversation. Often, the repeated words are said in a whispered or mumbling tone. A child who uses palilalia may say, "I want to go to the store" and then immediately whisper, "go to the store." This disordered speech pattern is included among the common characteristics of autism, and along with echolalia, is often an indication that a child is not acquiring or using verbal communication in a neurotypical fashion.

 Echolalia and palilalia are classified as pragmatic speech disorders or a developmental deficit in regard to maintaining a two-way conversation or using verbal language in the appropriate context. Children who have Asperger's syndrome or high-functioning autism often qualify for speech therapy based on these pragmatic disorders, as their general vocabulary skills can be quite extensive. Speech therapists work with these children in an individual or small group setting to strengthen pragmatic language so that the instances of echolalia and palilalia can be reduced over time.

Parents of autistic children with echolalia must be aware being of not falling into a trap when it comes to assessing their child's understanding of a communication. For example, a traditional method to test if the other person has understood you is to ask he or she to repeat what was said. You can then agree that the communication was understood or you can make corrections to help the other person come to a clearer understanding of what you are really saying.

However, this technique will not work and can be deceving when used with a child who has echolalia as they are merely "parroting" the words back to you without any real comprehension of what was said or the meaning of the communication. It is important for these parents to alert others who interact with the child—like caregivers and educators—to the fact that the child has echolalia and may or may not have actually understood a particular conversation or question.

Children who are lower-functioning on the autism spectrum may have little verbal functioning beyond the use of echolalia, but therapists can still encourage communication through sign language or picture boards.