Echolalia

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This article is about the speech disorder. For the album by Something for Kate, see Echolalia
(album).
Echolalia
Classification and external resources
Specialty Neurology
ICD-10 R48.8
ICD-9-CM 784.69
[edit on Wikidata]

Echolalia (also known as echologia or echophrasia[1]) is defined as the unsolicited repetition

of vocalizations made by another person (by the same person is called palilalia). In its
profound form it is automatic and effortless. 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 , meaning "echo" or "to repeat",[2] and
(lali) meaning "speech" or "talk"[3] (of onomatopoeic origin, from the verb
(lalo), meaning "to talk").

Contents
1 Signs and symptoms

2 Associated Disorders

3 Anatomical Correlates

4 Imitation and learning

5 Function

o 5.1 Tourette syndrome

o 5.2 Autism

6 See also

7 References

8 Further reading
Signs and symptoms
Echolalia can be categorized as immediate (occurring immediately after the stimulus) vs.
delayed (some time after the occurrence of a stimulus).[1][4] Immediate echolalia results from
quick recall of information from the short-term memory and "superficial linguistic
processing".[5] A typical pediatric presentation of immediate 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?"[6] In delayed echolalia the patient
repeats words, phrases, or multiple sentences after a delay that can be anywhere from hours
to years later. Immediate Echolalia can be indicative that a developmental disorder exists, but
this is not necessarily the case. Sometimes Echolalia can be observed when an individual
echos back a statement to indicate they are contemplating a response and fully heard the
original statement.

Researchers observed the daily repetitions of an autistic six-year-old in order to examine the
differences between triggers for delayed versus immediate echolalia.[7] Researchers further
distinguished immediate echos by the sequential context in which they occur: after
corrections, after directives, or in indiscernible sequential positions. Delayed echos are
distinguished on the basis of ownership: self-echos, other-echos, and impersonal echos. The
results showed that nearly all immediate echos produced by the six-year-old were found in
sequential contexts, while the delayed echos also occurred in the basis of ownership.

Although echolalia can be an impairment, the symptoms can involve a large selection of
underlying meanings and behaviors across and within subjects.[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]

Examples of mitigated echolalia are pronoun changes or syntax corrections. The first can be
seen in the example of asking the sufferer Where are you going? and with patient
responding Where am I going? The latter would be seen in the clinician asking Where are
I going? and the patient repeating Where am I going? In mitigated echolalia some
language processing is occurring. Mitigated echolalia can be seen is dyspraxia and aphasia of
speech.[8]

A Japanese case report describes a 20- year old college student who was admitted to the
hospital complaining about headaches and meningitis; however, he also exhibited signs of
ambient echolalia.[9] The researchers stated that the young patient's repetition was occurring at
approximately the same tempo as his normal speech rate. The patient did not simply repeat
words he had heard one after another. The patient reported that his ambient echolalia
appeared to be random but appeared when he was distracted. He was also aware of his
echolalia, but said he is unable to stop the repetitions.[9]

Associated Disorders
Echolalia can be an indicator of communication disorders in autism, but is neither unique to,
nor synonymous with syndromes.[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),[10] closed head injury,[11] in blind children, children with language impairments, as
well as certain developing neurotypical children.[4] Other disorders associated with echolalia
are Pick's disease, frontotemporal dementia, corticobasal degeneration, progressive
supranuclear palsy, as well as pervasive developmental disorder.[8]

In transcortical sensory aphasia, echolalia is common, with the patient incorporating another
person's words or sentences into his or her own response. While these patients lack language
comprehension, they are still able to read.[12][13]

Anatomical Correlates
Echolalia can be the result of left hemisphere damage. In specific damage to the frontal lobe
of the left hemisphere has been linked to effortful echolalia. Cases of echolalia have appeared
after lesions of the left medial frontal lobe and supplemental motor areas. Unintentional or
nonfunctional echolalia shows similarities to imitation behavior seen after disinhibition of the
frontal network is most likely related to mirror neurons.[14] In cases where echolalia is a part
of mixed transitory aphasia the perisylvian language area remains intact, but the surrounding
anterior and posterior association cortexes suffer from infarction or degeneration.

Imitation and learning

Echolalia is common in young children who are first learning to speak. Echolalia is a form of
imitation. 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] Children often first babble syllables and eventually
words they hear. For example, a baby may often hear the word bottle in various sentences.
The baby first repeats with only syllables such as baba but as their language skills progress
the child will eventually be able to say the word bottle. Echolalia becomes less and less
common as a childs language skills develop. It is not possible to distinguish the imitative
learning form of echolalia that occurs as part of normal development from automatic
imitation or echolalia characteristic of a disorder 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]

Function
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]

The use of echolalia in task response to facilitate generalization is an area that holds much
promise.[15] Research in this area is certainly needed. Marjorie H. Charlop performed a series
of task experiments with autistic children. The results suggest that perhaps in certain tasks
(i.e., receptive labeling), echolalia should not be eliminated, but taken advantage of as it may
facilitate acquisition and generalization for autistic children.[15]

Tourette syndrome

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".

Autism

It is estimated that up to 75% of persons on the autism spectrum have exhibited echolalia. A
symptom of some children with ASD is the struggle to produce spontaneous speech. Studies
have shown that in some cases echolalia is used as a coping mechanism allowing a person
with autism to contribute to a conversation when unable to produce spontaneous speech.[14]
Studies in the 1980s showed that there may be communicative intent with delayed echolalia,
"depending on the context in which it occurs";[16] this research on children with autism "raised
questions related to behavior modification programs that defended the revocation or
replacement of immediate echolalia".[16]

Uta Frith, Prizant and others have interpreted echolalia as evidence of "gestalt" processing in
children with autism, 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]

Ekolalia (Echolalia)

Istilah ekolalia (echolalia) berasal dari bahasa Latin ch yang berarti suara dan bahasa
Yunani lali yang berarti berbicara. Kata ch berasal dari bahasa Yunani ch yang juga
berarti suara (Sumber: Wikipedia).

Ekolalia (echolalia) adalah pengulangan dari apa yang dikatakan oleh orang lain. Anak
dengan ekolalia akan meniru perkataan yang mereka dengar dari orang lain dalam kehidupan
sehari-harinya, atau mengulang kalimat sebuah buku yang dibacakan kepada mereka, atau
lirik lagu yang mereka dengar, atau ucapan dari sebuah acara atau film yang mereka tonton;
tanpa mereka mengerti atau menggunakannya dengan tepat.

Ekolalia ternyata adalah bagian dari perkembangan bahasa yang normal dan merupakan cara
bagaimana kebanyakan anak-anak belajar berbahasa (dengan cara meniru). Ekolalia
umumnya dijumpai pada anak-anak balita berumur 18 bulan, dan akan berangsur-angsur
hilang pada umur sekitar 30 bulan dengan berkembangnya kemampuan berbahasa mereka.

Ekolalia juga merupakan salah satu karakteristik yang banyak dijumpai pada anak-anak autis
yang verbal. Dan anak dengan apraksia juga mempunyai kemungkinan mengalami fase
ekolalia. Ada dua alasan yang mungkin menjadi penyebabnya. Alasan pertama, salah satu
cara yang diajarkan kepada anak-anak dengan apraksia belajar berkata-kata adalah dengan
cara meniru. Jadi kemungkinan alasannya adalah mereka melanjutkan kebiasaan meniru
tersebut. Alasan kedua, meniru kalimat yang pernah dia dengar atau yang telah diajarkan
mungkin lebih mudah bagi anak dengan apraksia daripada membuat kalimat baru sendiri.

Tanda-tanda Ekolalia

Tanda-tanda ekolalia yang utama adalah pengulangan. Sebagai contoh, anak dengan ekolalia
akan mengulang pertanyaan yang diajukan dan bukannya menjawab pertanyaan yang
diajukan kepada mereka. Kemungkinan besar dikarenakan karena mereka tidak mengetahui
bagaimana harus menjawab atau mereka tidak tahu jawabannya. Tanda lain adalah anak
tampak frustasi ketika mereka ditanya di dalam suatu percakapan.

2 Macam Ekolalia

Terdapat 2 macam ekolalia. Ekolalia langsung (Immidiate Echolalia) dan Ekolalia tertunda
(Delayed Echolalia). Pengulangan yang dilakukan secara langsung oleh anak setelah anak
mendengar adalah ekolalia langsung. Contohnya, seorang anak ketika ditanya oleh orang
tuanya, Maukah kamu pergi? Anak menjawab dengan Maukah kamu pergi?, dan
bukannya menjawab dengan jawaban Mau atau Tidak mau. Sedangkan ekolalia tertunda
adalah ekolalia yang dilakukan anak setelah beberapa waktu ia mendengar. Contohnya, anak
berkata Mama datang, Mama datang, padahal ibunya sedang pergi.

2 Manfaat Ekolalia

Baik langsung maupun tertunda, ekolalia mempunyai 2 manfaat, yaitu interaktif dan non-
interaktif.

Interaktif maksudnya, anak mengatakan frase/kalimat dengan tujuan untuk berkomunikasi,

memberikan info, menjawab pertanyaan atau meminta sesuatu. Contohnya, ketika anak
tampak stress dalam mengerjakan sesuatu dan dia berkata berulang-ulang, Mama akan
menolong, Mama akan menolong.. Maksud sebenarnya dari anak adalah dia tidak bisa
melakukan pekerjaan itu dan dia meminta ibunya untuk menolong. Kalimat Mama akan
menolong adalah kalimat yang dia sering dengar dari ibunya ketika dia dalam kesulitan
mengerjakan sesuatu.

Non-interaktif maksudnya, anak berkata berulang-ulang kepada dirinya sendiri untuk proses
meregulasi/menenangkan dirinya sendiri.

Bagaimana mengatasi ekolalia?

Ekolalia adalah bagian alami dari perkembangan kemampuan berbahasa. Bukanlah

merupakan ide yang baik untuk mencegah ekolalia sepenuhnya ketika masih ada manfaat
yang masih dapat didapatkan. Dan untuk anak dengan apraksia, ekolalia juga bisa dijadikan
untuk menstimulasi perkembangan berbicara secara fungsional anak.
Tetapi untuk menghindari ekolalia permanen, orang tua harus mendorong berbagai bentuk
komunikasi dengan anak. Dan kunci untuk mengatasi ekolalia adalah dengan membentuk
setiap kata, frase atau kalimat seperti yang seharusnya anak katakan. Anak diajarkan baik
bahasa reseptif maupun ekspresif dengan metode-metode yang ada dengan bantuan
SLP/terapis. Dan dalam jangka waktu tertentu, pada umumnya anak akan mampu mengatasi
ekolalia mereka.