Echolalia

Echolalia is 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'. Echolalia may be an immediate reaction to a stimulus or may be delayed. Echolalia is 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'. Echolalia may be an immediate reaction to a stimulus or may be delayed. The word 'echolalia' is derived from the Greek ἠχώ, meaning 'echo' or 'to repeat', and λαλιά (laliá) meaning 'speech' or 'talk' (of onomatopoeic origin, from the verb λαλέω (laléo), meaning 'to talk'). Echolalia can be categorized as immediate (occurring immediately after the stimulus) vs. delayed (some time after the occurrence of a stimulus). Immediate echolalia results from quick recall of information from the short-term memory and 'superficial linguistic processing'. 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?' 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 echoes 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. 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 echoes 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. Mitigated echolalia refers to a repetition in which the original stimulus is somewhat altered, 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. Examples of mitigated echolalia are pronoun changes or syntax corrections. The first can be seen in the example of asking the patient “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 in dyspraxia and aphasia of speech. 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. 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. Echolalia can be an indicator of communication disorders in autism, but is neither unique to, nor synonymous with syndromes.Echophenomena (particularly echolalia and echopraxia) were defining characteristics in the early descriptions of Tourette syndrome (TS). Echolalia also occurs in aphasia, schizophrenia, dementia, catatonia, epilepsy, after cerebral infarction (stroke), closed head injury, in blind children, children with language impairments, as well as certain developing neurotypical children. Other disorders associated with echolalia are Pick's disease, frontotemporal dementia, corticobasal degeneration, progressive supranuclear palsy, as well as pervasive developmental disorder. 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.