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Part of a child’s early language development involves echoing back the words you say, which is why generations of new parents have stood before their baby and said something to the effect of, “Mama? Can you say ‘Mama’? Mama!” However, although this repetition, which is called echolalia, is an essential part of early language development, if it goes on for too long, or is associated with other symptoms, it may be a sign of something more, including autism spectrum disorder or another type of developmental delay.
“This is how children learn language, they imitate and repeat,” said Madeline Racine, a faculty member at Baylor College of Medicine and a psychologist at Texas Children’s Hospital. As time progresses, this repetition will start to decline. “As children learn more language, they start mixing in their own utterances and words,” Racine said.
Generally speaking, a very young child will do a lot of echoing in the early months of using language, with the proportion declining over time. “It’s a stepping stone for developing more flexible language,” Racine said.
For most children, their echolalia drops significantly as they get older. “Closer to age 3, the echoing declines, and the child is using more spontaneous speech,” Racine said. “They may repeat things, like something funny they heard on TV, but they have a lot of spontaneous and flexible speech to communicate their wants and needs.”
When to consult with your doctor
Although repetition is normal during the early stages of language development, if it goes on too long, or is very pronounced, you should talk with your doctor, as echolalia that persists tends to be associated with autism spectrum disorder or other developmental delays.
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Other signs to look out include whether your child struggles to communicate their wants and needs, or if they tend to repeat intonation of words. “Kids with autism, when they echo, they typically echo with the same intonation they hear,” Racine said. “If a parent says ‘Yay, good job,’ the child might say it exactly.”
Another common warning sign is if echolalia is accompanied by a speech delay. “When it comes to what is atypical, it really is about what the developmental history is of the child,” said Gabriel Anzueto, a faculty member at UTHealth Houston McGovern Medical School. “If you have a child who is not meeting their speech milestones, and all of a sudden, their first words are echoing words, then that’s abnormal.”
In Anzueto’s experience, parents whose children are speech-delayed will often be so relieved to hear those first words that they will assume that means everything is fine, when in fact, they still do need to have further evaluation done.
Although echolalia can be a sign of an underlying issue, the goal isn’t to get rid of it, but rather to diagnose the underlying issue, and find ways of supporting your child, which will often include speech therapy. “We don’t necessarily want to stop or prevent echolalia,” Racine said. For children who have speech delays or are on the spectrum, echolalia is part of how they learn language, even if it does go on longer than usual. And for some children, it can serve as a self-soothing mechanism. “A lot of times, echolalia is used for a purpose,” Racine said.
