Discuss Delayed Echolalia & Gestalt Processing Evidence Based

During February, our global speech and language professional community gathered to discuss Delayed Echolalia & Gestalt Processing evidence-based. Our online CPD session was led by Maggie Bergin, M.A., CCC-SLP based in Texas, United States.

Our noala club is a monthly CPD online session, where speech pros gather from around the world to discuss a specific topic, evidence-based, in both pediatric and adult populations. We welcome you to join this free session next month. Sign up for our noala club here.

What is gestalt language processing

This is explained as a form of language development that usually starts with memorized phrases turning to single words. These chunks of words or phrases can later evolve into meaningful individual words.

What is delayed echolalia

Delayed echolalia is referred to the repetition of phrases or noises sometime after the speech is heard. Meaning the repetition doesn’t occur immediately after they are heard.

During noala club, we discussed three research papers; namely

• Conventions for unconventional language: Revisiting a framework for spoken language features in autism - Rhiannon J Luyster, Emily Zane, Lisa Wisman Weil, 2022
• Repeating purposefully: Empowering educators with functional communication models of echolalia in Autism - Eli G. Cohn, Keith R. McVilly, Matthew J. Harrison, Lillian N. Stiegler, 2022
• Functional Delayed Echolalia: Insights from a movie

Conventions for unconventional language: Revisiting a framework for spoken language features in autism

Based on the first article that focuses on the nuances of phrases that are communicated by individuals with ASD that don’t have meaning to the common ear, but that have a meaning that needs to be investigated. Speech pros discussed the importance of trying to dissect speech that seems to be used in unusual ways. Some phrases become generative, or mysterious/ idiosyncratic in nature and are often difficult to understand.

In order to figure out the function/meaning of the echolalia or generative phrases/words produced, it is integral that collaboration is incorporated. The conversation in the group discussed how this collaboration needs to manifest: everyone needs to “crack the code together”.

Parents need to be introduced to understanding their child’s echolalia by asking parents about what they want their child to communicate. It is at this point that teachers, SLP’s and others who are close to the child can think about patterns that evolve in the child’s speech based on what the parent is working on. This requires home to school connections via conversation, communication notebooks, and email throughout the week.

Meaningful Speech blog was recommended, focusing on Immediate vs. Delayed Echolalia.

Repeating purposefully: Empowering educators with functional communication models of echolalia in Autism

This brings us to the next conversation of the group centred around how to use educators as communication models to help foster functional communication. It is understood that there is immediate echolalia, repetitive words/phrases that are often triggered by questions. Delayed echolalia is produced with a bit of a delay to attempt to create meaning out of words; in a sense children are buying time to produce meaningful language.

The conversation led to a discussion about letting children engage in their echolalia organically, without interrupting them. It is our job to be guests in their desire to communicate.  It was agreed through the conversation that new evidence based practices all point to encouraging echolalia instead of the past way of trying to stop children from communicating in this way. This requires retraining educators and SLP’s to think about the intent of the echolalia and what the meaning actually is; each child’s echolalia will be individualised and requires individual attention for analysis.

It was suggested that helping parents get on board with this means explaining to them that the end product will result in generated speech that can be understood. Furthermore, parents need to understand that there is not one way of language acquisition, and this type of language acquisition is one way to produce meaningful speech, albeit following a different trajectory.

Functional Delayed Echolalia: Insights from a movie

The third article focused on an individual with ASD using scripts from a movie that were interpreted as echolalia but eventually lead to his ability to use language to communicate - mirroring how scripts in a movie have meaning even though they are staged/prepared and repeated over and over again.

This child in the study - Owen - could benefit from strategies used and discussed by the group. The group discussion stated that therapy needs to be child led: singing with their children, using repeated lines, and mirroring intonational patterns of their children can contribute to a child's language development.

Additionally, it is important to model songs, nursery rhymes, intonational patterns, etc that are directly related to the child’s interest. Eventually, this repeated repetition/modelling will lead to developing and understanding communication/language that has a function. In order to create a safe space where children can feel comfortable, limit questions and observe and comment.

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If there is one takeaway from the research and discussion from noala club, it should be that it is our job as SLT’s/SLP’s to go into the world of the child to help them acquire meaningful language, rather than forcing them to say what we want them to say.