STUDENT VOICE : CONSIDERATIONS FOR ECHOLALIA IN A THERAPEUTIC DAY SCHOOL ENVIRONMENT : AN OCCUPATIONAL THERAPY PERSPECTIVE
By Cilla Prato OTR / L
I recently completed my final Level II fieldwork placement at a therapeutic day school with a unique population . In this setting , most occupational therapy goals were related to sensory regulation , self-regulation , and self-advocacy . I encountered echolalic students who were rewarded and encouraged to “ be quiet ” in the classroom as it was distracting others . During treatment sessions , I was waiting for my student to independently advocate for a break and instead they stood up , began jumping , and repeating echoes . I found myself sitting quietly , patiently , and essentially offering a safe space . After less than a minute , they independently returned to the task . At this moment , I realized my student utilized echolalia to assist with self-regulation . I considered the impact “ being quiet ” could be having on the student ’ s ability to communicate and selfsoothe . This student inspired me to research , learn , and advocate so I could share this information with others .
Echolalia is an immediate , delayed , or mitigated repetition of words , phrases , or sounds ( Cohn et al ., 2022 ). Consider the following statement : Echolalia is purposeless , meaningless , and a behavior that must be stopped . The aforementioned statement encapsulates misconceptions of echolalia that continue to exist and are damaging towards language growth and development . Current literature challenges what once was the gold standard behavioral approach towards echolalia and argues that developmental approaches provide increased benefits . These approaches are beneficial in their own way ; though , in academic contexts where both are utilized , they may provide contraindicating information ( Cohn et al ., 2022 ). According to Pruccoli et al . ( 2021 ), echolalia can serve seven main functions ; non-focused , turn-taking , declarative , rehearsal , self-regulatory ,
The above image is an example of a caregiver interpreting an echo that has meaningful intent .
Picture courtesy of INFORMEDSLP
yes-answer , and request . These echolalic functions impact the development of communicative strategies in growing children .
Echolalia is a natural part of a child ’ s development to assist with mastering new language , social communication , and play skills ( Luyster et al ., 2022 ). It can occur immediately after its original occurrence , be delayed , or mitigated by adding or changing words . It is common for children to engage in delayed echolalia when an emotion , environment , circumstance , or object is associated with its original occurrence . “ Delayed echoes often have meaning and purpose that may not be immediately apparent from their surface structures ” ( Cohn et al ., 2022 , p . 12 ). The paralinguistic and behavioral features that accompany echolalia can provide occupational therapy ( OT ) practitioners tools to determine if certain echolalic behaviors should be discouraged or utilized for communicative strategies ( Pruccoli et al ., 2021 ). Considering the evidence , providing non-verbal or verbal validation of echoes during interventions to encourage further communicative interactions demonstrates an acknowledgement of meaningful intent ( Cohn et al ., 2022 ).
In classroom settings , echolalia can be distracting to others and as a result may be extinguished with behavioral approaches ; however , recent literature states that “ it is inappropriate and counterproductive to apply abatement treatments in a wholesale attempt to extinguish echolalia ” ( Cohn et al ., 2022 , p . 13 ). Across other disciplines of psychology , speech-language pathology , and music therapy , the miscon-
1 Illinois Occupational Therapy Association | 2022 ISSUE 4