If I were to assign a percentage, I would say that only 5% of Corrigan’s speech is spontaneous. The other 95% is repetition of words and phrases that he has heard. He uses language mostly to label the world around him and his vocabulary is pretty good, all things considered. He really enjoys praise for “reading” words correctly, and because he thrives on positive reinforcement, and craves it really, it is difficult for me to ignore his echolalia. Some experts believe that echolalia should not be reinforced and others think that it can be used to help develop “normal” language skills.
Echolalia is actually a part of normal language development, usually beginning around 18 months and reaches its peak around 2 1/2 years old. I’ve seen statistics that up to 80% of verbal children with autism are echolalic in some form or another.
There are two kinds of echolalia. The first is immediate echolalia, and occurs almost immediately after the original words are spoken. Most of my questions to Corrigan go a lot like this:
Me: Hey Corrigan, do you want to watch Blues Clues?
Corrigan: Blues Clues?
Me: Do you want to watch the one about clocks or the one about sharing?
Me: okay, sharing it is.
Corrigan: It is.
He is just repeating the last word of my sentences, without real confirmation or denial, or any conveying of want or desire.
At least through words. While he will not answer a questions with yes, or no, despite this being our main goal in outpatient speech therapy for two years (exhausting), I am able to discern his answer by body language. I can also tell by how much inflection he puts on the repeated word, his voice rising for yes, or flat and even for no. I always give him the chance to answer yes or no, and when I interpret his body language, I give him a visual cue (sign language) of the proper answer.
The second kind of echolalia is delayed echolalia, and this has become the majority of Corrigan’s language. He can repeat lines from songs and movies that he could never form spontaneously, clearly speaking words of which their meanings have no value to Corrigan. This means he is pretty great with song lyrics and strangely, musical rhythms as well. Not long ago, I overheard him perfectly humming the Viennese Waltz. It also means that I hear dozens of phrases repeated hundreds of times a day.
Sometimes his delayed echolalia has no context. A phrase will just pop out spontaneously, and he will often jump around on song lyrics, without the tune too. When he is angry, he often yells a phrase from a song. For awhile he would angrily yell, “SWISH! SWISH! SWISH!” (with the hand motions too, by the way) from “The Wheels on the Bus” when I told him “no.” Then, for awhile, if he were furious he would yell, “SUPER WHY!!!” and stomp his foot, which is just the name of a cartoon that he used to love when he was little.
When people come over to visit, he almost always starts loudly singing, “Happy Birthday to You!” because often the only company we get is when we throw birthday parties, so he associates visitors with parties. When it is time to turn off the tv, I give him plenty of warning so as to avoid a meltdown, and then gently tell him that it is time for school. He will look at me every single time and say, “Say hello to Mr. Tom!” This is a phrase that we said when he started school two years ago, teaching him to be polite and greet people, and Mr. Tom is his bus driver. If someone asks him about school, he always replies, “Say hello to Mr. Tom!” as an answer.
Corrigan’s favorite thing in the world is bubbles and I often joke that we could teach this boy to recite the Gettysburg Address if there were ten seconds of bubble blowing between each verse. He will stand on his head to get you to blow another cloud of soapy spheres, so we use bubbles to build language. Our rookie mistake was too closely personalizing our teaching. Let me explain…
His therapist showed me how to sign “I want______” and then whatever it is we want him to say. In this case, we were teaching him to ask politely for bubbles. We wanted him to clearly find the words, ” I want more bubbles, please” so we blow bubbles a few seconds and when the last bubble is popped, and he turns to us for more, instead of simply signing “more” which he has used easily for years, we sign “I want bubbles please” while using the correct words as well. He wanted bubbles, at any cost, so he quickly learned to sign all four words.
Then, we began only signing, not using the words, and waiting for HIM to use the words. This worked wonderfully, he would only sign “please” at the end but spoke all four words well. I am now to the point that I only have to touch my chest for “I” and he immediately speaks the full request without signs. The first word is simply a prompt and sometimes, when his brain isn’t too foggy, I don’t even have to give him a sign language prompt, I just have to say “Use your words please” and he will produce the sentence request. He can do this for most things he wants: bubbles, PopTarts, Netflix shows, and usually with only a single prompt.
After the therapist and I had established this with him over a period of weeks, I showed Mark what I wanted him to do with the bubbles. I showed him how to prompt Corrigan, and also showed him how we are now using the bubbles to get him to do some gross motor things as well. “You want more bubbles? Okay, touch your……….elbow!” and he will fulfill the request.
I was gone for a few hours one evening, for a special ed seminar, and Daddy was using the bubbles. The next day, when I prompted Corrigan to “use his words” for something he was trying to ask me for, with grunts and tugging on my leg, he stopped…thought a second…and then said, “Daddy, can I have Pops, please?”
Later, the same thing “Daddy, I want more numbers, please”
It seems that in the short time I was gone, Mark had been prompting him as I showed him, but signed and added “Daddy” to his requests to help him understand that people have names.
Except, Corrigan doesn’t use names in the proper context, all dogs are Jericho, because HIS dog is named Jericho. Corrigan does not use any of our names in a proper way. He can say our names, he specifically repeats his bedtime prayer, asking “God Bwess (long pause while he thinks-sometimes we prompt him with the signs) Daaadddy, Nommmmy (with an “N”), Coddy (Connor) and Corrigan!” but if he wanted Connor’s attention, it would never ever ever ever occur to him to say his name to achieve that. Never. Point to a photo of Connor and ask who it is, he will gladly tell you “Coddy!” but using it in language? Nope.
Back to the bubbles….Corrigan, in just the short time I was gone, made adding “daddy” to his requests permanent. Weeks later he still puts “Daddy” on the front of his requests. He is simply memorizing whatever we teach him, in order to fulfill a need, there isn’t any meaning behind what he is saying other than that he knows saying it gets him what he wants. But isn’t that the beginning of real communication?
Because I was always reinforcing whatever words came out of his mouth, in hopes of encouraging more, he now does not understand why I do not repeat every single thing that he says these days, and this can sometimes make him furious. This shows me that his echolalia is not always mindless repetition, but his way of trying to communicate. In the car he may say “Look! A choo cho train” twenty times, clearly there is not a train nearby, and if I do not repeat the phrase back to him, he gets really angry- I think this is because he is trying to tell me that he wants to go to the local park, where there is an old caboose that he can climb on. I sometimes take him there after school and often while Connor was at soccer practice nearby. One time, many moons ago, I pointed out the parked caboose using the words, “Look! A choo choo!” and now that is the only way he can let me know he wants to go and visit the train. If I turn left to come home, instead of turning right towards the park, he starts yelling.
The last few weeks, as I mentioned in my last post, his echolalia has seemed more random. There doesn’t seem to be a whole lot of context in what he is repeating, and when he is stuck in this cycle, it can be exhausting and nerve-wracking. This week it has been a constant litany of “Night Night octopus. Night Night rain. Night Night Letter T. Night Night nose.” We were teaching him to walk to his brother’s room at bedtime and tell him “Night Night Connor” and now he thinks that any time we leave anything….a room, a store, school…that the “night nights” of everything he can possibly think of begins. It goes on forever and if I do not respond, or repeat what he says, he gets louder and louder until he is screaming “NIGHT NIGHT PLAYGROUND” at the back of my head the entire way home from school.
Do I think that Corrigan’s echolalia will lead to proper communication? I don’t know. I think so. I think that because a good bit of his repeated phrases are used in context, or trying to convey a need, it is a matter of developmental delay and he just needs time for his brain to speed up and find words-but I am not an expert and no one can tell me for sure.
It still thrills my heart to hear him speak a new word, and when I present him with something that he doesn’t want, and he literally dismisses me with a hand flick and rude “no!” it feels like a success. It hasn’t been that long since his only words were ball, more, bubble and please. That was when he was 3. It is slow going, and can be very frustrating, but he works hard and I can see the gears turning sometimes when he is standing in front of me, obviously trying to think of what he wants to say, and such a celebration when he manages to get it right, and just yesterday he surprised me with this…
He was given a gift bag full of his favorite snacks for his birthday this week, and I snapped a blurry photo of him holding up his beloved strawberry poptarts that day. Yesterday, he brought me my phone, having found this photo in my camera roll (he is obsessed with my camera roll) and simply walked into the kitchen, handed my my phone with the photo up, and said, “please?”
That’s communication, baby!
Keep working hard echo-man. I love you.