Echolalia is a term used when assessing or treating children with Autism. The term refers to the repetition or echoing of utterances, either our own or others’. It can also be echoing phrases heard on television, advertising jingles or catchy repeat phrases used in tv programmes or nursery rhymes and songs. Whilst we all use echolalia occasionally and it can be observed in typically developing children, we tend not to see/hear it beyond the age of 2.5 years old. Children with ASD, however, do use echolalia often into late childhood.
There are generally two types of Echolalia:
Immediate echolalia
Here the repeated phrases or words are produced immediately after someone has spoken the original words or within two conversational turns of the original utterance.
Delayed echolalia
The repeat echoing of the original utterance occurs sometime later, more than two conversational turns or with a much longer time delay. Due to the delay it can be hard to interpret the meaning of the echolalic utterance as it may refer to something that happened long ago and in a different context to the originally utterance.
(Stiegler, 2015, Fay 1967, Blanc 2014)
There are other unconventional speech behaviours which include:
Perseveration of Speech – persistent repetition of speech
Repetitive questioning – persisting even though answers were given
Vocalisations such as: humming, whistling, clicking, squealing etc.
Much research has gone into the meaning and treatment of Echolalia and the following list consists of possible functions that have been identified:
Information sharing
Responding to answers
Labelling
Drawing attention to self
Protesting
Requesting
Giving instructions
Self-regulation, calming
(Stiegler 2015, Prizant 1983)
Echolalia does have a function and is part of the Gestalt Learning Process (where longer units of speech are memorised and then used as a whole without the individual words being meaningful).
As a Speech and Language Therapist I promote sound and proven Intervention based on the Hanen Programme which helps provide a highly facilitative Interaction Style and I will tell you a bit more in my next blog how the “More Than Words” approach can help children with echolalia move through their Gestalt Learning into more analytic processing of language, grammar and meaning.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
We often hear from parents who are trying their best to connect with their child, especially when reading books, but are met with frustration. They’ll say, ‘I read the book exactly as it’s written, but my child can’t focus for very long and just runs off!’ or ‘my child just flicks through the pages then turns it upside down and runs off with it’ or similar.
It’s a common story. Traditional reading—going through the text from cover-to-cover—has its place of course, but for little ones with a language delay or autism it can move too quickly and place all the focus on the book’s words, not on the interaction.
But what if I told you that story time could become one of the most fun and productive times for your child’s communication development?
Watch the fantastic little video clip above! You can see the pure joy and connection between this dad and his son. This is the same family who, just a few weeks ago, felt defeated when trying to read a book, with their child quickly losing interest and leaving the reading/book corner.
What changed?
The power of parent coaching and Hanen principles
The difference you see in the video is the direct result of parent interaction therapy, or parent coaching, based on the internationally recognised Hanen principles.
I didn’t ‘fix’ the child. Instead, I coached the parents in a few simple, powerful strategies that completely changed the dynamic of their interaction. Instead of being a time for teaching and instruction, story time became a back-and-forth conversation.
Here are the four major transformations that coaching helped this family achieve:
1. From reader to play partner
Before coaching, the parents felt their job was to read the text and to teach the words in it to their child. Now, their job is to follow their child’s lead. They learned to Observe, Wait, and Listen (OWL). If the child points to the tree or the badger on the page, the parent talks about the tree or the badger.
The result
The child is now initiating and leading the conversation! He is sharing what he finds interesting, which makes him feel powerful and keeps him deeply engaged.
2. Building connection and attention
When parents focus solely on reading, they often forget to make frequent eye contact and use animated facial expressions. The principles taught them to put the text aside and prioritise connection.
The result
Our little boy is looking at his dad more frequently, making great eye contact, and clearly having fun! When the interaction is fun, the child’s attention span naturally lengthens, allowing him to attend to the book and the interaction for a much longer time.
3. Creating opportunities for communication
The parents learned simple ways to prompt communication without pressure. They stopped asking knowledge-based questions (‘What colour is that? Or point to the pig!’), which can feel like a test.
Instead, they learned to use techniques like ‘Saying less and pausing’ or ‘copying their little one’s echolalia ‘, signalling that they are very interested in what he is saying and that his communication matters!
The result
The child is now spontaneously using strings of sounds and gestures to communicate his needs and interests, knowing and enjoying his parents’ enthusiastic responses.
This video is a testament to the fact that you are your child’s best therapist. With the right tools and coaching, you can transform everyday routines, like reading a book, into the most joyful and effective communication sessions.
4. Acknowledging and interpreting echolalia
In the video, you may hear the little boy repeat a phrase from the book or from what his dad just said. This is called echolalia, and for a long time, it was often dismissed or discouraged.
However, a core principle of our parent coaching is that echolalia is communication. For children who are ‘Gestalt Language Processors,’ these memorised phrases (or ‘gestalts’) are their building blocks of language.
The key is not to stop the repetition, but to become a ‘language detective’ and ‘interpreter’!
By modelling the correct, first-person phrase right after the echo, parents/caregivers are teaching a child how to break down the ‘chunk’ and use the individual words functionally. They are showing their child: ‘I heard you. Your communication makes sense to me.’
This strategy is a game-changer because it:
Validates the child’s communication: It honours the child’s natural way of learning language, which boosts their confidence and willingness to communicate.
Facilitates language development: It provides the child with the next step—a meaningful, functional phrase—to move them from repeating language to generating their own spontaneous sentences.
Look at the child’s face again in the video. When his dad acknowledges and interprets his communication, you see that spark of joy and connection—that’s the moment when true, functional language learning happens!
Ready to unlock the potential in your family’s story time? Contact me to learn more about our parent coaching programs.
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of The London Speech and Feeding Practice.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
One of the most important things I have learned as a paediatric speech and language therapist is this:
Children do not all learn communication in the same way.
Some children learn best through listening. Some need visual support. Some need movement and gesture. Some benefit from symbols or technology. And many children need multiple supports together before communication truly starts to develop.
That is why flexible, responsive therapy matters so much.
In this short therapy clip, I model just two simple words: ‘Go’ and ‘Up’.
But underneath those tiny moments is a combination of therapeutic strategies:
speech sound prompting
visual cueing
Makaton signing
AAC (Augmentative and Alternative Communication) modelling
repetition
motor planning support
language modelling
total communication principles.
Communication is bigger than speech alone
One of the biggest misconceptions about speech therapy is the idea that communication only ‘counts’ if a child says the word verbally.
In reality, communication comes in many forms:
speech
gesture
facial expression
signing
pointing
symbols
body language
AAC.
This is particularly true for children with:
developmental language disorder (DLD)
autism
motor speech difficulties
childhood apraxia of speech (CAS)
phonological difficulties
global developmental delay
complex communication needs.
These children often need communication to be presented through multiple pathways at once.
That is where total communication approaches become so powerful.
This is important to know: this does not confuse children. In fact, for many children, it does the opposite. It creates clarity.
Research suggests that learning signs alongside spoken language does not hinder speech development and may support overall language acquisition, communication confidence, and vocabulary growth in many children.
For many children, signs actually help speech emerge because they:
reduce communication pressure
build confidence
strengthen understanding of words.
A child who can successfully communicate is far more likely to keep attempting interaction.
The power of AAC and LAMP Words for Life
In the clip, I also model language using an electronic AAC system: LAMP Words for Life.
AAC stands for Augmentative and Alternative Communication.
AAC includes any tool that supports communication beyond speech alone, including:
picture systems
symbol boards
communication books
speech-generating devices.
LAMP Words for Life is one of my favourite AAC systems because it focuses on consistent motor patterns and meaningful language development. Because communication is not about achieving perfection. It is about connection.
And when children are given multiple ways to express themselves, they often become more confident, more engaged, and more willing to interact with the world around them.
That is the true power of total communication therapy.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
What is a Speech and Language – Feeding Therapist?
You’ve probably heard of speech therapists helping people who stutter or struggle to pronounce words. But did you know that they also work with children and adults who have problems with eating and swallowing? This specialised area is called Speech and Language Therapy: Feeding and Swallowing, or Dysphagia Therapy.
Why does a Speech Therapist help with eating and swallowing?
The mouth, tongue, and throat are all involved in both speech and swallowing. When there’s a problem with any of these parts, it can affect both your ability to talk and to eat. For example:
Weak tongue muscles: Can make it hard to chew food and to form sounds.
Difficulty coordinating swallowing: Can lead to choking or aspiration (when food or liquid goes into the lungs).
Sensory issues: Can make certain textures or tastes feel unpleasant or overwhelming.
Communication: If we are not able to express ourselves we are likely to have difficulties during daily mealtimes: how do we ask for ‘more’ of something, how do we say we have had enough or we don’t like a particular food?
How does a Speech and Language Therapist help?
Our work involves a combination of assessment and therapy. We carefully observe how your child feeds, eats and swallows, and we look into your child’s mouth to help us see what the cause of the difficulties are: could be a very highly-arched palate, it could be a very flaccid/low tone tongue, it could be poor dentition. Then, we create a personalised treatment plan to address your specific needs.
Here are some of the things we might do:
Teach swallowing techniques: We can help your child learn strategies to improve or facilitate a safe swallow.
Recommend dietary modifications: We may suggest changes to your child’s diet to make it easier to eat and swallow.
Provide sensory therapy: If your child has sensory needs we can help your child become more comfortable with different textures, tastes, and smells.
Work on oral motor skills: We can help to encourage more effective chewing, or drinking skills, or we can help your child to close his/her mouth more during chewing or drinking from a straw.
Collaborate with other professionals: We often work closely with doctors, nurses, occupational therapists, and dietitians to provide comprehensive care.
What kinds of problems do Speech and Language Therapists help with?
We see a wide range of feeding and swallowing difficulties, including:
Delayed feeding: Children who are slow to develop feeding skills or who have difficulty transitioning to solid foods.
Tongue-ties: Babies can have significant difficulties with feeding when the tongue is very tightly tethered to the floor of the mouth.
Refusal to eat: Children who refuse to eat certain foods or textures.
Aspiration: When food or liquid goes into the lungs, which can lead to pneumonia and other serious complications.
Chewing difficulties: Problems with chewing food, such as difficulty breaking down food or keeping food in the mouth.
Swallowing difficulties: Problems with swallowing, such as feeling like food is stuck or choking.
Neurological conditions: Conditions like cerebral palsy, down syndrome or other genetic syndromes can affect feeding and swallowing.
Developmental delays: Children with developmental delays may have difficulties with feeding and swallowing.
Is there hope?
If your child is struggling with feeding or swallowing, know that there is help available. Speech and Language Therapy can make a significant difference in your and your child’s quality of life. We’re here to support you every step of the way.
Remember, you don’t have to suffer in silence. If you’re concerned about your child feeding or swallowing, please reach out. You can find a Speech and Language Therapist with a Feeding/dysphagia qualification near you via www.asltip.co.uk or contact me.
Sonja McGeachie
Early Intervention Speech and Language Therapist
Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice
The London Speech and Feeding Practice
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Between 9 and 18 months, your little one undergoes a remarkable transformation, blossoming from a curious explorer into a budding communicator. This period is filled with exciting milestones in speech, language, and social development. Let’s delve into what you can expect.
9–12 months: The world opens up
Communication takes flight
Babbling becomes more complex with a wider range of sounds. By babbling we mean syllables like: pa ga ka ma da and then ‘baba’ gohgoh’. First we hear one and two syllables together and then longer and longer strings! This is so exciting!
First words! One day around the 12 months–14 months mark we hear a first word! My older son’s first word was ‘Licht’ which is the German word for ‘light’ as literally every time I carried him along the corridors in our home, I pointed out the light switches to him and turned them off and on a few times. And each time I said ‘Licht!’ and it stuck! PS: sadly I cannot remember what my younger son’s first word was… poor second and third babies they just have to muddle along and call loudly to get noticed!
Understanding grows! Baby now understands simple instructions like ‘where is your ball’ and responds by looking to the ball across the room!
Social butterflies
Your baby now starts to show interest in other children, and may try to copy their actions. Now we are getting proper traction with simple social games like peek-a-boo and patty-cake. Whilst your baby is generally interested in other people and children he or she may show separation anxiety when mum or dad or other familiar person suddenly leaves the room and they feel alone with strangers.
Fine motor skills
Pincer grasp develops. This is where your child puts an index finger to the thumb in order to pick up of small objects, hold them and transfer them to either a box, back on the floor or into the other hand.
Your baby may start to explore objects by banging, shaking, and mouthing.
12–15 months: Words are taking shape
Language explosion: From our early words we now suddenly see baby’s vocabulary expanding, with new words added each week. I would highly recommend parents keep a little journal of all the words they hear. If nothing else this is a wonderful aide-memoire for years down the road when you might like to reminisce about the first ten words. I promise you otherwise you won’t recall! (especially for second and third babies; I would do this now, had I the time again).
Understanding grows:
By about 15 months our baby can follow simple two-step instructions like ‘Go get your shoes and bring them here.’
Begins to understand the concept of ‘no.’ and that’s a very useful thing. Though before you breathe a sigh of relief… your toddler may well show you that he is understanding a ‘no’ though he may not stop doing what he is doing or come down off the table!
Playtime gets interactive:
Now we engage in more complex play, such as stacking blocks, pretending to eat with a spoon, and imitating actions.
Many toddlers now start showing an interest in picture books.
15–18 months: Communication blossoms
Words combine: Towards 18 months or around about then your toddler may start to put two words together, such as ‘more milk’ or ‘bye-bye dada.’
Gestures and sounds: Now we also use gestures to communicate, such as pointing, shaking head ‘no,’ and waving ‘bye-bye.’
Exploration and curiosity:
Your toddler is now EVERYWHERE! Turn your back and he or she is gone! Your toddler now shows a strong sense of curiosity and explores their environment with enthusiasm.
Copying
Look out for actions and gestures your toddler will copy such as clapping hands or patting a cushion or banging a spoon on the table .
Remember
Every child develops at his or her own pace.
These are just general guidelines, and some children may reach certain milestones earlier or later than others.
If you have any concerns about your child’s development, please consult with your speech and language therapist. We are always keen to hear from parents and happy to help promote all those lovely early skills.
General tips to encourage communication if you feel your child needs a little more help
Talk, talk, talk! Engage in frequent chatting with your child.
Listen to your child: Allow for periods of silence when playing with your child to allow them to say something or make sounds which you can then copy and respond to.
Read aloud regularly. Use books with simple words and pictures.
Play interactive games: Hickory Dickory Dock, Row Row the boat, Old McDonalds, 5 little monkeys jumping on the bed, chasing and catching, tickling games.
Respond to your child’s babbling and gestures. You can copy them or if your toddler says long strings of babbling you cannot understand you could just say: ‘Oh ok!? ‘yes that’s great!’ ‘who knew!’ ‘wow you’ve got much to say!’ as if you understood.
Limit screen time or if your child is very passionate about watching clips then sit and watch with your child so that you can see what is the best bit, which songs they like the best and what sort of phrases they love hearing.
This exciting period of rapid growth and development is a precious time for both you and your child.
By providing a loving, stimulating, and responsive environment, you will naturally nurture their communication skills! Any more questions, please get in touch!
Sonja McGeachie
Early Intervention Speech and Language Therapist
Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice
The London Speech and Feeding Practice
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Your child’s speech, language and communication difficulties may impact their self-esteem. And they may show signs of increased frustration. You want them to be full of confidence, increasing their participation in school and fully engaging with their peers.
1. Practise active listening
Speech difficulties can mean that it’s more challenging to understand what your child says. It’s important to show that you’re paying attention, giving them time to express themselves. Focus on what your child says rather than how they are speaking. Remember to maintain eye contact, and actively listen. Active listening and giving time can be trickier than it sounds. I can provide strategies to support your active listening skills.
2. Give other means and forms of communication
Allowing children to express themselves in a variety of ways (e.g., gesture, signs, written, use descriptions to describe a word (e.g., sand – you find it out the beach, it can have pebbles on it, it’s not the sea), use of symbols or high-tech augmentative communication methods such as a computer). Using different ways is vital in reducing frustration and communicating their message. If you’re unsure of what other forms of communication you can use, please contact me for some top tips.
3. Praise efforts
Providing specific praise allows your child to understand what they’ve achieved. E.g., you could praise the way your child listens, or how they take turns, or their resilience (e.g., “I like the way you listened” or “good listening”). Think of different ways you could praise you child during different activities, so you are prepared with phrases that you can use.
4. Have clear start and end points in activities
Some children with speech, language and communication needs have difficulties with transitioning from one activity to another. They also have difficulties with changes in routine. This can add to their frustration and changes in behaviour. So, how do you show a clear start and end to an activity? You can have a visual timetable, or you could have ‘start’ and ‘finish’ boxes where you place all the materials in the box labelled ‘start’. And once the activity has finished, you put the items in the box labelled ’finished’. If you need support with transitions, please contact me.
5. Use visuals
Visuals can support your child to understand routine and spoken language. Visuals can range from symbols to online images, to photographs, or a combination. Explore which type of visuals work well for your children. Using visuals can be powerful if used correctly. Make the most of the opportunities that visuals can provide for your family.
Increase confidence and reduce frustration in children with speech and language and communication difficulties today. Please feel free to contact me if you need any support or tips on maximising these opportunities.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Intensive Interaction is an approach that I might suggest for your child. Here is an overview of this approach to increase your knowledge. There are a range of approaches that overlap and having trained in them all I use them all interchangeably to tailor to each child individually. This approach is particularly good for children who work mostly to their own agenda and find it hard to engage with others.
So, what is Intensive Interaction?
According to its founder, Hewett (1980), the approach “involves mirroring a person’s actions, sounds and facial expressions.” This allows your child to recognise and form communication between themselves and another, in a fun, play-based setting. Attention and listening are the fundamentals to speech and language development. By using the Intensive Interaction approach, we can increase the time your child can attend for and with another person. We are working towards a child enjoying another person’s presence. We are hoping to make gains with playing together with a child, taking turns and achieving reciprocity. That is the platform which we need to start with to build communication, language, words and perhaps even speech.
There are many aspects that this approach supports:
such as using facial expressions
being in the presence of other people
having a shared space
attending to others
recognising and using non-verbal behaviours (e.g., gestures)
making sounds/noises (vocalisations) that have meaning
and eye contact. Although, we must be careful when suggesting ‘improving’ the use of eye contact. For some individuals making eye contact can be physically painful. So be aware that we are not making our children ‘look’ we are encouraging their natural behaviour.
Who benefits from Intensive Interaction?
Children with more complex communication and learning delay can benefit from the Intensive Interaction approach. Each session can be adapted to the needs of the individual and the sessions can be designed to use the whole or part of the approach. It is especially useful for children who are finding it hard to engage in any way socially with another person. Autistic children who tend to work to their own agenda often benefit from this approach.
How is Intensive Interaction implemented?
You need to have an environment that your child is comfortable in, and to be able to come down to their level so that you can see each other. This is why I often visit children in their own homes to ensure that they are comfortable and that they can withdraw for periods of time if they need to as well.
Ensure your child knows you’re there and you are 100% present. This is very important. I would recommend that you put your phone away for some 10 minutes or so and give your undivided attention to your child for that period of time.
Waiting
Waiting is very important: we need to give your child time to process what is happening around them. After waiting for a response, you might want to start copying any gestures they use, any facial expressions they make, or perhaps imitate any sounds. You’ll want to continue with this for a few minutes to see if the communication between you and your child changes. Remember always take the cues from your child; if they communicate a message with you, respond. It might be that they are ready to finish and that they’ve shown this by walking away or signing.
Giving your child a way to respond is vital. We can use visuals to support their communication. We can create ‘yes’ and ‘no’ symbols so they can use them in a functional way.
A top tip in these sessions is to use mirrors, so that your child can see and begin to recognise their own facial expressions.
Now you know a bit about Intensive Interaction, why not book a call to discuss how we can support your Autistic child’s communication using this evidence-based approach.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
