Making Sense of Echolalia: It’s All About

Language Development!

Marge Blanc, MA., CCC-SLP

Speech-Language Pathologist
Communication Development Center
Madison, Wisconsin 1
Part 1: Echolalia = language development

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Part 2: It’s all about language development…
and beyond!

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Gestalt language development — Analytic language development

What is analytic language development?

Natural language development that starts with single words, builds into
phrases, then sentences

What is ‘gestalt’ language development?

Natural language development that starts with ‘gestalts,’ (‘units of
meaning’ of any size), breaks down into smaller ‘mitigated
gestalts’ (mitigations/chunks), breaks down again into single words, then
builds into phrases, then sentences (two extra stages)

A ‘gestalt’ (meaning: ‘whole’) is a chunk of language of any size that

serves as a ‘unit of meaning’ (like a word does but with more context and
emotion)
 A thousand years will give you such a crick in the neck.
To infinity and beyond! Fish are friends, not food.
Coming soon to a theater near you!
Game over!
I don’t want to see it any more!
You’re such a baby I’ve told you a thousand times!
You need a time out! Quiet hands!
You’re not listening
And a partridge in a pear tree.
Touch nose
Sit down! Do you want some water?
Say ‘ball’ No echoing! No movie talk
Back off !
I already told you Take a seat Are you ok? 5
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 Dylan’s language development: the ‘textbook’ case study

‘Let’s get out of ‘We to basketball’

here!’ ‘Bubbles?’ ‘I yuck’
‘We got it’
‘Cut out dinosaur’ ‘I slam it.’

‘I got it!’ ‘of bubbles’ ‘You go in there,
‘Cut out Slinky’
‘You cut out Slinky Mom.’
‘Here I come!’ ‘I…toy’ ‘I got magic!’

‘Go get a magic.’
‘I’m the king!’

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‘Block’ ‘Block red’ ‘Get red block’ ‘We put blocks?’
‘Big’ ‘Block block’ ‘Block on top’ ‘Top block on top’
‘Mine’ ‘Mine block’ ‘More block me’ ‘No fall, block!’
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• Gestalt language processors are the
children whose language development
style often goes undetected if they are
neurotypical — and misunderstood if
they are neurodiverse.

• Gestalt processors begin their natural

language development journeys with
‘gestalts,’ or ‘language bundles’

• These bundles are their first ‘units of

meaning’

• It takes them two more steps to get to

self-generated sentences, so they are
‘delayed’ but not ‘disordered’
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The foundation of our understanding of gestalt language development: The
Units of Language Acquisition (Ann Peters, 1983)

“…one of the central processes in all early language acquisition…is the extraction of
pieces, or ‘units,’ from the speech stream in which the child is immersed…”
“…Since the child does not know the language, it is unreasonable to assume that the first
units she or he extracts will coincide exactly with the words and morphemes of the
system.”
“…the existence of a ‘one-word stage’ of language acquisition…would have been more
accurately labeled the ‘one-unit stage…”
“…recognizing that children may be extracting phrases as well as words as their first units
can explain the wide range of variation in the size of these units, measured in…words or
morphemes.”
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'Language Acquisition and Communicative Behavior in Autism: toward an understanding of
the ‘whole’ of it,’ (Barry Prizant, 1983)
Stage 1: “…utterances are predominantly echolalic…”

Stage 2: “…a child may…be applying…strategies to break down echolalic utterances…

For some children, it is possible that the emergence of apparently spontaneous speech
may involve both a breaking down of echolalic utterances and acquisition of one- and
two-word utterances… For other children, acquisition of more flexible language
knowledge …may depend solely on the breaking down of echolalic utterances, allowing
for the conjoining of language ‘chunks.’”

Stage 3: “…a decrease in echolalia with a concomitant increase in spontaneous

language…”

Stage 4: “…acquisition of more…flexible language that reflects a child's increasing

knowledge of semantic-syntactic and morphological rules…vestiges of echolalic
behavior may appear during…fatigue, confusion, or distraction.” 14
A longitudinal understanding of gestalt language development in autism
(Marge Blanc, 2012)
“Natural Language Acquisition on the Autism Spectrum: The Journey from Echolalia to Self-Generated
Language …provides the most comprehensive consideration of echolalia and language
characteristics of persons with autism to date. In this seminal work, Marge Blanc,
an experienced clinician and clinical researcher, brings us back to a crucial
understanding of language characteristics and language acquisition in ASD based
on her deep understanding of language development from a social-pragmatic, child-
centered perspective…”

“By looking at echolalia only through a behavioral lens of pathology rather than
through a developmental perspective based on research on autism and typical
development, such practices may actually be hindering functional language
development…This book is a 'must-read' for all who care about supporting social
communication for persons with ASD based on research and sound clinical
practice.” (Barry Prizant, 2015) 15
 Natural Language Acquisition (Blanc, 2012) streamlined and quantified
the four stages of gestalt language processing reported by Ann Peters and
Barry Prizant. Stage 4 was expanded to two more stages to acknowledge
the greater complexity of grammar identified by other researchers.

Stage Stages of NLA

1 Language gestalts
2 Mitigatations
Mix and match combinations
3 Single words and
combinations
4-6 Original sentences
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The reasons we’re biased towards Analytic Language Acquisition
Analytic processors are:

• their early words are easy to understand

• they’re celebrated in the literature and baby
books (‘baby’s first word’) ‘
• they follow our point and respond directly to us
• they quickly combine their first words into
short phrases and sentences
Analytic language acquisition is:

• straightforward and logical

• easy for us to understand
• matches adult grammar
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The reasons gestalt language processing is under-recognized in both
neurotypical and neurodivergent children and young adults
Young neurotypical gestalt language processors
aren’t often recognized: Their gestalts sound like
babbling and they’re broken them down so fast
that their ‘first units’ go undetected

Older gestalt language processors were too

unintelligible when they’re young to be seen as
talking at all. By the time they can make
themselves understood, they are deemed too old
to develop self-generated language. Plus their
gestalts sound more like Goofy or Buzz Lightyear
to be taken seriously! 18
Stages of Natural Language Acquisition



1 Storing/using whole language gestalts

“Let’s get out of here!”

“Want some more?”



2a Mitigating/dividing gestalts into chunks

“Let’s get” + “out of here!”

“Want” + “some more?”



2b Recombining these chunks

“Let’s get + some more?” 

“Want + out of here!”

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3A Further mitigating/dividing chunks into single words

3B Recombining single words

“Get … more.” 

“Want … out?”

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4 Generating first phrases and sentences

“Kitty get more water.” 


“Kitty want out!”


5, 6 Generating more complex sentences

“How long do you wanna play outside?”


“I know what to do: play inside!”
“I don’t want any more, so you can have mine.”

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 ‘Eeyore + help you’
‘Me’ ‘Put on your head’
‘I can help you’ Pinkie Pie + help you’
‘On’ ‘Put on my head’
‘Excuse me’ ‘Mommy + under tree’
‘On…tree’ ‘Eeyore want one’
‘Don’t!’ ‘There + Pinkie Pie’
‘Tree’ ‘Jessie help me’
‘There you go’ 22
• Evaluate what has gone on so far: if your child
has not responded well to analytic input (e.g. What if your child
single words), that child may be a gestalt processor does not speak?
• Probe the child’s reactions to some gestalt
• utterances
• How did the child react?
• If it was with relief, then try this again the next
session
• If it was with joy, you’re probably on the right
track
• A child does not have to speak to develop
language: analytic or gestalt!
• Speech does not equal language!
• Lack of speech does not mean lack of
language!
Lillian N. Stiegler (2015):

‘Examining the Echolalia

Literature: Where Do Speech-
Language Pathologists Stand?’

Echolalia in autism is not a

pathology; it is part of gestalt
language development

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Part 2: And beyond!

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How we can support older students and young adults - and learn from them!

• We can support natural language development

with teens and 20-somethings!
• Each student may not achieve a full grammar
system, or even reach Stage 3
• Even so, Stage 2 mixing-and-matching allows
for more flexible communication!
• Communication is the larger goal! As Ben’s
mother noted when he began NLA at age
almost-10:
• Once I realized he was using his ‘movie talk’
to communicate with ME, our entire
relationship changed!
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 Benjamin

College Student
Farmer
Horticulturist
Zoo Keeper
Friend

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 I…just…free!
‘I was imagining
all the time’

Diamond in the rough!

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‘That was a long time ago…’

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‘I was imagining all the time’
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 Love is Fluffy
That’s where I was little
No scary…not any more
You just gotta believe
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I…just…free! 34
 Derek
College Student
Voice Actor
Artist
Friend

The creator of:

Sir Joey’s Animals and
Dragon

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The ghost, sorcerer, and sof, sorcerer, Jafar.
They’re working, those villains, together?
And Hunter, and xx and Chief.
They’re all villains working together?
Huhn!
Humph!
I gather that.
Captain Hook, Captain Pete.
It is the two of us, Ursula.

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 “Hi. I’m Sir Joey”

We are protecting horses, pigs, goats,

sheep, turkeys, chickens, geese, rabbits…
all the many animals in farm land and all
the people … with Charlie the dog, my
blue and gold macaw named Pepe, Dahl
sheep…and the Spanish dragon,Tom the
Turkey, the Seal from the Arctic, Sir
Duncan, the Spanish Knight Rider, and Sir
Jackie the Spanish Dragon Rider, the
Captain.

…for freedom
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