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The Functions of Immediate Echolalia in Autistic Children

Article in Journal of Speech and Hearing Disorders · September 1981

DOI: 10.1044/jshd.4603.241 · Source: PubMed

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 THE FUNCTIONS OF IMMEDIATE ECHOLALIA
IN A U T I S T I C C H I L D R E N

BARRY M. PRIZANT JUDITH F. DUCHAN

State Universit~l of New York at Buffalo

This research was intended to discover how immediate eeholalia fimctioned tbr autistic children in interactions with tamiliar
adults. Four echolalic children were videotaped at school and at home, in both group and dyadic interactions in natural situa-
tions such as hmchtime, family activities, and play activities in school. After conducting a multilevel analysis (of over 1,000
utterances) of verbal and nonverbal factors, response latency, and intonation, it was discovered that immediate echolalia is fiir
more than a meaningless hehavior, as has been previously reported. Seven functional categories of eeholalia were discovered
and are discussed in reterence to behavioral and linguistic features of each category. It is argued that researchers who protx)se
interxention progrmns of echo-abatement may be overlooking the important communicative and cognitive timctions echolalia
may serve ~br the autistic child.

Language abnormalities and problems in communica-
tion are primary criteria in the diagnosis of autism. Of
the language abnormalities, immediate echolalia is the
most frequently cited characteristic of verbal autistic
children (Prizant, 1975). Rutter (1968) and Wing (1971)
found that echolalia was characteristic of some three-
quarters of the autistic children they studied. Fay (1969)
defined immediate echolalia as the "meaningless repeti-
tion of a word or word group just spoken by another per-
son." (pg. 39). In attempting to differentiate between au-
tistic and non-autistic manifestations of echolalia, he
noted that in autism, eeholalia is evidenced at preschool
and school ages and is characterized by longer echoic
utterances, a larger percentage of echoic utterances, de-
layed echolalia, and minimal mitigation (change or revi-
sion).
There is much controversy regarding the significance
of immediate echolalia for autistic children. On one
hand, behaviorally oriented researchers have considered
eeholalia a nonfunctional (Koegel, Lovaas, & Schreib-
man, 1974) or an undesirable symptom (Coleman &
Stedman, 1974) of the language behavior of autistic chil-
dren. Such researchers have considered echolalia a
communication disorder in itself and are therefore advo-
cates of the extinction or replacement of echolalic be-
haviors through the use of behavior modification proce-
dures (Lovaas, 1977).
On the other hand, a number of theorists have recently
considered immediate echolalia in terms of how it may
function for autistic children. Fay (1969) has suggested
that immediate echolalia enables autistic children to
I Barr!! M. Prizant, PhD., is affiliated with the Southern ]
Illinois Universit!t at Carbondale. Judith F, Duchan
is affiliated with State Universit!l of New York at
B,(ffalo.
J studies have used audiotapes or written transcripts. In
maintain social interaction in the face of a severe com-
prehension problem. He believed that autistic echolalia
has as its basis " v e r b a l c o m p r e h e n s i o n difficulties
coupled with an urge to sustain . . . social contact" (pg.
45). Similarly, Shapiro (1977) has attributed the function
of social facilitation to immediate eeholalia, and Philips
and Dyer (1977) have gone as far as to hypothesize that
immediate eeholalia is a necessary stage of language de-
velopment for verbal autistic children. In describing "af-
firmation by repetition," Kanner (1946) has been the
only researcher to ascribe a specific function for im-
mediate echolalia. Although these authors have at-
tempted to understand immediate eeholalia from a func-
tional perspective, the functions immediate echolalia
may serve still need to be specified.
Previous research has not provided information on its
functions, due to a number of related reasons. First of all,
the primary focus of such research has been on the lan-
guage structure of echolalic utterances. For example,
Fay (1967) and Shapiro, Roberts, and Fish (1970) de-
vised classifications of echolalic utterances that de-
scribed structural linguistic change imposed on the orig-
inal utterance. Voeltz (1977) and Buium and Steucher
(1974) demonstrated that autistic echolalia was not just
rote repetition but involved structural changes that dem-
onstrated syntactic rule mediation. Although these
studies provided important information regarding struc-
tural linguistic considerations of immediate echolalia,
they offered little insight regarding functionality.
A second characteristic of previous studies, which may
be partially due to the focus on language structure, is the
lack of description of immediate echolalia as it occurs in
natural communicative interactions. Without exception,
because communicative context and nonverbal behavior
were of little or no interest to the researchers, previous
addition, researchers (Schreibman & Carr, 1978; Voeltz,
1977) have commonly used a corpus of stimulus utter-

Journal of Speech and Hearing Disorders 241 © 1981, American Speech-Language-Hearing Association
0022-4677/81/4603-024151.00/0

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 242 Journalof Speech and Hearing Disorders
ances that did not relate to a stream of interaction.
Therefore, one may question whether the utterances that
were elicited in such controlled experiments are repre-
sentative of the phenomenon of immediate echolalia as it
oceurs in natural interactions.
Finally, immediate echolalia of autistic children has
most often been considered a unitary phenomenon that
represents a child's lack of comprehension of the model
utterance. Previous researchers have not considered
immediate eeholalia as possibly reflecting "degrees" of
comprehension, with the surface manifestations func-
tioning as realizations of differing underlying processes.
Shapiro and Lucy (1978) have claimed that immediate
echolalia is reflective of a lack of comprehension and
low level cognitive processing. They measured response
latencies (time between offset of a model utterance and
onset of a child's response) of eehoie utterances and
spontaneous utterances of autistie children. The authors
found that echoic responses were produced with signifi-
cantly shorter mean latencies than were the Spontaneous
utterances, thereby suggesting a response process of less
complexity for immediate echolalia. Along these lines,
Schuler (1979) has suggested that it may be fruitful to
evaluate eeholalic behavior in terms of automaticity vs.
intentionality. In addition, there is little discussion of au-
tistic echolalia as a transitional phenomenon, in which
the evolution of linguistic knowledge may be traced in
the structure and function ofecholalic responses.
In consideration of such deficiencies, the major focus
of this research was to analyze immediate eeholalia of
autistic children as it occurs in natural interactions. The
motivation for undertaking this study emerges from our
own clinical interactions, informal observations, and dis,
eussions with many parents and teachers who indicate
that immediate eeholalia appears to serve different func-
tions for autistic children. Typical comments of those
who interact with eeholalic autistic children include "he
tells himself what to do," "he learns language through
repeating," and "echoing helps him to understand."
Recent literature in pragmatics (Bates, 1976; Dore,
1975: Halliday, 1975), the study of language usage in
context, has emphasized that to understand fully the sig-
nificance of verbal language or vocalization, it must be
studied in reference to nonverbal behavior, paralingnis-
tic f~atures of the utteranee, and situational context. The
literature in pragmaties has also emphasized that lan-
guage development involves much more than the acqui-
sition of language strueture. It involves the mastery of
basic fimctions of language, and researchers such as
Bruner (1975), Bates (1976), and Halliday (1975) have
demonstrated that such functions are expressed in a
child's vocalizations prior to and along with the use of
words. However, one apparent weakness of the recent
pragmatie literature is that such functional categories
were most often predetermined and were not derived
from the data.
The pragmatic literature does offer, however, a basic
fi'amework fbr the study of immediate echolalia of autis-
tic children. Such literature has suggested that one
cannot examine surf?tee structures of a child's linguistic
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241-249 August 1981
output and conclude that they are meaningless or non-
functional by reference only to the structures them-
selves. Unfortunately, this has been the situation in most
of the literature concerned with immediate eeholalia of'
autistic children.
The present study considered many of the issues
raised by the pragmatic literature, including concern for
natural e'ontexts, situational factors, and nonverbal be-
haviors co-occurring with the production of the eeholalie
utterances. The major purpose of this study was to de-
termine the answer to the following question: Is im-
mediate echolalia a unitary phenomenon that reflects a
lack of comprehension, or does it serve a variety of func-
tions?
METHOD
Subjects
Four boys were the subjects. Each had been diag-
nosed as autistic by a psychologist, psychiatrist, or pro-
fessional evaluation team. In general, each of the chil-
dren displayed the four central characteristics of the
autistic syndrome (Rutter, 1974), including (1) disturb-
ances of language and communication, (2) ritualistic and
compulsive behaviors (insistence on sameness), (3) dis-
turbed social relationships, and (4) onset of the disorder
prior to 30 months of age. At the beginning of' the study,
the ages of the subjects were 4:8, 5:2, 6:3, and 9:3.
As an attempt to obtain an adequate data base, the
children had to demonstrate that at least 25% of all ver-
bal productions were echolalic responses. Information to
determine this was obtained through a preliminary ses-
sion with the examiner in which sta'uctured activities de-
signed to elicit verbal responses were used. The per-
centage of echoic responses was based on the first 100
utterances that each child produced in the session. Table
1 presents the results of standardized intelligence testing
and a breakdown of each child's expressive language
behavior according to utterance types. Except for im-
mediate eeholalia, the percentages cited are approxima-
tions.
Data Collection
IMbrmation and data fbr the study were collected
through three distinct methods:
1. Interactions with the subjects provided the inves-
tigators with the opportunity to evaluate each child's
eommunieative abilities (approximately 500 hours).
Analysis of language samples collected in a variety of
contexts was the primary means of evaluation.
2. Further considerations of' each child's communicative
abilities were based on information acquired through
discussions with the teachers and parents of the chil-
dren.
3. Systematic analyses of the videotapes provided the
primary data concerning the structure and usage of
immediate eeholalia produced by the children in the
study. The specific results of the study were based

TABLE 1. Breakdown by percentage of each child's expressive language behavior according to utterance types, and results of
standardized intelligence testing.
Approximations of
% of immediate
Child Age echolalia*
Brian (6:3) 27.7%(205/740)
++
Jeff (5:2) 40.4%(334/827)
David (4:8) 29.4%(183/623)
Robbie (9:3) 53.0%(287/541)
*Based on analysis of the tapes.
**Approximationsbased on the videotapesand judgements of the language pathologist, teacher, and teacher assistant.
+Memorized verbal routines which are not necessarily reflective of comprehension (e.g., Adult: What do you say?; Child: Thank you.).
+ + Number of immediate echoes/numberof total utterances.
solely on the analysis (approximately 250 hours) of
the echoic utterances from the videotapes.
Each of the subjects was videotaped in the following
situations:
1. H o m e - - T h i s situation involved direct interaction be-
tween the child and one or more family members in
the home, in which specific requests were made of
the child. The only instruction given to the parents
was to engage the child in activities that were familiar
to him and would be conducive to social interaction.
2. School-Individual--These situations involved each
child in his classroom setting, in whieh he was in-
teracting directly and on an individual basis with the
teacher or language clinician. Specific requests were
presented to the child in the framework of the child's
daily school activities.
3. Sehool-GroupmThese situations were characteristic
of group activities and interaction in each child's
classroom, (e.g., lunchtime physical games).
Each child was videotaped three times in individual
interactions with diftbrent, but familiar adults, and one
time at home, In addition, five periods of group activities
were videotaped at approximately one-month intervals.
All echoic utterances were extracted for analysis from
the 21 videotapes, which averaged 25 minutes per re-
cording. The data collection extended over an eight-
month period fbr each child.
The echoic utterances were of the Wpe of repetition
that is commonly referred to as immediate eeholalia. The
child's echoic response must have occurred subsequent
to the interlocuter's utterance, and it must have con-
sisted of segmental and/or suprasegmental similarities to
the utterance of the previous speaker, involving either
rigid echoing of the model utterance (pure echolalia) or
selective repetition of elements occurring within two ut-
terances of the original utterance.
An important aspect of the research was to determine
if a categorical system representing the variety of uses of
echolalia could be derived from the tapes. Therefore, the
classification was not developed on a priori basis. Be-
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PRIZANT,DUCHAN:Immediate Echolalia 243
Other verbal
productions
(delayed Results of
Spontaneous eeholalia, Intelligence
Speech** rote routines +) Test
60% 10% 76 (Leiter International
Scale)
50% 10% 69 (Stanford-Binet Scale)
10% 60% Untestable
Negligible 50% Untestable
cause of the objective of deriving a categorical system
from the data, we needed to analyze the factors involving
(1) c o m m u n i c a t i v e context, (2) structural linguistic
characteristics of the echoic utterances, and (3) latency
between the end of the original utterance and the onset
of the echoic utterance. The importance of the factors
was suggested by informal observations and pilot inves-
tigations conducted by the first author (Prizant, 1975).
The following are the factors that were deemed appro-
priate for analysis:
Communicative Context. Responses were examined
for the following characteristics:
a) Was the child being addressed directly?
b) Did the child change his behavior in any way at the
time of the production of the echoic utterance?
e) What or who was the child looking at prior to, during,
and after the echoic response? (Gaze behavior)
d) Was the echoic utterance functionally appropriate to
the task?
e) Did the child display any indications of expecting a
fhrther response from the previous speaker (verbal or
nonverbal?)
Structural Characteristics. Each echoic response was
compared to the speaker's utterance according to struc-
tural change such as a) addition, deletion, or substitution
of segmentals; b) tempo and loudness; and c) intonation
contour.
Measurement of latenc~t of onset of the echoic utter-
ance. Subsequent to the fnnctional categorization, re-
sponse latencies were measured on a graphic level re-
corder to determine if the differences among the mean
latencies of the echoes in each functional category
helped to differentiate the categories.
Data Analysis
In the first level of analysis, model utterances and
echoic utterances were extracted fl'om the videotapes
and each pair of utterances was coded as part of a stream
 244 Journal of Speech and Hearing Disorders 241-249 August 1981

TABLE2. Total echo breakdown by functional categories for each of the subjects.

%of
Functional
Category
Relative
Total to Total
Functions Brian David Jeff Robbie Echoes Echolalia
NF (non-focused) 2 13 11 14 40 3.97
TT (Turn-Taking 84 44 108 100 336 33.30
D (Declarative) 56 40 82 81 259 25.67
R (Rehearsal) 24 25 66 21 136 13.48
SR (Self-regulatory) 17 24 40 52 133 13.18
YA (Yes-Answer) 14 17 12 9 52 5.15
Req. (Request) 8 20 15 10 53 5.25
Total Immediate Echolalia 205 183 334 287 1,009
Total Utterance for each child 740 623 827 541
% Immediate Echolalia Relative to Total
Utterances 27.70 29.37 40.38 53.04

of interaction. Included was analysis of gaze behavior RESULTS

and other nonverbal c o m p o n e n t s such as pointing,
touching, general body orientation and movement, and
manipulation of toys or objects. The second level of
analysis determined the structural change in the echoic
utterance, including changes in segmental, supraseg-
mental, and paralinguistic characteristics. The third level
of analysis included intonation and latency analysis per-
formed on a sample of echoic utterances from each func-
tional category for each child. Determination of the
categories was based primarily on the clustering of
characteristics from the first two levels of analysis, with
the third level providing supportive evidence in deter-
mining integrity of the categories.
One thousand and nine model utterances and the
echoic utterances of the four children were transcribed,
using orthographic transcription for clearly articulated
words and broad phonetic transcription for utterances
that deviated significantly from clearly articulated
speech. Above and below each utterance, a coding sys-
tem described the child's gaze behavior and nonverbal
behavior in relation to the model utterance and the
echoic utterance (see Appendix A).
The notation above the dialogue reflects nonverbal
movements deemed significant or potentially significant
fbr differentiating the echoes. Simultaneous nonverbal
movement was transcribed by using additional lines of
nonverbal notation above the utterance, with the accom-
panying notes providing specific information about the
movement. In a manner similar to the nonverbal nota-
tion, the notation under the utterance indicates the
child's gaze behavior and shifts in gaze direction. A let-
ter code was used to indicate points of significant ibcus
that might be important in determining the child's at-
tending behaviors (e.g., 0 = object, P = person, NS =
nonspecifie). In addition to nonverbal and gaze analysis,
notes were made as to the seating arrangement, objects
present, and other factors not taken into account in the
nonverbal and gaze analysis.
Seven distinct categories of echolalia based on unique
constellations of behavioral and linguistic features were
derived from the multilevel structural analyses of the
echoic utterances. A function was attributed to each
structural category. Table 2 presents the proportion of
eeholalia in each category relative to the total amount of
echolalia (1,009 examples) analyzed in the study. Nonlb-
eused echolalia was relatively rare, while turn-taking
echoes were the most frequently (33.3%) produced of all
the categories. However, interesting patterns of the fre-
quency of" functional usage are apparent by viewing the
data in alternative ways. Table 3 compares the produc-
tion of echolalia produced with evidence of compre-
hension (NF, TT) for each of the children. For all four
children in the study, regardless of individual com-
municative abilities, the percentage of' eeholalia pro-
duced with evidence of comprehension was greater than
the percentage produced with no evidence of com-
prehension.
Interjudge reliability was measured by comparison of
the results obtained by the investigator with those of a
judge who had previously observed the children. After
being trained on the significant features of the fimctional
categories, the second judge was shown a videotape of
TABLE 3. Echoes with evidence of comprehension vs. no com-
prehension.
Evidence of Comprehension No Comprehension
(D, R, SR, YA, Req.) (NF, TT)
Brian *119 (58.0%) 86 (4g.0%)
David 126 (68.9%) 57 (31.1%)
Jeff 213 (63.8%) 121 (36.2%)
Robbie 173 (60.3%) 114 (39.7%)
*Number of echoic utterances.

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the children, which he had never seen. After analyzing
and categorizing all 53 echoic utterances from the vid-
eotape, his categorization was compared to the original
analysis previously conducted by the investigator. Inter-
judge reliability tbr fimctional categorization was .96.
Disagreement dealt with Ibatures of timing of the utter-
ance in relation to the child's activity. Intrajudge relia-
bility was .97 based on reanalysis of a videotape with 63
echoic utterances. The reanalysis was c o n d u c t e d 6
months aIker the original analysis.
DISCUSSION
Deriving Structural Categories From the Tapes
The most striking differences that were initially dis-
covered among the echoes was that many echoes were
produced with no change in behavior nor any task at-
tempt (if a task was requested of the child), while others
were produced with either an accompanying or sub-
sequent task attempt providing evidenee of some com-
prehension of the previous utterance. (However, some
echoes not accompanied by an attempt to perfbrm an ac-
tivity may reflect a lack of willingness to comply, rather
than a lack of comprehension.)
Another dichotomy was between echoes that appeared
interactive in that they were directed to the interlocutor
with appropriate gaze behavior or a gaze check sub-
sequent to the utterance, and echoes that were nonin-
teraetive, as suggested by lack of directedness of the ut-
terance (love volume, whispering) and lack of specifie
gaze orientation. It was therefbre determined that, in
general, the fbllowing categorical possibilities existed:
1. Interactive echoes with concomitant evidence indi-
cating some degree of comprehension of the model
utterance.
2. Non-interactive echoes with concomitant evidence
indicating some degree of c o m p r e h e n s i o n of the
model utterance.
3. Interactive echoes with no evidence of comprehen-
sion of the model utterance.
4. Non-interactive echoes with no evidence of com-
prehension of the model utterance.
Further subcategorization of the four major categories
dealt specifically with timing of the echoic utterance in
relation to the child's behavior (in cases in which there
were significant behavioral changes) and the specific na-
ture of the behavioral changes. Such changes included
gestures of pointing, showing, and requesting, and such
actions as picking up, grabbing, and accepting objects.
With these further considerations, Category 2 (non-
interactive, some e v i d e n c e of comprehension) sub-
divided into two distinct categories as determined by
whether the echo occurred during the behavioral change
or prior to the behavioral change (with some interval be-
tween the echoic utterance and the s u b s e q u e n t re-
sponse). Category 1 s u b d i v i d e d into three distinct
categories, that were primarily determined by the nature
of the child's action on an object, and/or nonverbal indi-
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PRIZANT, DUCHAN:Immediate Eeholalia 245
cations of expecting a further response from the inter-
locutor (gaze hold, grabbing interloeutor's hand or arm,
etc.).
By documenting observable behaviors and determin-
ing how these behaviors clustered with different echoie
utterances, the seven categories were derived. Each eat-
egory was described in terms of the features needed for
inclusion in that category, while other co-occurring be-
haviors indicated variations within a particular category.
Therefore, some behaviors were relegated to a secondary
role in category determination.
Ascribing Functions
Inasmuch as the categories were structural patterns
dervied from observable behaviors, the next problem in-
v o l v e d the a t t r i b u t i o n of functions to each of the
categories. For example, w h e n p r e s e n t e d with the
echoic utterance that Let's get the boat produced with
evidence of comprehension (i.e., child gets boat), there
was the dilemma of attributing to the child either full
knowledge of the semantic relations of the utterance, or
little or no knowledge of the meaning of the utterance. It
is not implied that the child fully understood the seman-
tic and syntactic relationships in the utteranee. However,
comprehension was considered in terms of a child's rel-
evant, intentional actions that occur immediately prior
to, during, or subsequent to the echoic utterance. Mean-
ing was considered in terms of usage, or how an utter-
ance funetioned for a child.
The Functional Categories
Following are the defining characteristics of the func-
tional categories according to core attributes (see Ap-
pendix B for summary). The descriptions represent ca-
nonical forms of each category, with the presence of the
cenh:al features or core attributes being necessary tbr the
inclusion of an echoic utteranee in that category. Core
attributes for the functional categories are designated by
an asterisk. In addition, frequently occurring secondary
attributes based on structural linguistic and/or latency
analyses are listed subsequent to the core attributes.
Non-focused
*1. No evidence o£ attention to person or object as de-
termined by gaze or body orientation.
*2. No significant behavioral change indicating evidence
of comprehension.
*3. No evidence of echoic utterance being directed to-
wards the interlocutor nor any evidenee of expecta-
tion of a fhrther response from the interloeutor.
4. Echo may occur during agitated or highly aroused
state (e.g., pain, temper tantrum, etc.).
5. Echo is usually rigidly congruent to the model utter-
ance.
The category of non-tbeused echolalia appeared the
most automatic, and relatively nonflmetional variety;
therefore, it may be a misnomer to call it a thnctional
category. Although the occurrence of noMbcused echoes
 246 Journal of Speech and Hearing Disorders
was s o m e w h a t rare (ranging from 1.0%-7.1% o f e a c h
child's utterances), e a c h child d i s p l a y e d some produc-
tions in this category. Some interesting examples from
the tapes i n c l u d e d echoes that occurred d u r i n g highly
aroused states. F o r e x a m p l e , after hitting his mouth on a
large plastic rocking toy, one child e c h o e d O.K! (in a
screaming voice) w h e n asked Are you O.K?, although he
was o b v i o u s l y in g r e a t p a i n and not a t t e n d i n g to the
speaker. T h e echoic response was, in essence, a synthe-
sis of crying and articulating O.K.
O t h e r e x a m p l e s in this c a t e g o r y i n c l u d e d a c h i l d ' s
echoing o f utterances d i r e c t e d to other children. T h e r e
were few examples o f this t y p e o f e c h o l a l i a found in this
study (less than .5% o f all echoes). O n e other interesting
characteristic of this category was that the p e r c e n t a g e o f
non-focused echolalia was a reflection o f the child's lin-
guistic abilities. That is, non-focused echolalia d e c r e a s e d
as a function of a child's linguistic abilities. This cate-
gory is r e m i n i s c e n t o f t h e a u t o m a t i c i n d i s c r i m i n a t e
echolalia of the visually i m p a i r e d girl in F a y and Cole-
man's (1977) study.
Turn-taking
*1. Evidence of attention to person or object as deter-
mined by gaze or body orientation.
"2. No significant behavioral change indicating evidence
of comprehension.
3. Echoic utterance is most often directed to inter-
locutor as determined by paralanguage, gaze be-
havior, or gaze check subsequent to the utterance.
4. Echoic utterance is usually rigidly congruent to the
model utterance, with some exceptions.
Turn-taking echoes a p p e a r e d to function as a d e v i c e
for social closure (Shapiro & Lucy, 1978) or for mainte-
nance of social interaction (Fay, 1973). T h e child s e e m e d
to be p l a y i n g out his role in d y a d i c interaction through
repetition. Although the child d i s p l a y e d no e v i d e n c e of
comprehension, the echoic utterance was u s u a l l y very
interactive. O n e r e l a t i v e l y f r e q u e n t o c c u r r e n c e was a
gaze check, in w h i c h a child l o o k e d at the interlocutor
apparently e x p e c t i n g some a c k n o w l e d g e m e n t . An exam-
ple from the tapes s h o w e d that Robbie, the oldest child
in the study, r e a c t e d with extreme sensitivity to the in-
terlocutor's r e s p o n s e to his turn-taking echoes. R o b b i e
often b e c a m e u p s e t if the r e s p o n s e was not a c c e p t e d
through indications of verbal or n o n v e r b a l approval. Ap-
parently, for some children, turn-taking echoes m a y de-
velop as part of an interactional routine that results from
intervention t e c h n i q u e s stressing rote verbal imitation.
F o r other c h i l d r e n , it m a y r e f l e c t a n a t u r a l r e s p o n s e
strategy to c o m m u n i c a t i v e pressures.
Declarative
*1. Evidence of attention to person or objeet as deter-
mined by gaze or body orientation.
*2. Demonstrative gesture (touching, pointing, showing)
to object, body part, etc., displaying some evidence of
comprehension of the model utterance. Gesture oc-
curs prior to or during echoic utterance.
3. Echoic utterance is most often directed to inter-
locutor as determined by paralanguage, gaze be-
havior or gaze check subsequent to the utterance.
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241-249 August 1981
4. Echoic utterance may range from rigidly congruent
reproduction to selective repetition involving dele-
tions and/or additions.
D e c l a r a t i v e echoic utterances a p p e a r e d to be l a b e l i n g
b e h a v i o r s , in w h i c h a c h i l d d e m o n s t r a t e d some com-
p r e h e n s i o n b y n o n v e r b a l l y i n d i c a t i n g a c o n n e c t i o n be-
t w e e n the e c h o i c u t t e r a n c e and an object, action, or
location. In all instances, an object, b o d y part, or en-
vironmental referent was central to the c h i l d ' s gesture.
T h e gesture most often i n d i c a t e d attention to the object,
but examples i n d i c a t i n g action p e r f o r m e d on an object or
location o f an o b j e c t w e r e also found for some of the
children.
Rehearsal
"1. Evidence of attention to person or object as deter-
mined by gaze or body orientation.
*2. Some evidence of comprehension as indicated by
demonstrative gesture, action on object, or appropri-
ate verbal response.
*3. Verbal or nonverbal response is initiated subsequent
to the echoic utterance and after a short delay.
4. Echoic utterance is most often not directed to inter-
locutor as evidenced by paralanguage (low volume,
whisper) and/or lack of gaze to interlocutor.
E c h o i c utterances o f this category a p p e a r e d to serve a
cognitive rather than c o m m u n i c a t i v e function. This cate-
gory is non-interactive in that the echo is not d i r e c t e d to
the interlocutor and was o ~ e n w h i s p e r e d or of low vol-
ume. T h e notion of " t h i n k i n g out l o u d " is often m e n -
t i o n e d in the literature on autistic language, and these
echoes may w e l l b e an e x a m p l e o f that p h e n o m e n o n .
T h e child s e l e c t i v e l y r e p e a t e d words (usually of high in-
formation value) or e c h o e d i n t a c t utterances as an aid to
further p r o c e s s i n g o f the utterance. A s u b s e q u e n t re-
sponse, e i t h e r v e r b a l or n o n v e r b a l , i n d i c a t e d that the
echoic utterance was a processing aid and that e c h o i n g
was a t y p e of rehearsal strategy. This strategy is analo-
gous to what normal speakers often do w h e n a t t e m p t i n g
to learn a foreign language or w h e n there is some dis-
traction in the e n v i r o n m e n t , that is, r e p e a t the utterance
to aid in c o m p r e h e n s i o n . On the tapes, it was not un-
c o m m o n to find m a n y e x a m p l e s of the c h i l d r e n e c h o i n g
utterances in a low voice and s u b s e q u e n t l y " s n a p p i n g
in" with a directed, interactive response. Apparently, the
echo a i d e d the c h i l d in focusing on the verbal message.
Self-regulatory
*1. Evidence of attention to person or object as deter-
mined by gaze or body orientation.
*2. Some evidence of comprehension as indicated by in-
itiation ofa motoric response involving the child's ac-
tion on an object or self.
*3. Initiation of response oecurs during the production of
the echoic utterance.
4. Echoic utterance is most often not directed to inter-
locutor as evidenced by paralanguage (low volume,
whisper) and/or lack of gaze to interlocutor.
5. Utterance is usually echoed in an intact form, al-
though deletions, substitutions, and/or additions to
the utterance may infrequently occur.

Self-regulatory echoes are similar to r e h e a r s a l echoes
in that t h e y a p p e a r e d to serve a cognitive rather than
c o m m u n i c a t i v e function. Therefore, most sell-regulatory
echoes w e r e not clearly d i r e c t e d to the interlocutor. T h e
major distinction between the rehearsal and self-
regulatory categories was that r e h e a r s a l echoes a p p e a r e d
to l e a d to a response, w h i l e self-regulatory echoes ap-
p e a r e d to h e l p a c h i l d d i r e c t his own b e h a v i o r d u r i n g the
p r o d u c t i o n o f the utterance. This p h e n o m e n o n s e e m s
similar to "self-talk" in y o u n g n o r m a l - s p e a k i n g children,
in w h i c h t h e y may v e r b a l l y d i r e c t their own behavior.
C o n s i d e r also the n o r m a l - s p e a k i n g a d u l t w h o is attempt-
ing to m a s t e r a difficult motoric task. F o r e x a m p l e , w h e n
l e a r n i n g a n e w dance step, adults may v e r b a l i z e their in-
t e n d e d actions w h i l e p e r f o r m i n g them, e.g., Left foot
forward, right foot back, etc. Some of the c h i l d r e n u s e d
m u l t i p l e r e p e t i t i o n s o f an utterance if a task c o u l d n ' t b e
c o m p l e t e d promptly. F o r example, w h i l e searching for
h i d d e n objects, a c h i l d r e p e a t e d , Go find the dog until
he was able to c o m p l e t e the task. (See Luria, 1959, 1966
for discussions of the role of s p e e c h in the r e g u l a t i o n of
behavior.)
Yes-Answer
"1. Evidence of attention to person or object as deter-
mined by gaze or body orientation.
*2. Verbal or nonverbal evidence of affirmation prior to
or subsequent to the echoic response (e.g., accept-
ance of object, reaching for object, initiation of ap-
propriate action.)
*3. Echoic utterance is directed to interlocutor as evi-
denced by paralanguage or gaze.
4. Utterance is usually echoed in an intact form with oc-
casional change in intonation.
5. The child often displays some nonverbal indication
of expecting a further response from the interlocutor
(e.g., gaze hold, child grasping hand or arm of inter-
locutor, open-handed reach).
T h e Yes-Answer category has b e e n referred to as "af-
firmation by r e p e t i t i o n " (Kanner, 1946) a n d is the only
specific function a t t r i b u t e d to i m m e d i a t e e e h o l a l i a in the
autism literature. H o w e v e r , to avoid r e l y i n g on infer-
ence, an echoic r e s p o n s e to a "Yes-No" q u e s t i o n was not
sufficient for inclusion in this category. T h e child had to
d i s p l a y some n o n v e r b a l i n d i c a t i o n o f affirmation inde-
p e n d e n t o f the v e r b a l r e s p o n s e . T h e r e f o r e , r e s p o n s e s
c o n s i d e r e d " a f f i r m a t i o n b y r e p e t i t i o n " b y o t h e r re-
searchers may not have fit the Yes-Answer category un-
less e v i d e n c e o f affirmation was d o c u m e n t e d .
Request
*1. Evidence of attention to person or object as deter-
mined by gaze or body orientation.
*2. Verbal or nonverbal evidence of the child's desire to
obtain an object or perform an aetion prior to, during,
or subsequent to the echoic utterance (open-handed
reach, carrying out action when givenpermission).
*3. Echoic utterance is directed to interlocutor as evi-
denced by paralanguage or gaze.
4. The child displays some nonverbal and/or verbal in-
dication of expecting a further response from the in-
terlocutor.
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PRIZANT, DUCHAN: Immediate Echolalia 247
5. Child's response usually consists of echoic segment
with added elements, although some rigidly con-
gruent echoic utterances also serve the request func-
tion.
In general, the r e q u e s t category p r o b a b l y exemplifies
the most intentional and least automatic r e s p o n s e cate-
gory. T h e c h i l d m o s t o f t e n u s e d s o m e o f t h e i n t e r -
locutor's words, a n d then a d d e d e l e m e n t s to indicate a
desire to obtain an o b j e c t or perform an action. T h e r e -
q u e s t funetion was most often s e r v e d b y echolalie struc-
ture that w e r e affected b y some changes (usually addi-
tions) a n d may therefore be the most extreme examples
of intentional mitigation.
F o r the autistic child, the first c o m m u n i c a t i v e and
functional s p o n t a n e o u s speech, and/or d e l a y e d echolalia,
a p p e a r s to serve a r e q u e s t fimetion. One w o u l d e x p e c t a
c h i l d ' s motivation to be relatively strong w h e n he de-
sires certain n e e d s met. Some v e r b a l aut'istie c h i l d r e n
w h o are r e l a t i v e l y n o n i n t e r a e t i v e are m o s t often ob-
s e r v e d initiating interaction d u r i n g m e a l t i m e or during
favorite activities, situations w h i c h p r o v i d e a strong in-
h e r e n t motivation to c o m m u n i c a t e .
R e q u e s t e c h o e s a p p e a r e d r e l a t e d to Y e s - A n s w e r
echoes in t h a t the c h i l d ' s goal was acquisition o f a de-
sired object, h e l p from the interlocutor, etc. T h e major
differentiation b e t w e e n t h e s e two categories was that
with the q u e s t i o n in the Yes-Answer echoes (e.g., Do
you want ?), the c h i l d was p r o v i d e d the
language, and all he n e e d e d to do was indicate affirma-
tion b y r e p e a t i n g the utterance. H o w e v e r , with r e q u e s t
echoes, in w h i c h the r e q u e s t was often in response to an
o p e n - e n d e d question, a c h i l d most often n e e d e d to a d d
words to an e c h o e d s e g m e n t to specify his desires (e.g.,
Q u e s t i o n : What do you want? A n s w e r : What do you
want a pringle.).
CONCLUSIONS
T h e results of this study suggest some directions fbr
r e s e a r c h on the language b e h a v i o r of autistic children.
F u t u r e r e s e a r c h s h o u l d a t t e m p t to e x a m i n e d e v i a n t
characteristics of autistic language within a ffmnework of
how such eharaeteristies may function for the c h i l d r e n
a n d how t h e y p o s s i b l y fit into a theory of language ac-
q u i s i t i o n for autistie children. Most p r e v i o u s r e s e a r c h
has e x a m i n e d characteristics such as i m m e d i a t e and de-
l a y e d e e h o l a l i a as isolated p h e n o m e n a , rather than as in-
tegral parts of the d e v e l o p i n g finguistic and cognitive
system of autistic children.
In addition, the results of this study raise m a n y ques-
tions c o n c e r n i n g the w i d e variety o f b e h a v i o r modifica-
tion programs that advocate extinction or r e p l a c e m e n t of
i m m e d i a t e e c h o l a l i a with rotely t r a i n e d surface struc-
tures. Specifically, indiscriminate extinction of" all fbrms
of i m m e d i a t e e c h o l a l i a is i l l - a d v i s e d b e c a u s e of the time-
tions that e c h o l a l i a may serve fbr autistic c h i l d r e n . It
may b e fi-uitful to view i m m e d i a t e echolalia fi'onl a time-
tional p e r s p e c t i v e and to a t t e m p t to d i s c o v e r patterns of
usage tbr i n d i v i d u a l children.
 248 Journal of Speech and Hearing Disorders
C o n c e i v a b l y , a c h i l d w h o has b e e n p r e d o m i n a t e l y
echolalic for m a n y years with little e v i d e n c e o f com-
p r e h e n s i o n or change in his echolalic b e h a v i o r should
be treated differently from a y o u n g e r child who displays
evidence of comprehension and progressive change.
Considering his l i m i t e d linguistic abilities, the ~brmer
child may n e e d to b e taught rote verbal routines that
w o u l d be useful for d a i l y functioning. Such r o u t i n e s
should be taught in a natural context so that the child
may realize the full i m p a c t of the use of language and
thus increase g e n e r a l i z a t i o n o f a c q u i r e d structures.
The latter child, however, n e e d s to accept and exploit
immediate eeholalia and learn to relate the repetitions to
aspects o f the e n v i r o n m e n t and c o m m u n i c a t i v e interac-
tions. T h r o u g h modification and expansion of a child's
echolalic utterances in a natural context, a w e l l - t r a i n e d
clinician can h e l p an autistic child d e v e l o p more effec-
tive c o m m u n i c a t i o n with p e o p l e and the environment.
Success in c o m m u n i c a t i o n would, therefore, m o t i v a t e
the autistic c h i l d to w a n t to learn language, initiate in-
teraction with others, and b e c o m e an active m e m b e r of
the world a r o u n d him.
ACKNOWLEDGMENTS
To Rita Joyce, Bart Ferraro, the children and their parents for
all of their help and support. This research was supported in
full by BEH grant #G00-77-00017. Requests for reprints should
be directed to Barry M. Prizant, Ph.D., Department of Speech
Pathology and Audiology, Southern Illinois University, Car-
bondale, IL. 62901.
REFERENCES
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BBUNER, J. S. The ontogenesis of speech acts. Journal of Child
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BUIUM, N., • STEUCHER, H. On some language parameters of
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COLEMAN, S., & STEDMAN,J. Use of a peer model in language
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DORE, J. Holophrases, speech acts, and language universals.
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FAY, W. H. On the echolalia of the blind and of the autistic
child. Journal of Speech and Hearing Disorders, 1973, 38,
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Received May 9, 1979
Accepted April 9, 1980 '
 PRIZANT,DUCHAN: Immediate Echolalia 249

APPENDIX

A. Example of the Transcription of an Echoic Utterance

Barry (clinician) Brian (child) Nonverbal
(9 --
® , ® Barry's left index finger pointing to Bert puppet and
pulled back
What does Barry do Bert do (~)
Brian's right hand extends to Bert puppet
*0 *, o . ® Brian's right hand pushes Bert puppet off block
Gaze ® Brian's right hand picks up Bert puppet
® .®
Gaze
**- down *O - Object
+p - Person
0 P +p ** - indicates pause

Situation
Brian and Barry sitting at table
Book open on table
Acting out scenes in book with blocks and finger
puppets
Bert puppet on top of block
The notation above the dialogue (circled numbers) represents significant gestures and bodily movement, and the notation below the
dialogue represents the child's direction and shifts in gaze behavior in temporal relation to the utterance.

B. Features of the Functional Categories

Timing of Evidence
Evidence Echo directed Degree Echo Re: of Expectation
Echo of to of Behavioral Compre- of Response
Category Attention Person Change Change hension From Adult Comments
Non-focused No* No* Minimal N.A.** No* No
Turn-Taking Yes* Yes Minimal N.A. No* No
Declarative Yes* Yes Variable During or Yes* Checking * Demonstrative
subsequent gaze gesture indi-
to possible cating object,
location
Self- Yes* No, with Variable During* Yes* No
regulatory exceptions
Rehearsal Yes* No, with Selective; Prior to* Yes* No *Delay between
exceptions high echo and verbal
information or nonverbal
segmentals
Yes-Answer Yes* Yes* Minimal N.A. Yes* Yes* *Verbal or non-
verbal evidence
of affirmation
Request Yes* Yes* Variable; N.A. Yes* Yes *Verbal or non-
usually verbal evidence
elements of child's desire
are added to obtain an object
or have action
performed
*Core attributes.
**N.A. - Not applicable.

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