Echolalia is reflective of how the child processes information. The child with autism processes information as a whole "chunk" without processing the individual words that comprise the utterance. In processing these unanalyzed "chunks" of verbal information, many children with autism also process part of the context in which these words were stated, including sensory and emotional details. Some common element from this original situation is then triggered in the current situation which elicits the child's echolalic utterance.We first started addressing Pamela's language way back in 1991, when she was two years old. We could not find much information because Pamela was at the beginning of increase in the rate of autism. We had to improvise while we kept on top of emerging research and started Pamela off with sign language. When her echolalia emerged, we opted to mold it and use it, rather than discourage it. For example, Pamela picked up one phrase "It's Sunday" advertising a show aired on that day of the week. Every day, we would use that phrase "It's _______". Then, when she could do that, we would work on negation "It's not _______". After that, we twisted it to, "Yesterday was ________" and "Tomorrow's _______". We eventually transitioned to months and seasons. One little jingle afforded a great deal of mileage. This word pattern started out as a stim and, as such gave us many opportunities to practice new language.
Today, books are dedicated to teaching scripts that help autistic children learn to converse. This still would not have helped Pamela because she has a hard time memorizing scripts unless they are jazzed up for "viewers like you" (*ahem* a new scripted line). We did not figure out until recently that Pamela can memorize poetry with multi-sensory methods and have known for several years that meaningful progress in syntax comes in seven multi-sensory steps! Children who can memorize scripts can also become dependent upon the scripts and unsure of what to do with people who fail to follow the script. Thus, researchers have developed ways to fade scripts.
I am not a fan of the formal teaching of scripts, and I tend to concur with RDI's recommendation to avoid them. Anyone who has been sucked into scriptland knows that sense of helplessness as your sanity evaporates. We have tried a variety of techniques to teach flexibility: laughing at unexpected twists I made in the script, making her own twists, being silly with pauses, changes in pitch, sound effects, etc. Monkeying around with scripts taught Pamela to go with the flow and enjoy surprises.
One of Pamela's issues is that she does not always realize when she confuses people with references to her scripts. She has a couple of patient aunts who play along and that is it! Lately, I have been experimenting with ways to discourage scripting without discouraging Pamela from speaking and interacting with us.
* Ignoring It - Ignoring scripting is the least effective strategy in my experience. When I ignore Pamela, she gets annoyed and will repeat the script prompt followed by "Say it!" In this case, Pamela wagged her finger at me and badgered me. Ignoring her only intensified her nagging.
* Sad Reaction - After she started wagging her finger, I become very quiet, stuck out my poochie lip, and looked down at my feet. Pamela did something splendid. She walked up to me, studied my face, smiled, and said, "Sad." Then, she abruptly transitioned to the locked box.
* Springing off of It - Pamela started a Betty Crocker script, so I declared in off-script sentences, "We're just like Betty Crocker! You could be the Betty Crocker of gluten-free, casein-free." She clasped her hands and giggled with delight at my surprising comment.
* Adapting It - I adapt the script to her task. Pamela said, "You must be 18 or older to order." I ignored her, so she came back to it, "You must . . . I must . . ." She was stirring her batter, so I said, "stir and stir and stir." She laughed and giggled since she likes twisting scripts.
* Distracting Her - Sometimes, I can distract Pamela by gasping and turning my gaze to the next step in whatever we are doing. I have also succeeded by using declarative language to switch topics completely. In this case, I started talking about the need to stir the batter thoroughly until all the dry ingredients to become wet. Later, Pamela was stuck on her, "You must . . . " prompt. We had just added the pecans, so I asked her about her preference on how to say this nut, "Pamela, do you prefer PEE-can or pe-CAHN?" She persisted, so I added, "You must . . . eat . . . PECAAAHHNNNSSS!"
* Saying the Wrong Thing - I often say something wrong to encourage flexibility. She was stuck on the "You must" train, so I said, "Eat spinach." She prompted, "You must be" and I returned, "29!" We have been doing this for years, so she loves when I say the wrong things.
* Reacting to Her Script Twists - Sometimes, she twists her own script as a joke. This time, she said, "You must be 18 to . . ." while reaching for a utensil. She paused and glanced at me to see my reaction when she sneakily added, "die". Pamela is about the happiest person you will ever meet and not morbid about death. I think she was trying to surprise me with something entirely unexpected. I exaggerated my reaction by covering my mouth and said, "Nooooo! We don't want that to happen. You made a joke! That was a joke!" Then she confirmed it by saying, "Only to order!"