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Echolalia, also known as echophrasia, is the involuntary repeating of words or phrases. It’s commonly seen in young children who are still learning to speak and in individuals on the autism spectrum. However, like most health conditions, echolalia can take several forms. The condition can be immediate or delayed, communicative or semi-communicative, mitigated or unmitigated, and ambient or echoing approval. With communicative echolalia, the repeated phrase clearly contributes to the conversation. In cases of mitigated echolalia, the tone and/or pitch of the repeated phrase is different from its original delivery. Finally, ambient echolalia is a word or phrase that’s repeated from the surrounding environment, while echoing approval is spoken as a tonal response to its original delivery (Cleveland Clinic, 2023, Echolalia).

Often, people assume that this condition is simply a symptom of Autism Spectrum Disorder (ASD). There is indeed a strong correlation; approximately 75% of those with ASD have some form of echolalia, which usually fades by age three. However, its main cause is unknown. It’s also seen in those with ADHD, aphasia, head injury, dementia, developmental delays, encephalitis, Tourette’s syndrome, stroke, schizophrenia, stress and anxiety, and other related conditions. For this reason, some medical professionals have suggested that there’s a potential link to a type of frontal lobe dysfunction that affects conscious thoughts, movements, and memory. Theoretically, this dysfunction could lead to a significant imbalance of dopamine, affecting brain-body communication. Alternatively, the improper mirror neuron function and/or processing issues may change how the body responds to stimuli (Cleveland Clinic, 2023, Echolalia).

While the main cause of echolalia remains unknown, therapy to identify potential causes and other relevant details of an individual’s case may improve communication. Medication, psychological counseling, and consultations with neurodevelopment specialists may also help in some cases. However, without some intervention, individuals can experience significant anger, stress, delayed learning, isolation, trouble forming relationships, depression, and/or anxiety (Cleveland Clinic, 2023, Echolalia).

It’s also important to seek medical help for your loved one if they are a child reverting to echolalia, or an adult with no history of echolalia, suddenly developing it. For allies, friends, or family members of someone with the condition, observing how the repeated phrases are expressed and paying attention to specific words or phrases that are repeated can be highly beneficial. Trying to correct or interrupt the individual may make things more difficult for them (Cleveland Clinic, 2023, Echolalia). 

A good example of this might sound something like the following:

“Would you like some tea?”

“Like some tea?”

Instead of repeating yourself or criticizing them, try rephrasing what you said.

“I’m going to make myself some tea. Would you like some?”

Similar to echolalia, echopraxia (also known as echokinesis or echomotism) is the involuntary mimicking of physical and/or facial movements. Unlike voluntary imitation, which can be helpful when learning a new skill, echopraxia is entirely involuntary. It can manifest as simple actions like grimacing when someone else tastes a sour flavor, or as more complex actions, such as copying someone’s walk (Cleveland Clinic, 2024, Echopraxia).

Echopraxia is a symptom of brain dysfunction, movement disorders, and psychiatric conditions. Diagnosis often involves asking the individual to respond to verbal commands while watching another person’s movements. If the individual has a strong compulsion to mimic the movements before or instead of responding to the verbal commands, they may have echopraxia. Like echolalia, its main cause is also unknown and is likely a symptom caused by frontal lobe and/or mirror neuron issues. It is more commonly seen in those with ASD, catatonia, epilepsy, schizophrenia, and Tourette’s syndrome. Currently, there is no single treatment or prevention method. However, identifying the underlying cause and addressing this with psychotherapy, cognitive behavioral therapy (CBT), and/or medication may be beneficial. It’s crucial to seek treatment for echopraxia, as the condition can lead to physical injury if untreated (Cleveland Clinic, 2024, Echopraxia).

References

Cleveland Clinic (2023). Echolalia. Health Library. https://my.clevelandclinic.org/health/symptoms/echolalia

Cleveland Clinic (2024). Echopraxia. Health Library. https://my.clevelandclinic.org/health/symptoms/echopraxia