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Is Echolalia always an indicator of autism or aspergers? Is there an age limit where it should be gone by?

(43 Posts)
MrsMushroom Thu 17-Jan-13 21:37:25

My close friend's DS is almost three and he's exhibited echolalia both immediate and delayed (mostly delayed now) since he first began to speak at two.

She's begun asking me now and then if I think he's ok but when she asks she does it in a way where I get the feeling she wants me to reassure her things are ok...she says "Do you think that's ok?" and sort of nods encouragingly so I have said yes...it's ok....is that wrong?

He's now a month off three and all his language is parts of cartoons and fave television shows and ads. He does also use phrases which he's heard from friends and family...so during a day out he heard the phrase "Come on Sarah!" and now, my friend says whenever she tells him they are going to visit Sarah he will say "Come on Sarah"

He doesn't respond at all to his new siblings (not unusual I don't think) except to get very upset and have a meltdown when they cry. He has to leave the room immediately one begins crying.

So basically I am wondering if the speech pattern is something some kids go through....and then grow out of or is it a real sign of something amiss by the time the child is three? I am very aware that she's stressed and when she asked me this, I said that I thought it was a normal part of speech development which I have heard to be a fact. She's just had a baby...I didn't feel like I should say anything to worry her and as I mentioned above, she seemed to be willing me to say it was fine.

Her DS likes playing with my DC....to the extent of jumping on the trampoline with them and he laughs as he does this....the game is always the same though and my DC fall down and he laughs and then he waits for them to do it again.

He has excellent fine motor skills on an iphone as well as counting, colours, recognising numbers and animals etc....he can match pairs and play quite complex games on the phone.

He doesn't line things up but neither does he point or clap....he sometimes lies on the floor and looks at his fave thomas books by lying his head on one side and looking sideways at them.

If it IS something she needs to see about, can you advise me...if she asks me again, should I say yes and ignore the vibes she's giving me to reassure her?

firawla Thu 17-Jan-13 21:55:19

tbh he is nearly 3, the sooner she does think about getting him seen the better cos it can take time for the whole process. does he speak other than the echolalia, because if all or majority of his speech is echolalia then it could be a cause for concern. i think you can say yes get him seen, in a reassuring way - and sometimes it feels more reassuring to have someone say that actually yes, i understand why you would be concerned about that and give them support while they go through the process off assessments etc, rather than saying "no no, all sounds fine" but in the back of their mind they really know that it isnt?

MrsMushroom Thu 17-Jan-13 22:02:02

He does speak in other ways but it is very rare...if I give him and my DC something to eat, they'll talk about it....(my DC) and he will relate to that...announcng "cheese!" or whatever as they eat it. So he does recognise things but it's not often.

Mainly he's always muttering phrases and things he's got from TV...often in a low voice so you'd not necassarily know.

I feel like she asked me...and I let her down...but she's JUST had twins and was already tired and stressed.

firawla Thu 17-Jan-13 22:08:38

Oh god.. poor woman yes she must have a lot on her plate with twins!!
still, if she brings it up again I would be honest with her that there could be some concerns. it seems like your being kind not to say anything but the kindest thing is to help her to help her ds getting the support he needs. Deep down she must know there is some concern or she wouldnt be asking?

MrsMushroom Thu 17-Jan-13 22:10:23

I will try to say it in a way as not to cause too much worry then. I could just say "I don't know...maybe you could ask the health visitor?" as she'll be having visits from them won't she....at least that wont need a special trip to the drs.

PoshCat Thu 17-Jan-13 22:21:12

I don't know either. My DD (4) has severe speech delay/disorder. There is a lot of repeating of words and phrases but she has always responded with appropriate words, "yes, no, more, please, thank you" but she still has over traits to suggest a possible ASD diagnosis. Her speech therapist seems to strongly suspect this.

PoshCat Thu 17-Jan-13 22:23:01

Meant "other" not "over" traits.

MrsMushroom Thu 17-Jan-13 22:25:08

Posh, my friends DS doesn't ever respond if you ask him if he wants anything....he doesn't say hi but looks happy to see you...he doesn't say more or please or anything indicating his needs or desires.

The more I write, the guiltier I feel for not saying yes...get an opinion from a professional. I just couldn't say it.

PoshCat Thu 17-Jan-13 22:29:50

But her paed has ruled it out.

Sorry. Not a lot of help overall. [Embarrassed]

Ineedmorepatience Thu 17-Jan-13 22:29:50

You sound like a good friend mrs, maybe you could say that you had been thinking about how her ds speaks and you think she should get it checked just in case. I am sure she would appreciate the fact that you have been thinking about it.

Good lucksmile

PoshCat Thu 17-Jan-13 22:31:51

I agree with Ineedmorepatience

zumbaleena Thu 17-Jan-13 23:14:41

Hi there. This is exactly what my dd went thru. She was ditto like the three yr old you have described here and I just kept thinking is she delayed or what. I would ask my friend as well and she kept saying everything is fine. Probably cos your df has had twins, she cannot see it but the first thing she will need to do is turn off the tv. It took full 3 months for my dd to stop the scripting. She needs to forget the hv or GP and ask straight for a speech assessment. She needs to ask straight for a community ped as well to see her kid. He is already 3 and she should move hard and fast

MrsMushroom Fri 18-Jan-13 07:33:14

Zumbaleena thanks Is your DD ok with speech now?

MummytoMog Fri 18-Jan-13 11:28:04

Turning off the TV can be a bit tricky if you've JUST had twins, although I agree that it makes a big difference with the scripting.

My DD has always done this, has a severe speech delay and also ignored her new sibling. SALT and the EP think she may be somewhere on the spectrum. I am less convinced, and it's a moot point at the moment anyway as we've refused further assessment to give me time to calm down and not do bad things to the EP when he calls my daughter abnormal. DD also has a hearing loss. It's easier for her to pick up phrases that she hears repeated over and over and over, or on a day when she has good hearing, than it is for her to pick up the sometimes indistinct speech of adults and then translate that into the rules of language. DD does use appropriate language in the right context, but this is quite a new thing for her.

We had Speech Therapy from just before DD was three. Useful in teaching us how to interact with her in a way that helped her communicate, the PECS was good for giving her ways to communicate her needs with us (although she's gone right off it now), and DD's nursery have also done sterling work with her.

I would suggest your friend asks for a referral to SALT, but I would also suggest that she looks at some of the learning language DVDs so that if she pops the TV on while dealing with her twins, she doesn't need to feel guilty that he is scripting, and it might well help him pick up words and phrases. For what it's worth, my DD moved on from ignoring her brother, to disliking him, to actively adoring him now. New siblings are a big change for a toddler, and ignoring is a far better reaction than pinching or slapping.

paranoid2 Fri 18-Jan-13 11:39:53

I would say something along the lines of " I have been thinking about your question regarding your DS’s echolalia and my response. I’ve been worried that I may have influenced you to not get him referred. You are his Mum and if you have a gut feeling that something is not quite right, then I think you need to act on that , as you are with him all the time and others may not see the same thing as you. You have nothing to lose in getting him referred and if all is ok by the time the referral comes through then there is nothing lost.”

My DS had echolalia at that age. He also had functional appropriate speech but there was something a little odd about the echolalia and I remember asking MN about it. He also had some sensory issues . When he was about 3 it was just repeating some scripts from TV and sometimes acting them out as well as copying some phrases that others would say. Then it continued a bit and when he was about 4 to 6 I noticed that he used it a bit to communicate if he was unsure of what to say in a social setting. He would say “hear this” and recite a script. Throughout all this though he also had good age appropriate speech also.
He was diagnosed with Aspergers last year (he is now 11) and his main difficulty is his processing . I believe his echolalia was related to this but of course its possible to have processing difficulties without having aspergers . It could also just be normal toddler behaviour but for me the lack of response when spoken to , no clapping and pointing would be as much cause for concern regarding ASD as the echolalia and worth looking into asap.
My Ds is a twin and his twin looked at TV for the same length of time as DS and there was a bit of scripting with DT1 at aged 3 but I had no concerns as everything else was fine and I would say it was at a normal level for a child of that age

MrsMushroom Fri 18-Jan-13 12:20:55

paranoid what you say about your DS having good age appropriate speech through all his echolalia rings a bit of an alarm bell for me because Dfs Ds does not.

I'm not an expert of course but at nearly three, I can guess he should be able to have a small conversation? Perhaps instigate a game or ask for something...but he doesn't.

Im going to broach it next week. Bit nervous but if she's asking me, as someone else said it means she's got doubts and wants confirmation.

zumbaleena Fri 18-Jan-13 12:41:23

Yes dd is not scripting like crazy anymore. She is at phrase level functional language

EllenJaneisstillnotmyname Fri 18-Jan-13 12:42:43

When I was in denial about my DS2, who has ASD, I would always be seeking reassurance/confirmation from friends. Most would try to reassure, thinking they were being kind, saying things like, 'lots of DC do that.' What I really needed to hear was someone gently confirming my worries and persuading me to seek help, via the HV or GP. My SALT persuaded me to get my HV to assess my DS age 3, who then immediately referred me to a Paed. I spent about 12 months in denial, 12 months wasted IMO.

I would say there are a number of red flags from your description, the echolalia, the lack of interaction with peers apart from rough and tumble play, the fact that the 'game' has to be the same each time. Looking at his toys from odd angles. Not asking to have his needs met. Sensitivity to the sound of his siblings crying.

Any one of them could be present in a NTly (Neurotypically) developing child, but the fact that there are quite a few would concern me quite a lot, I'm afraid. You don't need to go in all guns blazing, of course, but a gentle suggestion that she may be right to be concerned and an assessment from her HV may reassure her? Nothing to lose, etc.

I would guess that she's going to spot that things aren't quite as they should be herself once she has got over the twins early days, and once her DS attends a preschool, hopefully staff there 'may' pick up on things, but the earlier she can kick off getting some assessment in place the better for her DS, early intervention can be so useful.

paranoid2 Fri 18-Jan-13 12:58:45

yes I would think a small conversation would be expected although if a child has a S&L delay this may not be attainable. However as I said earlier I think there are other issues that would give cause for concern.

Although DS did have good appropriate speech at that age, I suppose it was around that age or maybe a bit later that i started to notice how he lacked the intuitive, non taught ability to interact with his peers. He still lacks the banter type conversations that 11 year olds engage in and looking back I suppose his conversations even at aged 3 were a bit onesided and a bit factual. However I was a bit in denial I suppose and always looking for evidence that there was nothing wrong. So I would see his great vocabulary and how every report would arrive with "DS is a very sociable and popular Boy" and I would convince myself that all was Ok. On the surface he was and is but mainly on his terms and mostly with adults. After DS' diagnosis last year I vowed never to ignore my gut instincts again as I suspected from a very young age that DS was ASD and no prof ever mentioned it until he was 10. i dont think it was any ones fault as his traits are pretty subtle and masked by many non asd traits and he had been having ASD type therapy such as OT and help at school . Sorry for too much info but all I'm saying is that often if a mother thinks there is something not quite right , she is correct.

TheLightPassenger Fri 18-Jan-13 15:54:58

agree with the others, by 3 you would not expect this sort of echolalia, and it's particularly concerning since his general language/understanding seem behind for his age. I think it's worth you suggesting that your friend looks for a hearing test and speech therapy assessment, she may be able to refer directly for speech therapy rather than needing HV or GP to "permit" that.

Btw my DS was v similar to how you describe your friend's child at 3, his language and understanding of language were delayed, he didnt quite have all the traits for an autism diagnosis, just traits. Over the years, his language is now pretty much age appropriate, his social skills not quite there yet, I would not be surprised if he ends up with some sort of Autism diagnosis before adulthood. If I hadn't gone for NHS and private speech therapy for him, he probably would have not made as much progress (also v good infant school).

BackforGood Fri 18-Jan-13 16:21:19

I agree with others. There definitely sounds like there are enough concerns there to seek further advice. I also think the fact she is asking you (and others?) shows that the Mum is already concerned, and I think that telling her you wouldn't be isn't what she needs now. By supporting her to ask for a Paediatric Assessment - or at least a Sp&Lang Assessment, you are not diagnosing anything yourself, you are just saying "Yes, I see what you are a bit worried about, I think if it were me Id like to be reassured everything is OK, or, if it isn't, to know that he's started in the system, so the right professionals can give us some support."

mariammama Fri 18-Jan-13 17:59:23

She can phone and discuss with a speech therapist or a if that's too scary, a trained parent volunteer.

Or you can ring the local speech therapy department and find out when they're next running a drop-in triage/advice session in the local children's centre (not every area has this, but lots do).

The TAMBA boards usually are a great source of advice, as lots of twins have additional needs.

mariammama Fri 18-Jan-13 18:02:03

I wouldn't waste her time with a random HV or GP till she knows what to ask them for, and how to insist if they try to reassure her too quickly. Most health professionals will realise this is a red flag, but not all... and unlike you, they probably don't have access to mumsnet for second opinions grin

HecateWhoopass Fri 18-Jan-13 18:14:23

She needs to get him seen.

If there's no issue, then having him assessed won't hurt.
If there is somethjng then I promise you that the earlier its picked up on, the better.
Cases like this, the wait and see approach is the very worst thing someone can have

zzzzz Fri 18-Jan-13 18:23:40

hecate what intervention do you think might be needed/offered?

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