Is this echolalia?

[Saker]

As you know I am worried about my ds2 who has some "odd" behaviours but does communicate quite well and interacts with us a lot. The paed saw him a couple of weeks ago and said he didn't strike him as on the autistic spectrum but there are still some things that worry me. One of them is whether he shows echolalia.

Is this echolalia?
He repeats things I've said to him - nearly always reprimands or instructions to do something - but he always repeats them in context and like he's prompting me to say them. So for example if we are walking somewhere, sometimes he just sits down on the ground. He then looks at me and says "Get up!". Or he runs a little way away and looks back at me and says "Don't run on the road". It doesn't seem like meaningless repetition because it seems to be involved in communicating with me - and could be interpreted just as attention seeking behaviour, but equally it doesn't seem quite normal either. Recently I have been trying to avoid these responses because I don't find they get me anywhere so is he trying to prompt me to say them for the attention or is this some type of echolalia? Incidentally if I then walk away from him and do the classic "Well we'll have to go without you" routine, he leaps to his feet and runs after me.

Agree with dinosaur. My son also had echolalia and is doing it a bit now. Often the repetition is meaningless and can be said much later out of context. I think all children like to repeat phrases particularly 'bossy' instructions. It is good that he is saying things about the road. Also autistic kids tend not to use words such as "don't" as they find them hard to to understand. Kids with echolalia will also ask themselves questions.

Hope you are reassured.

How old is he? Echolalia is normal between 2 and 3 anyway. Autistic ds1 only ever uses echolalia in context but it is often bizarre and shows that he doesn't understand the content. Eg "I'll get the keys" when he wanted me to open the car boot and "don't press the button" when we walk past pelican crossings.

He does the same as your son- will do something he's not allowed to whilst shouting "no" but I've always thought that was one of the more normal things he did

He's three in August, so maybe it falls within "normal" range especially as his speech seems to be delayed. Sometimes when he does it I do feel it's just cheekiness - you know he makes sure he catches my eye before he says it. Sometimes I feel he is using it as a prompt almost to stop himself doing something - for example, he had a phase of pushing other children and then we managed to get through a whole session of Tumbletots without him pushing although I could see he was sorely tempted some of the time and when he was he would say, "Don't push".

Now I'm thinking about it I can think of a few other examples which are not to do with him doing "naughty things" - e.g. he might come up to me and say "hello Ds1", wanting me to say "hello Ds1" back. Then he would say "How are you today?". Quite often he says "Do you know what, Mummy?". So I say "What?" but he never answers because I'm sure he doesn't know what that means. The thing I would say though is that he always does it as a way of getting my attention, not to himself.

Eulalia - he certainly knows the meaning of the word " don't" - "I don't want to ...." being one of his favourite phrases.

Catching your eye while saying it is a good sign. As you may know poor eye contact may be a sign of autism although not all autistic kids have this trait. I would say my ds has never gone out of his way to catch my eye. He would just make a loud noise or what he does now is say "mummy I am looking at you" very very loudly.

Now he is adding on words to his sentences and if you ask him for a drink he will say "well maybe not" which I am impressed with. He'll also use 'perhaps' and words like this but doesn't understand them. Experimenting is a good sign that your ds is exploring language.

Thanks, that is reassuring. I feel he does communicate with expressions and eye contact quite a lot - he also has a really sort of imploring look when he wants something. My gut feeling is that he isn't on the spectrum though may well be dyspraxic as he has poor motor skills, articulation etc. But every now and then I get worried because he does something that seems "odd". However it is also the case that dyspraxic children can have social problems and communication problems so it may be related to that if he is dyspraxic.

Saker I've lost track - is your son being assessed? I think the thing is not to get too hung up on individual behaviours- its the bigger picture that's important. DS1 has pretty good eye contact. When he is doing something naughty he will wait until he has caught my eye and then do it looking right in my eyes and laughing as he does it. (Today it's been pretending to poo on the floor- only does it if he has eye contact and waits for it). His eye contact with strangers is less good but a lot of people used to autistic children comment how good it is. When people make demands on him it then disappears (demand avoidance). However despite having good eye contact he is still severely autistic. I don't think there's much point analysing individual bits from the list when it comes to autism.

Dyspraxia and autism overlap so often dyspraxics are quite autistic in many ways (and vice versa) but again its the bigger picture that's important.

Hi Jimjams

Yes he has been seen twice by the paed and also by the SALT, physio, OT and he has a portage worker who comes every two weeks. I asked the paed if he thought he was autistic and he said he didn't thing it was likely. I also asked the portage worker and she also said he wasn't like autistic children she had worked with. He is on the waiting list for a full assessment with the clinical psychologist and hopefully this will help make things clearer because as yet no-one seems to know what to make of him.

He seems to want to communicate and tries to a lot, but it is still hard to have a conversation with him. Also he never asks me questions about things - he asks for things and he asks where are things but he never asks what things are or why things are. Another thing that bothers me (and a lot of mothers probably think I should count my blessings!) is that if you take him in a toy shop he doesn't demand toys. It doesn't seem to occur to him that I might buy him something whereas ds1 can't walk past the charity shop without his eye on some toy in the window.

However on the positive side (things that make me thing he's probably not autistic):
he seems to like joint activities, like three times just now he's come and got me to look at his jigsaws
he likes to sit in bed with his brother reading stories together
he seems to have an idea of turns, shouts "my turn" when his brother has finished a story and less often "ds1 turn"
he says "I want mummy to play with me"
he has some imaginative play although I feel it is a bit limited but he does things like makes his baby elephant say "I want my mummy" or make his dinosaurs have a fight.

and now he's here wanting to look at the animals on the computer with me so I'd better go.

The bigger picture is quite confused isn't it! DS1 is the same with toys- whilst ds2 does demand the entire toyshop.... so I know what you mean.

Have you got books etc on strategies for dealing with autism? I never think there's any harm in doing these with children even if they aren't autistic- it's just a lot easier than if they are They would help any language problems he may have.

A good book as well for tips for children with communication problems (whether ASD or not) is "more than words" which is basically the Hanen programme. I don't have a link but google will find it easily. It can be very successful (especially for children who aren't ASD, but are struggling a bit or a bit delayed).

Yes I feel very confused. Sometimes I think there's really very little wrong with him and other times I think he has real problems. The thing that frustrates me most is that although he has been seen by all these people we don't seem to be offered any actual help. I asked the SALT if she thought speech and language therapy would help him and she said they wouldn't start that formally until he was at least 3.5y. The paed says plenty of input from me and the nursery will be the best thing. I am not sure if that is really the case or just that they don't know what to make of him and are under-resourced to do much. I would happily go privately but don't want to burn my boats with the NHS too early on.

I am moaning too much - things are being done slowly -hopefully he can get some 1:1 at preschool in the autumn and once he has had the clinical pyschology assessment I can push for a bit more because they can't just say "let's see what the outcome of that is". I have been lucky to have got to see people so quickly here compared to the waits some people describe.

Do all autistic children have those massive tantrums that I have heard some of you describe on here? Ds2 is quite laid back - never really has proper tantrums. Neither does he spin, line up, obsess about routine etc. I know, I know...the bigger picture....

why do they have to wait until 3.5? Sounds like under-resourcing to me. The NHS is completely under-resourced for things like this. I was told yesterday (in relation to ds2) that s[peech therapy is non-existent in our area at the moment. And although HV are allowed to refer children on, no new children are being seen (he was referred in January- been told it will be at least another 7 months- despite the fact that he has now been diagnosed with a speech disorder- we are in the process of trying a different route to get him into the local ICAN nursery). Check what they mean by regular theraoy as well- in our case that means two or 3 times a term- woefully inadequate. Our NHS therapist doesn't even know him- she was "amazed" to see him throw his arms around his private SALT and give her a big cuddle- not unusual behaviour at all for him with someone he likes.

Going private doesn't affect what you get on the NHS- in fact you can sometimes end up with more (so peopl ewho can't afford it are completely stuffed) as you tend to then get reports from prosfessionals statying that X , Y and Z is needed....... Our private reports were a godsend for statementing.

It depends how much support your son needs. If you just need some guidance every now and then hte NHS will be adequate- if he needs proper continued assessment and therapy forget it and if you can afford it pay.

I've said this often enough before but my autistic son has never lined anything up in his life. He doesn't realy spin round himself and when he does he gets very dizzy......

Sorry first paragraph is a bit confused- the second part about the 2 or 3 times a term etc refers to ds1.

I agree with Jimjams, going private can speed things up - we have now been given an early appointment with the NHS paed clinic because we got a private report. My son is getting NHS SALT and he's 2.5 - it's not a great deal at the moment, half an hour per week for four weeks - but it is available at that age. My SALT tells me that what really counts is what you do at home, and that the sessions with her are really for us to decide what sort of exercises we should do next. She also told me that we were lucky to be seen within 16 weeks, most people wait longer.

Thanks that's useful to know. We haven't been given any specific exercises to do at home - just told to keep talking to him. We haven't had to wait too long for NHS appointments compared to a lot of people - saw the paed within 2 months, the SALT and OT and PT in the same time.

I am tempted to consult a private SALT but it's hard to know who's any good plus my ds2 is fed up with being assessed and I don't want to make things worse by pushing yet more assessments on him. My dh is less keen on the idea also - he is a GP and is fed up with explaining to patients the treatment that he genuinely believes /knows is in the best interests for them just to ignore him and go and do something else. His feeling is that the paed has a good reputation and if the paed and the SALT both say ds2 won't benefit from "formal" speech therapy at the moment then we should believe them. On the other hand he is prepared to acknowledge that under-resourcing can mean that patients don't always get the best offered and of course wants to do the best for our ds2.