Echolalia and answer questions

[Claire123e]

Sorry for the long post
I have been here before and would like your opinion on something.
I am not asking for advice on whether my child is autistic or not as I know she is showing symptoms but it is all so vague that I’d like a feedback from mums/ families that have encountered this type of behaviour. I have a 19 months old DD who can say 100 words , can distal pointing , waves and claps , does a lot of pretend play , has always brought us toys / books etc , follow commands , understand everything we say . She is also a good sleeper ( can self settle after the bottle ) and very affectionate, a bit wilful though . She imitates everything . She has good joint attention and always look where I am pointing . Now to the point of this post .
She has anxiety when faced with unfamiliar people or situations ( including her grandparents who doesn’t see often due to the fact that they live in a different country ) . She doesn’t let people get near her to touch her . She is an only child and doesn’t go to nursery .
She occasionally repeats words , (immediate echolalia concern ) she hears from nursery rhymes or us ( “please sit down from the wheels on the bus ) and most of the time uses them in appropriate situations but not always . She can identify animals on books .
She doesn’t point to request but she uses words when she wants something out of reach .
She tenses up and tippy toes when excited and a bit of side looking when turned her head .

I most concerned she doesn’t answer the typical yes or no questions. if I ask “ do you want milk ? She replies “milk “

My issue is that my HV , GP and paediatrician don’t see a reason to refer her for an assessment as she passes the Mchat test . I don’t know what to do at this point or what other families have tried or how things have evolved for them . ☺️

She sounds like a typically developing 19 month old but your anxiety surrounding her development sounds unusually high. If her GP and HV and paediatrician all think she is developing typically what is it specifically that makes you think they are missing something?

hi thank you so much for your reply
It is mostly the fact that she seems to speak using both immediate and delayed echolalia sometimes. She comes out with phrases like “ please sit down “ and “ milk it is coming “ out of the blue and I can’t tell if this is within normal range or not ( first time mum) . Still not answering “yes “ or “no “ questions . The words she knows she uses them in the right context but she seems to be doing a lot of talking by memory or imitating . Do you reckon is normal ?

Yes it sounds like normal development. All the toddlers I’ve known have done that as part of becoming fluent. It sounds like you could do with observing other children her age. Have you thought about going to playgroup and other activities together?

Hi x
thank you for your feedback
Tbh I have always avoided play groups . We tried a few times but she would play on her own and be around us observing other kids . Having that she absolutely loves newborns and tries to give them a cuddle 🤗

All toddlers parallel play (play next to each other) especially at your daughter’s age. You could try swimming classes or gym, but you do need a good handle on what is normal development and your daughter needs to be around other children. It’s no more or less “fun” than bathing her or giving her exercise, it’s just part of building a solid start for her.

I agree with the advice above. It's all part of her development at this age. If it persists, then it can indicate an issue.

Thank you so much for your answer . I have also notice she does some finger posturing like flexing or crossing her fingers . I just don’t like this wait and see game but I guess I have no choice now ☺️

All these things you mentioned, those are the things autistic kids are rubbish at:
”can say 100 words , can distal pointing , waves and claps , does a lot of pretend play , has always brought us toys / books etc , follow commands , understand everything we say . She is also a good sleeper ( can self settle after the bottle ) and very affectionate, a bit wilful though . She imitates everything . She has good joint attention and always look where I am pointing . “

And she is good at all of them, so I would say 100% not autism.

Though, saying that, she does have echolalia, but echolalia is a part of a normal development under 3 years old. After 3 years old, it would have been a problem

”Echolalia, a form of imitation, is a useful component of language acquisition. Echolalia is common in toddlers as they learn to speak. Echolalia becomes less and less prominent as language skills develop. A disorder may be suspected if automatic speech imitation persists or reemerges after the age of three.”

https://www.ncbi.nlm.nih.gov/books/NBK565908/#:~:text=Echolalia%2C%20a%20form%20of%20imitation,after%20the%20age%20of%20three.”

Hope this helps reassure you.

Regarding not answering yes/no question, there are certain exercises you can do with her to teach her that.

The stuff we did with our son is asking ”Do you want chips?”, then saying “Yes”, bringing the chip closer to him, then saying “No”, and put the chip behind our back. Repeating the arm actions again and then waiting.

Don’t let her grab the chip (or whatever you are using) but if she gets frustrated let her have the chip and say “Yes yes yes” very excitedly.

Every time you says “No no”, wave left right with your head. Exaggerate all movements. For “yes yes”, nod with head. Pretend to be Ms Rachel. That’s how you will capture her attention fully.

Try with lots of other things, always do some physical actions which demonstrating Yes or No. She should learn in few weeks, if you do it 5-10 times a day. Studies show that after no more than 200 repetitions, kids suddenly start doing it. Be persistent and consistent.