COMMUNICATION
and using language as he/she hears without inter-
preting how it changes with each speaker. Typically
developing toddlers also imitate language a lot, but
they repeat mainly the key words, and they shift the
intonation to match their conversational roles. Chil-
dren with echolalia learn concrete vocabulary, espe-
cially names of objects, letters, and numbers, easily,
but “I” and “you” pronouns are repeated as heard, and,
therefore reversed, and concepts like “yes,” “maybe,”
and “I don’t know” are confusing. Interpreting ques-
tion forms is usually difficult, and questions are often
repeated instead of answered.
Children may develop beyond echolalia to more
conventional speech and language without help, or
after a lot of intensive intervention, or not at all. For
some people, echolalia persists into adulthood. Chil-
dren who echo may be quiet and passive and only
speak when prompted, or they may be extremely
verbal and seem to talk nonstop. Usually, they show a
combination of echolalic and more appropriate con-
ventional speech. Articulation may initially be poor
as the child is repeating things such as movie scripts
and book passages that he/she doesn’t understand,
but clarity of speech typically improves as more con-
ventional language develops.
There are also children and adults with autism who
have essentially normal language structure, appar-
ently good comprehension, and strong academic
skills. But here too there are differences. These are
the people who have had to study the meanings of
idioms, want to monologue repeatedly on their fa-
vorite topics, think social greetings are a waste of
time because no information is shared, correct the
smallest errors of teachers and professors, try to be
social by telling jokes they don’t understand, and get
into arguments about their moral values. Some can
read before they can converse; they typically prefer
reading nonfiction instead of fiction, may resist and
struggle with handwriting, and they usually find it
difficult to organize ideas to express themselves ef-
fectively in speech or writing.
At all levels of development, the communication dif-
ficulties of people with autism are challenging and
overlap with their many behavioral, social, and learn-
ing difficulties. And at all developmental levels, there
is always the potential for improvement.
22 | Autism Parenting Magazine | Issue 87
Elizabeth “Betsey” Ives Field, MEd, CCC-SLP, lived in
Maine until 2015 and had a rewarding career as a
speech-language pathologist working in a state in-
stitution, community agencies, schools, a universi-
ty, and private practice. The majority of that time
she was serving as a consultant to school teams
and to families, working with children and young
adults diagnosed on the autism spectrum, focusing
on increasing communication, independence, and
appropriate social behavior. Betsey now lives in
Massachusetts, where she works part-time, main-
tains some long-distance consultation in Maine,
and enjoys having four grandchildren nearby.
Email: [email protected]
Phone: 207-852-1835
Autism Spectrum Consultant
250 Main St. # 405
Hudson, MA, 01749