By: Kelli Ellenbaum, MS CCC-SLP

Have you ever been in therapy with a child diagnosed with autism, and you ask them “How are you?” and they repeat the question back to you?  Maybe you’ve tried to teach the concept, but find that it is more difficult than you thought?  Well, I’ve been there a time or two….or eight or nine!  Echolalia can be tricky!
For those of you who have not experienced this “who’s on first” therapy session,  echolalia is defined as the automatic repetition of vocalizations made by another person.   Although echolalia has its place in typical development, it often overstays its welcome with our kids on the spectrum.  For neurological purposes, it is likely to have a functional purpose in learning however we’ll leave that discovery to the brain scientists.  In the meantime, how can we practitioners teach functional language?  More specifically, how can we practitioners teach language that is relevant from the child’s perspective?  How do we teach our kids to refer to themselves with “I” or “me” or use possessive concepts like “yours” and “mine?”  In order to get to the root of this, we have to teach the “language” along with the concept of “perspective taking.”  While we can use scripts to teach this, we must also monitor their comprehension of the concept.
In thinking more seriously about how these concepts could be taught, I have started to work on an approach that would help my hard working (but sometimes very confused) echoers.  I decided that perhaps I could use their echolalia to my advantage.  I started trialing this new concept with three of my favorite buddies.  I think it might be working!  So here’s a little bit about it:
It’s called “Perspective Speak.”  This method/approach is developed for children on the autism spectrum presenting with echolalia.  “Perspective speak” is a simple concept to understand, but a more difficult concept to put into action.  It requires the therapist to modify his/her own language use to occur from the perspective of the CHILD rather than from his/her OWN perspective. For example, instead of telling the child “its your turn,” the therapist would say “my turn.”  The child would then echo/repeat the phrase presented by the adult/therapist, with the phrase being appropriate from his/her own perspective.
This approach has 5 phases to mastery.  Phase 1 requires an additional adult for teaching.  When two adults are present, their roles can incorporate the ‘perspective’ concept.  In this scenario, one therapist/adult is able to provide the direction and facilitate the activity, while the other therapist provides the correct functional and perspective-specific dialog for the child (to echo).  This initial phase focuses solely on teaching the concept of ‘self’ along with the vocabulary reference of “I.”  Putting this teaching concept into action is not as easy as it seems.  All other perspective language reference words (you, your, he, she, her, him) must be completely omitted from both adults’ dialog during this phase.  Difficult? Yes.  Impossible? No.
The following phases introduce the concepts of you/your and he/she/his/hers.  By the end, children should be able to understand and use perspective specific language even as the references change during the course of a simple conversation.  Let me provide you with an example of a therapy exercise in which the perspective vocabulary shifts:

Me: “What is my name?”  (my=reference to Kelli)

Buddy: “Your name is Kelli.” (your=reference to Kelli)

Me: “What is your name?” (your=reference to Buddy)

Buddy: “My name is Buddy.” (my=reference to Buddy)

Me: “Who likes Reece’s Pieces?”

Buddy: “I do” (I=reference to Buddy)

Me: “Is this my nose?” (my=reference to Kelli)

Buddy: “No, this is my nose.” (my=reference to Buddy)

This approach is implemented using “phases” so that kids learning these concepts can phase in and out of prior targets. Repetition and revisiting items from past phases helps to reinforce the concept and the expectation becomes more difficult.  Depending on the child, there may be countless ways to provide prompts/cues (written, phonemic, tactile, pictures).  It is key to have parents aware of the concepts so they that assist in generalization across multiple settings and people.
To learn more about ways in which to teach these perspective language concepts, come to the 2012 ASHA Convention!  Technical research session: Use of Echolalia in Creating Meaningful/Functional Communication, or contact me at [email protected].


Featured Author: Kelli Ellenbaum, MS CCC-SLP
We thank Kelli Ellenbaum for providing us with this article for our newsletter.
Kelli Ellenbaum is an ASHA certified Speech Language Pathologist who completed her master’s degree at the University of North Dakota in 2001. She is licensed in the state of North Dakota where she has owned Red Door Pediatric Therapy since 2006. Kelli received her Autism Certification in 2005. Kelli specializes in treating children and the autism spectrum. She serves as an executive board member for the Social Key Non-profit organization in North Dakota