Echolalia in Toddlers: Normal, or a Symptom of Autism?

Beginning at about 20 months of age, my daughter began parroting almost everything I said. When I asked her, "Do you want to read a book?" she would respond with "Do you want to read a book!" as an affirmation. I was initially unconcerned about this. Then, at one point, she began exhibiting this behavior in front of my friend, who has a son with autism. My friend looked concerned and informed me that my daughter was displaying echolalia, a classic symptom of autism-spectrum disorders.

It had never occurred to me that my daughter might have autism, because her speech development was otherwise impressive. By two years of age, she spoke in 12-word sentences, identified colors, memorized long books, and used surprisingly advanced words like "negotiable" and "obviously". She seemed to have little in common with any autistic children I had known.

Nevertheless, I was concerned when her echolalia, a symptom of autism, persisted for several months. She would frequently exhibit pronoun reversal; referring to herself as "you" and everyone else as "me". She would ask me to hold her by saying "You want Mama to hold you," and would ask for a book by saying, "I want to read a book to you, Sweetie."

When the echolalia and pronoun reversal persisted at 27 months, I decided to contact my town's early intervention program to find out if echolalia is normal for toddlers, or if it was a symptom of autism. I gave some information about my daughter to a speech pathologist, who told me that echolalia is normal for toddlers up to 36 months old, but that my daughter seemed to be displaying the pattern more frequently than average.

The early intervention specialist did give me good news. She said that even persistent echolalia, in the absence of other symptoms, was essentially normal and rarely the only symptom of autism. Echolalia can occur in toddlers with no speech disorders or learning problems; in fact, it is the way that children initially begin to speak. Very intelligent, verbal toddlers may display the behavior as they learn the ins and outs of articulate speech.

After asking a few questions, the speech pathologist told me that my daughter's echolalia was not a symptom of "full-blown" autism, because my daughter showed no other symptoms of the condition. However, she did warn that it may be an early symptom fo Aspeger's syndrome-- a high-function condition on the autism spectrum. Still, in general, 27 months is generally considered to be far too young to diagnose Asperger's syndrome, and my daughter wasn't showing any particularly troubling symptoms. I decided to take a "wait-and-see" approach.

The speech pathologist didn't seem to think that my toddler's echolalia warranted further evaluation, but she urged me to mention it to my pediatrician if it persisted. I worked carefully on correcting my toddler's echolalia and pronoun reversal, and she seems to be overcoming it a little at a time. While I expect that she will stop displaying echolalia by 30 months of age, I have been told to mention it at her three-year checkup if it is still persisting at that point.

If you are noticing echolalia in your toddler, it may be normal. However, echolalia may be symptomatic of an autism spectrum disorder, so it is important to mention it to a speech pathologist or pediatrician if it seems to coincide with speech delays or other symptoms of autism. If your toddler's echolalia does turn out to be a symptom of autism or Asperger's syndrome, early intervention could help improve his development.