The Influence of Language Context on Repetitive Speech Use in Children With Autism Spectrum Disorder.

Purpose Although repetitive speech is a hallmark characteristic of autism spectrum disorder (ASD), the contributing factors that influence repetitive speech use remain unknown. The purpose of this exploratory study was to determine if the language context impacts the amount and type of repetitive speech produced by children with ASD. Method As part of a broader word-learning study, 11 school-age children with ASD participated in two different language contexts: storytelling and play. Previously collected language samples were transcribed and coded for four types of repetitive speech: immediate echolalia, delayed echolalia, verbal stereotypy, and vocal stereotypy. The rates and proportions of repetitive speech were compared across the two language contexts using Wilcoxon signed-ranks tests. Individual characteristics were further explored using Spearman correlations. Results The children produced lower rates of repetitive speech during the storytelling context than the play-based context. Only immediate echolalia differed between the two contexts based on rate and approached significance based on proportion, with more immediate echolalia produced in the play-based context than in the storytelling context. There were no significant correlations between repetitive speech and measures of social responsiveness, expressive or receptive vocabulary, or nonverbal intelligence. Conclusions The children with ASD produced less immediate echolalia in the storytelling context than in the play-based context. Immediate echolalia use was not related to social skills, vocabulary, or nonverbal IQ scores. These findings offer valuable insights into better understanding repetitive speech use in children with ASD.

A voz no autismo: uma análise baseada em autobiografias / Voice in autism: an analysis based on autobiographies / La voz en el autismo: un análisis basado en autobiografías

Neste artigo, abordamos a voz no autismo a partir da análise de autobiografias de autistas e de seus pais. Para esta finalidade, enfocamos manifestações como o mutismo, o grito gutural, o monólogo, a expressão irruptiva de palavras esporádicas, a ecolalia, uma língua privada não compartilhada, o recurso a intermediários como o gravador, a mimetização de voz de animais, o recurso a scripts de personagens Disney ou livros. Após descrevermos e sinalizarmos alguns aspectos importantes evidenciados nessa maneira singular de se relacionar com a voz, apontaremos algumas nuanças do funcionamento psíquico do autista.

In this paper, we analyse voice in autism based on the analysis of autobiographies written by autistics and their parents. For this purpose, we focus on manifestations such as mutism, guttural scream, monologue, the irruptive expression of sporadic words, echolalia, a private non-shared language, the use of intermediaries such as tape recorders, animal voice mimicry, Disney characters or books. After describing and signaling some importante aspects evidencied in this unique way of relating to the voice, we will point out some nuances of the psychic functioning of the autistic.

En este artículo trataremos de la voz en el autismo a partir del análisis de autobiografías de autistas y de sus padres. Para tal finalidad, abordamos manifestaciones como el mutismo, el grito gutural, el monólogo, la irrupción de palabras esporádicas, la ecolalia, una lengua privada no compartida, el recurso a intermediarios como el grabador, la mimetización de la voz de animales, el recurso a guiones de personajes de Disney o a libros. Tras describir e indicar algunos aspectos importantes puestos de manifiesto en esta manera singular de relacionarse con la voz, señalaremos algunos matices del funcionamiento psíquico del autista.

A Multidimensional Reappraisal of Language in Autism: Insights from a Discourse Analytic Study.

In this article, we leverage theoretical insights and methodological guidelines of discourse analytic scholarship to re-examine language phenomena typically associated with autism. Through empirical analysis of the verbal behavior of three children with autism, we engage the question of how prototypical features of autistic language-notably pronoun atypicality, pragmatic deficit, and echolalia-might conceal competencies and interactional processes that are largely invisible in mainstream research. Our findings offer a complex picture of children with autism in their use of language to communicate, interact and experience others. Such a picture also deepens our understanding of the interactional underpinnings of autistic children's speech. Finally, we describe how our findings offer fruitful suggestions for clinical intervention.

On the differential nature of induced and incidental echolalia in autism.

BACKGROUND: Echolalia is a verbal disorder, defined as 'a meaningless repetition of the words of others'. It is pathological, automatic and non-intentional behaviour, often observed in a variety of neurological and psychiatric disorders and above all in autism. We assume that echolalia is an imitative behaviour that is due to difficulties in inhibiting automatic repetition as seen in patients with frontal lobe damage. Our aim is to study the occurrence of echolalia under experimental conditions to investigate the nature of the phenomenon and its relationship with the severity of autism. METHODS: Eighteen participants with autism from 17 to 36 years old were recruited; they were administrated the Vineland scale, the Observational Rating Scale of Basic Functions and the Echolalia Questionnaire. In the Echolalia Questionnaire, questions were directly addressed to the autistic subject (induced procedure) or to the subject's caregiver while the subject was free to do what he wanted (incidental procedure). The data were analysed by multivariate regressions and Pearson's correlations. RESULTS: The results showed that echolalia occurred in both experimental situations; the mean value was significantly higher in the induced procedure, but results did not support the correlation with Vineland's score in the incidental procedure. It is likely that the two situations activated different processes. In particular, echolalia was statistically higher in the induced procedure as compared with the incidental one only for subjects with low score on Vineland, but in the incidental procedure, the presence of echolalia appeared to be uninfluenced by the functional capacity of subjects. CONCLUSIONS: The two experimental conditions require different monitoring systems to control this verbal behaviour. The echolalic phenomenon is an expression of dependence on the environment and may occur in a situation in which the autistic person is participating in a communicative act and, lacking inhibitory control, repeats the other's communication rather than selecting an answer. The deficit in inhibitory control in this situation does not seem to be present in subjects with higher efficiency. Incidental echolalia reflects the inability of the subject to filter out background environmental noise, which occasionally results in environmental dependency.

Ambient echolalia in a patient with germinoma around the bilateral ventriculus lateralis: a case report.

Ambient echolalia is a rare condition with few reported cases. We report the case of a 20-year-old man with a germinoma around the bilateral ventriculus lateralis who exhibited ambient echolalia. Clinical features included instinctive grasp reaction and compulsive manipulation of tools in his right hand. Speech or mental deterioration has been cited as a cause of ambient echolalia, but neither dementia nor aphasia was present. We propose that ambient echolalia in our case could be interpreted as a disinhibition of pre-existing essentially intact motor subroutines due to damage of the medial frontal lobe.

Do Japanese children with high-functioning autism spectrum disorder respond differently to Wh-questions and Yes/No-questions?

The present study compared 12 Japanese children with high-functioning autism spectrum disorder (HFASD), ranging in age from 7.3-14.8 years, with 12 typically developing (TD) children matched for age, gender, and vocabulary. The means of full-scale IQ and verbal-IQ of the children with HFASD were 95.92 (SD = 15.30) and 98.00 (SD = 18.44), respectively. Children responded to questions from their mothers in conversations collected under a semi-structured setting, and the responses of both groups were examined from the viewpoint of adequacy. Compared to TD children, HFASD children produced more inadequate responses to Wh-questions than to Yes/No questions. To both types of questions, HFASD children produced more inappropriate responses than TD children. The findings suggest that parents of HFASD children should consider the influence of the question format on these children's response inadequacies.

Criminal and legal responsibilities in Tourette's syndrome.

Tourette's Syndrome (TS) is a neuropsychological disorder characterized by the presence of multiple involuntary motor tics accompanied by one or more vocal tics. Articles about TS and criminal responsibility and the restriction of civil rights are limited. A person with TS was evaluated to consider his criminal responsibility after swearing at a referee during a football game. He was also evaluated as to whether or not he was capable of professionally driving a service bus. Additionally, medico-legal situations regarding military service, obtaining a shotgun license and marriages of patients with TS were considered.

Echolalia in the language development of autistic individuals: a bibliographical review.

BACKGROUND: echolalia is one of the most common symptoms among the language characteristics in Autism. AIM: to provide a detailed literature revision about the role of echolalia in the language development process of autistic individuals, and to discuss the use of this language feature in the speech-language clinical practice. The researches show classifications and analysis criterions of echolalia in a discursive context. A few of the analyzed studies are against the use of echolalia, pointing that it has no communicative function, and therefore should be discouraged. On the other hand, other studies indicate that echolalia has a communicative value and can be used as a communicative in speech-language intervention. CONCLUSION: this bibliographical review raises the issue about the importance of evaluating the conditions in which echolalia might occur before considering it as having a communicative value or not.

A ecolalia no desenvolvimento da linguagem de pessoas autistas: uma revisão bibliográfica / Echolalia in the language development of autistic individuals: a bibliographical review

TEMA: a ecolalia é um dos sintomas mais comuns dentre as características da linguagem no Autismo. OBJETIVO: oferecer uma revisão bibliográfica detalhada sobre o papel da ecolalia no desenvolvimento da linguagem de pessoas autistas, seguida de discussão sobre seu uso na prática clínica fonoaudiológica. As pesquisas mostram classificações e critérios de análise da ecolalia no contexto discursivo. Alguns estudos se posicionam contra seu uso afirmando que a ecolalia não tem função comunicativa e, por isso, deve ser desestimulada; outros defendem que a ecolalia tem um valor comunicativo, podendo ser inclusive utilizada em terapia fonoaudiológica. CONCLUSÃO: a pesquisa nos leva a refletir sobre a importância de avaliar as condições em que a ecolalia ocorre, antes de classificá-la como comunicativa ou não.

BACKGROUND: echolalia is one of the most common symptoms among the language characteristics in Autism. AIM: to provide a detailed literature revision about the role of echolalia in the language development process of autistic individuals, and to discuss the use of this language feature in the speech-language clinical practice. The researches show classifications and analysis criterions of echolalia in a discursive context. A few of the analyzed studies are against the use of echolalia, pointing that it has no communicative function, and therefore should be discouraged. On the other hand, other studies indicate that echolalia has a communicative value and can be used as a communicative in speech-language intervention. CONCLUSION: this bibliographical review raises the issue about the importance of evaluating the conditions in which echolalia might occur before considering it as having a communicative value or not.

Engagement with electronic screen media among students with autism spectrum disorders.

This study investigated the relative engagement potential of four types of electronic screen media (ESM): animated video, video of self, video of a familiar person engaged with an immersive virtual reality (VR) game, and immersion of self in the VR game. Forty-two students with autism, varying in age and expressive communication ability, were randomly assigned to the experimental conditions. Gaze duration and vocalization served as dependent measures of engagement. The results reveal differential responding across ESM, with some variation related to the engagement metric employed. Preferences for seeing themselves on the screen, as well as for viewing the VR scenarios, emerged from the data. While the study did not yield definitive data about the relative engagement potential of ESM alternatives, it does provide a foundation for future research, including guidance related to participant profiles, stimulus characteristics, and data coding challenges.

Using time-delay to improve social play skills with peers for children with autism.

Interventions that teach social communication and play skills are crucial for the development of children with autism. The time delay procedure is effective in teaching language acquisition, social use of language, discrete behaviors, and chained activities to individuals with autism and developmental delays. In this study, three boys with autism, attending a non-public school, were taught play activities that combined a play sequence with requesting peer assistance, using a graduated time delay procedure. A multiple-baseline across subjects design demonstrated the success of this procedure to teach multiple-step social play sequences. Results indicated an additional gain of an increase in pretend play by one of the participants. Two also demonstrated a generalization of the skills learned through the time delay procedure.

Two forms of spoken repetition in a girl with autism.

BACKGROUND: The talk of persons with autistic spectrum disorders (ASD) often features distinctive forms of repetition (echophenomena). Although often characterized as meaningless or inappropriate, there is evidence that such practices can sometimes have communicative functions. AIMS: To investigate the interactional organization of repetition practices found in the talk of an adolescent girl with an ASD. METHODS & PROCEDURES: As part of a project examining the interactional practices of children with ASD, we video-recorded 6 hours of activity in a school classroom for severe learning difficulty (SLD) children. This paper considers instances of repeated talk produced by a class pupil, 'Helen'. The analysis involved assembling a collection of examples of the repeated talk which were then transcribed in detail. Conversation Analysis was used to explore the sequential contexts in which they occur and precisely how they are produced. OUTCOMES & RESULTS: Two forms of repetition occur very frequently in Helen's talk: first, repeats of turn-final lexical items from another speaker's immediately before talk (prior-turn repeats, a form of immediate echolalia), and second, repeats of the first item within a turn such that a turn is produced consisting entirely of repeated items (within-turn repeats). The latter appears to be a form of palilalia (repeats of one's own prior talk) that has not been widely reported in ASD. The prior turn repeats follow other speaker's initiating actions (e.g. questions) that are addressed specifically to Helen and make a response from her relevant. Helen apparently uses these to demonstrate that she has nevertheless heard, and is orienting to, that prior turn. Within-turn repeats are tied to and bounded by the accomplishment of non-vocal activities, e.g. handing an object to a co-participant, such that the repetitions cease when the object has reached its recipient. The two forms of repetition frequently co-occur to display on-going engagement with a recipient's prior turn. CONCLUSIONS: Although Helen has limited verbal resources she is more interactionally competent than this may initially suggest. We propose that these repetition practices may constitute an adaptation to interacting with a limited lexicon. We discuss the relevance of Conversational Analysis for understanding autistic children's pragmatic competence, and the implications for remediation and further research.

A retrospective journal-based case study of an infant with autism and his twin.

This report describes the development of an infant who was later diagnosed with autism, and a direct comparison of his development to that of his twin, from a prenatal period through the age of 4 years, through the examination of personal journals and medical records kept by the mother of the twins. Examination of these journals revealed several differences in development between the twins, some as early as 6 months of age. In the first year of life, the infants already differed in language development, social development, sleep patterns, and sensitivity to pain. This rare opportunity to view early autistic development gives direction to developmental theories of autism and clinically useful cues to early signs of autism.

Chronic 'speech catatonia' with constant logorrhea, verbigeration and echolalia successfully treated with lorazepam: a case report.

Logorrhea, verbigeration and echolalia persisted unremittingly for 3 years, with occasional short periods of motoric excitement, in a patient with mild intellectual handicap suffering from chronic schizophrenia. The speech catatonic symptoms, previously refractory to various antipsychotics, responded promptly to lorazepam, a benzodiazepine with documented efficacy in the treatment of acute catatonia but not chronic catatonia. It is suggested that pathways in speech production were selectively involved in the genesis of the chronic speech catatonic syndrome, possibly a rare form of chronic catatonia not previously described.

Effects of a computer-based intervention program on the communicative functions of children with autism.

This study investigated the use of computer-based intervention for enhancing communication functions of children with autism. The software program was developed based on daily life activities in the areas of play, food, and hygiene. The following variables were investigated: delayed echolalia, immediate echolalia, irrelevant speech, relevant speech, and communicative initiations. Multiple-baseline design across settings was used to examine the effects of the exposure of five children with autism to activities in a structured and controlled simulated environment on the communication manifested in their natural environment. Results indicated that after exposure to the simulations, all children produced fewer sentences with delayed and irrelevant speech. Most of the children engaged in fewer sentences involving immediate echolalia and increased the number of communication intentions and the amount of relevant speech they produced. Results indicated that after practicing in a controlled and structured setting that provided the children with opportunities to interact in play, food, and hygiene activities, the children were able to transfer their knowledge to the natural classroom environment. Implications and future research directions are discussed.

Phenomenology of tics and natural history of tic disorders.

Tic symptoms, the hallmark of Tourette's syndrome (TS), may simply be fragments of innate behavior. As such, the sensory urges that precede tics may illuminate some of the normal internal cues that are intimately involved in the assembly of behavioral sequences. The occurrence of tics in time appears to have fractal characteristics that may help to explain the waxing and waning course of tic disorders. Longitudinal studies are currently underway that should permit a close examination of the natural fluctuations in tic severity using valid and reliable clinician-rated scales of tic severity. The natural history of tics typically shows a marked decline during the course of adolescence. However, TS can also be associated with social, emotional, and academic difficulties in early adulthood. Comorbid attention deficit/hyperactivity disorder and obsessive-compulsive disorder are likely to influence the long-term adaptive outcomes of individuals with TS. Future progress may also be expected as endophenotypes, and possibly genetic markers, are identified that are associated with specific comorbid conditions and etiologically distinct forms of TS.