Echolalia: What It Is, Causes And Related Disorders
Alterations and lesions that affect the brain structures involved in language, imitative behaviors and behavioral inhibition can cause symptoms that we know as echophenomena, consisting of repeating movements or words that the person has previously seen or heard.
One of these symptoms is echolalia, in which words or phrases are imitated. In this article we will describe What is echolalia, what are its most common causes? and what psychological and medical disorders it is normally associated with.
The term “echolalia” is used to refer to the involuntary repetition of words said by other people. It is a characteristic symptom of different psychological disorders, both organic and functional, such as autism, aphasia and schizophrenia.
Repetition can consist of a single word or, on the contrary, very long messages; Sometimes not only words or phrases are repeated, but monologues, conversations or entire songs. When the person imitates themselves instead of others we speak of palilalia.
echolalia It is an ecophenomenon, that is, an imitative behavior that occurs without conscious control. Two other very common ecophenomena are echopraxia, in which actions or gestures of others are repeated, and ecomimia, consisting of the imitation of facial expressions.
Types of echolalia
Symptoms of echolalia are classified based on two criteria: the latency of the response (that is, the time it takes for the repetition to appear) and the intentionality of the behavior. Thus, we can talk about Immediate or delayed echolalia and functional or non-functional echolalia.
Immediate echolalia, as the name suggests, occurs right after the person hears the vocalization. Delayed echolalia can occur at any time, sometimes with a temporal distance of years between the original verbalization and the imitation.
Following the criterion of intentionality, we divide echolalic manifestations into functional ones, when the person has a communicative or self-regulatory intention and non-functional, if the previous conditions are not met.
Causes of this phenomenon
Imitative behavior, including echolalia, It is normal and adaptive in boys and girls since they use it to acquire and internalize new behaviors. However, as language develops and the child learns cognitive self-regulation skills, this phenomenon becomes less common.
From the age of 3, echolalia can be a sign that there is an underlying disorder that affects the progress of language or behavioral inhibition; In this way, echolalia frequently appears in blind children, with learning difficulties or with a pervasive developmental disorder.
Echolalia in adults is generally considered pathological because it tends to be a manifestation of lesions in the brain; is particularly associated with damage to the frontal lobe of the left hemisphere caused by genetic factors, trauma, stroke or other causes.
In this sense, the supplementary motor area and the medial part of the frontal lobe seem to be especially relevant. The role of the so-called “mirror neurons” has also been highlighted, which fire when we imitate the behavior of others, both externally and in the imagination.
Related disorders
There are many disorders that alter the functioning of language and behavioral inhibition and therefore are susceptible to causing echolalia. Below we will briefly describe the alterations that are most commonly associated with this phenomenon.
The concept “autism spectrum disorders,” which was introduced in the DSM-5, encompasses Asperger syndrome, childhood disintegrative disorder, and Rett syndrome, in addition to Kanner’s own autism and other pervasive developmental disorders.
This set of syndromes is probably due to dysfunctions in mirror neurons derived from genetic causes. Autism spectrum disorders affect communication, social interaction and the breadth of the behavioral repertoire, and in many cases they cause intellectual deficits.
In the context of autism, the type of echolalia can vary depending on the intensity of the alterations and the specific situation. Thus, non-functional echolalia is more likely to occur in autistic people who do not understand speech, while functional echolalia can be used to compensate for linguistic difficulties. In these cases, immediate echolalia is common.
2. Tourette syndrome
Tourette syndrome is characterized by chronic and simultaneous presence of motor and vocal tics. One of the best-known symptoms of Tourette syndrome is coprolalia, which consists of the impulsive emission of obscene or socially incorrect words, although it only occurs in approximately 10% of cases.
Similarly, and although they are less common than coprolalia, echophenomena such as echolalia and echopraxia also occur in the context of this disorder. Palilalia is another possible symptom of Tourette syndrome.
3. Aphasia
Injuries due to stroke or traumatic brain injury often cause aphasia, a group of language disorders associated with brain damage. In these cases echolalia It usually has a compulsive and non-functional nature.
Echolalia is particularly common in sensory transcortical aphasia, which occurs as a consequence of lesions in the temporal lobe. In addition to echolalia, other characteristics of this type of aphasia are the presence of paraphasias (substitution of words for incorrect ones) and the maintenance of verbal comprehension.
Dementias are neurodegenerative diseases that cause a progressive loss of cognitive abilities, especially memory. When lesions affect the brain regions involved in language and self-regulation, they can cause symptoms of echolalia similar to those of aphasia.
Echolalia is especially common in frontotemporal dementias especially in Pick’s disease. Degenerative disorders affecting the basal ganglia, such as Parkinson’s disease, Huntington’s disease, and progressive supranuclear palsy, also frequently cause echophenomena.
5. Schizophrenia
The DSM-IV defines schizophrenia as a chronic disorder characterized by the presence of hallucinations, delusions, disorganized language and/or affective flattening, among other symptoms.
One of the subtypes of schizophrenia is catatonic. which involves alterations due to excess or defect in movement. Echolalia and echopraxia are common in catatonic schizophrenia.
