Delayed Echolalia and Scripting in Children with Autism

Many kids with autism who have some language but are not conversational say lines from movies and pat phrases repetitively. We call this scripting or delayed echolalia. So today I’m going to cover why kids with autism script so much and give some strategies to reduce it if it becomes a problem.

Each week I provide you with some of my ideas about turning autism around. So, if you haven’t subscribed to my YouTube channel, you can do that now. Delayed echolalia was one of the first signs of autism in my son Lucas when he was under two years old before I was aware that he was showing signs of autism. My husband and I used to take Lucas to the park and read to him. They had signs there that said, “Please do not feed the ducks.” So, my husband would read this sign and he would add “quack, quack”. Then Lucas would run to the next sign which was several feet down the way and my husband would again read the sign, “Please do not feed the ducks. Quack, quack.”

A week or two after we would go to the park, in the middle of the night, Lucas might wake up and he would say, “Please do not feed the duck. Quack, quack.” I actually counted these eight words and I added them to Lucas’s list of 20 words that he said pretty consistently, not realizing that these eight words were not functional and were actually a sign of autism. This sign was called delayed echolalia.

How bad can this repetition in speech get?

Over the years as a Behavior Analyst, I’ve had clients with a lot of scripting and delayed echolalia. One former client named Alex scripted 500 times a day when I first started with him. Another client was having trouble reciting road names and traffic sign details. For many of my clients, scripting lines from favorite movies is a really big issue that interferes with home and school life.

Like in the case of Alex who scripted 500 times per day when he was in sixth grade, this high level of delayed echolalia even effected our job placement decisions for him. Parents and teachers don’t know how to deal with delayed echolalia or scripting, so I’m going to cover some things to think about. Before we start talking about this as a problem behavior or strategies to fix it, I do want to point out that the fact that if children are talking and saying anything, even if they’re scripting from the same movie over and over again, the fact that they’re talking is a good thing. It’s just an issue if it happens at high rates and interferes with functional communication.

If I have my choice between a totally silent child who’s not talking at all or a child that’s scripting constantly, I would have more success working initially with the child who is scripting. This is because we know that they can speak and it’s just a matter of getting that language under some instructional control when the floodgates will open.

Is there an echolalia treatment plan that I can put in place?

The first step in reducing scripting or delayed echolalia would be assessment. What does the child say at all? What do they say repetitively? When does the scripting happen? Is it when they’re alone or when you’re trying to engage them in other tasks and how often does it occur?

Lucas doesn’t script a lot anymore but just yesterday, he said, “Please do not kick.” We have no idea where this came from as he’s never had a problem with kicking and I don’t think anyone, especially me, has ever said “Please do not kick” to Lucas. He may have heard it with another kid years ago but once in a while, about every month or so, we’ll hear, “Please do not kick.” It’s kind of out of the blue and it’s definitely not a problem. Also, yesterday he said, “It’s okay. It’s not going to hurt,” when he banged his elbow while we were shopping.

We have to make a plan for scripting. For Lucas it’s not an issue and we want to make sure that everybody is following the plan. For Lucas ignoring the “Please do not kick” is what we do. But for the second script that he said yesterday, “it’s not going to hurt,” I realized that, that script actually told me that he had hurt himself. So, I asked him what he had hurt, and I transferred that language into “I hurt my elbow.” Dr. Vincent Carbone, who I’ve learned a ton from over the years, is a Behavior Analyst, he gives lectures, and talks about the three buttons. I did a video blog on the three buttons theory many months ago, so you may want to check that out now.

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He described the three buttons of engagement with a child with autism and that the middle button with them responding without any problem behaviors means that you have the right language, the right directions at the right level with the right reinforcement. You’re going to want to see that middle button being pushed. If you don’t have everything right, the skills that you’re trying to teach are too hard or too easy or you don’t have the right level of reinforcement. So, either you’ll see escape, like, this is boring, I want to be done, when can we be done, and they might actually fall to the ground or run away from you. Or you will have that other button on the other side which is self-stimulatory or scripting behavior.

You might be trying to teach the child something or engage with the child and they are scripting. So, if you use Dr. Carbone’s three-button theory, that self-stimulatory behavior, scripting, is a problem behavior and it does interfere with our middle button of great language and great instructional control. With Alex, we were able to use that three-button theory, and in fact, for all of my clients who are talking but not conversational and who have problems with scripting, we really analyze things from those three buttons. If we get a lot of scripting or a lot of escape, either verbalizations or physical movements of escape, we have to think that it’s our analysis that needs to be sharper, our teaching procedures that need to be better, and our reinforcement systems that need to be better.

So, with Alex we were able over time to get his scripting and his delayed echolalia down from 500 a day to a single digit. Another client I had, I did a functional behavior assessment on across three different settings. When I started with her at age five, during 90% of the intervals she had some level of self-stimulatory and scripting behavior. We were able to take that client and get her down from 90% of the intervals with scripting and self-stimulatory to zero. So, what did I do? What did we do to get this scripting and delayed echolalia down? It involved years of great ABA, systematic step-by-step programming, thinking about the three buttons, thinking about reinforcement, the right level of demands and the right reinforcement.

If you watched the video or read this post, I’d love it if you would leave me a comment, give me a thumbs up, and share the video/post with others who might benefit. To get started using my approach, and learn more about how to help children with autism, you can sign up for one of my free online workshops today that will help you increase language and decrease problem behaviors in your child or client with autism. I’ll see you right here next week.

Want to get started on the right path and start making a difference for your child or client with autism?
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