Echolalia: what is it, causes and related disorders?

This phenomenon consists of the involuntary repetition of phrases or words pronounced by others.

Alterations and lesions affecting brain structures involved in language, imitative behaviors and behavioral inhibition can cause symptoms known 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 echolalia is, what its most common causes are and to which psychological and medical disorders it is usually associated.

What is echolalia?

The term "echolalia" is used to denote the involuntary involuntary repetition of words spoken by other people.. It is a characteristic symptom of various psychological disorders, both organic and functional, such as autism, aphasia and schizophrenia.

The repetition may consist of a single word or, on the contrary, of very long messages; sometimes not only words or phrases are repeated, but also monologues, conversations or entire songs. When the person imitates him/herself instead of others we speak of palilalia.

Echolalia is an echophenomenon, that is to say, an imitative behavior that occurs without conscious control. Two other very common echophenomena are ecopraxia, in which actions or gestures of others are repeated, and ecomimia, consisting of the imitation of facial expressions.

Types of echolalia

The symptoms of echolalia are classified according to two criteria: the latency of the response (i.e., the time it takes for the repetition to appear) and the intentionality of the behavior. Thus, we can speak of immediate or delayed echolalia and functional or non-functional echolalia..

Immediate echolalia, as its name indicates, occurs right after the person hears the vocalization. Delayed echolalia can occur at any time, sometimes there is a temporal distance of years between the original verbalization and the imitation.

Following the criterion of intentionality, we divide echolalic manifestations into functional, when the person has a communicative or self-regulatory intention. communicative or self-regulatory intentionand non-functional, if the above conditions are not met.

Causes of this phenomenon

Imitative behavior, including echolalia, is normal and adaptive in childrenThey 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 years and older, echolalia may be a sign that there is an underlying disorder affecting language progress or behavioral inhibition; thus, echolalia is often found in blind children, children with learning difficulties, and children with learning disabilities. in children who are blind, have 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; it is particularly associated with damage to the frontal lobe of the left hemisphere caused by genetic factors caused by genetic factors, trauma, stroke or other causes.

The supplementary motor area and the medial part of the frontal lobe seem to be particularly relevant in this regard. The role of the so-called "mirror neurons", which are triggered when we imitate the behavior of others, both externally and in the imagination, has also been highlighted.

Related disorders

There are many disorders that alter the functioning of language and behavioral inhibition and are therefore susceptible to and are therefore likely to cause echolalia. The following is a brief description of the disorders that are most commonly associated with this phenomenon.

1. Autism spectrum

The concept of "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 group of syndromes is probably due to dysfunctions in mirror neurons resulting from genetic causes.. Autism spectrum disorders affect communication, social interaction and the breadth of the behavioral repertoire, and in many cases are associated with intellectual deficits.

In the context of autism, the type of echolalia may vary depending on the intensity of the alterations and the specific situation. Thus, non-functional echolalia is more likely to occur in autistic individuals who do not understand speech, while functional echolalia may be used to compensate for linguistic difficulties. Immediate echolalia is common in these cases.

Tourette Syndrome

The syndrome of Tourette's syndrome is characterized by the 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 the cases.

Similarly, although less frequent 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 result in aphasia, a set of language disorders associated with brain damage. In these cases echolalia is often compulsive and non-functional in nature.

Echolalia is particularly common in sensory transcortical aphasia, which occurs as a consequence of temporal lobe lesions. 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.

4. Dementia

Dementias are neurodegenerative diseases that cause a progressive loss of cognitive faculties, especially memory. When lesions affect 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 common in frontotemporal dementiasespecially 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, delusional ideas, disorganized language and/or affective flattening, among other symptoms.

One of the subtypes of schizophrenia is catatonic schizophrenia.which involves alterations by excess or defect in the movement. Echolalia and ecopraxia are common in catatonic schizophrenia.