Gestalt language processing and echolalia in children: what repeated phrases mean

A Cadabam's CDC speech therapist explains gestalt language processing and echolalia: what repeated phrases can mean and what parents can say instead of correcting.

Some children learn language in whole phrases first and break them into words later. This is called gestalt language processing, and repeating phrases is called echolalia. Rashmi R, Speech Therapist at Cadabam's CDC, says the repeated phrase usually carries a meaning for the child, even when it does not fit the moment. The aim is not to stop the phrase but to understand what the child is trying to say, then model the words they could use.

Two ways of learning language

Most children are described as learning language in this order: sounds, words, phrases, sentences. Rashmi R explains that a gestalt language processor learns in the reverse order. They take in whole sentences or phrases first, then phrases, then separate words, and finally sounds. The phrases are often something they have heard, from a cartoon, from a parent or from a person nearby, and the child may or may not know what each word means. For the usual path into speech, see communication milestones from birth to three years.

What a repeated phrase can mean

A single phrase can carry several meanings. Rashmi gives the example of "let's go, bye bye". It can mean "let's leave", "I am done", or "stop". Parents and professionals who do not know this may think the child is saying something unrelated. She suggests sitting down, writing down the phrases, noting where and how often each is used, and working out the meaning in each situation. Phrases can also change from day to day.

Explaining it to parents who have not noticed

Many parents find this hard to accept because they have not seen the chunks. Rashmi uses everyday examples parents can recognise: a child repeats dialogue from a cartoon, or says "bye-bye, we are going" because a parent said it once when leaving. The phrase was learned in one context and is being used in another. Her message to parents is that the phrase is meaningful to the child, and the intent is what matters.

The goal is not to stop the phrases; it is to understand what the child is trying to communicate.

Echolalia: immediate and delayed

Echolalia is the repeating of words or phrases. In immediate echolalia a child repeats what has just been said: you ask "What is your name?" and the child says "What is your name?". In delayed echolalia the phrase appears later, from something heard earlier, and it is harder to know where it came from or what it means. Rashmi points out that when a child repeats a question, it often means the child has not understood it. Asking the same question again and again does not help.

What to do at home

Model the answer, do not ask again. If you ask, "Do you want a snack?" and the child repeats the question, say, "I want a snack." Say the words the child could use, rather than "say I want a snack".
Add one word. If the child says "ball", say "big ball", "let's throw the ball".
Use real-situation phrases. More, let's go, finished, I want.
Acknowledge any attempt. "Good try" and a response to what the child meant.
Work out the meaning. Keep a short list of the phrases, when they appear, and what the child seemed to want.
Do not force. Give a model. Do not expect the child to repeat it immediately.
Pause and wait a few seconds for a response.

How speech therapy works with other therapists

When a child's phrases do not make sense to the other therapists, speech therapy helps the team understand. Rashmi describes telling the occupational and behaviour therapists that a child is a gestalt language processor, and helping them work out what a phrase means in each situation. They also rephrase their instructions as soft statements and model the language the child could use. See demand-avoidant profile in children for an example of how the team works together.

When to ask for an assessment

Ask for a speech and language assessment if your child mostly uses repeated phrases and rarely uses their own words to ask for things, does not seem to understand questions, or if you are unsure what their phrases mean. Cadabam's CDC speech therapists see children and adults. Book an appointment or call 95355 85588. Learn more about speech and language delays in children.

Frequently Asked Questions

What is gestalt language processing?

It is a way of learning language in which a child takes in whole phrases or sentences first and only later breaks them into words and sounds. Rashmi R, Speech Therapist at Cadabam's CDC, describes it as the reverse of the usual order of sounds, words, phrases and sentences.

What is echolalia?

Echolalia is the repeating of words or phrases. It can be immediate, repeating what was just said, or delayed, repeating a phrase heard earlier.

Why does my child repeat questions instead of answering?

Often because the child has not understood the question, or does not know what to answer. Asking again and again does not help. Say the answer for the child instead, for example I want a snack.

Should I stop my child from repeating phrases?

Rashmi R advises against it. The aim is to understand what the child is trying to communicate and then model the words they could use in that situation.

Can one phrase mean many things?

Yes. A phrase such as let us go, bye bye might mean let us leave, I am done, or stop. Noting when the child uses it helps work out the meaning.

What can I do when my child uses only single words?

Expand the word: if the child says ball, say big ball, let us throw the ball. Do not force the child to repeat it; acknowledge every attempt.

Does repeating phrases mean my child has autism?

Repeated phrases can be part of how some children learn language. Only an assessment can tell you what they mean for your child. See also speech delay or autism: key differences and autism in children.

Support at Cadabam's CDC

Speech and language therapists at our three centres, JP Nagar, Kalyan Nagar and Kanakapura Road, work with children and their parents as part of a multidisciplinary team. Book an appointment or call 95355 85588, Monday to Saturday, 9 am to 7 pm.

This article shares the perspective of Cadabam's CDC professionals. It is general information and does not replace an assessment.

Gestalt language processing and echolalia in children: what repeated phrases mean | Cadabam's CDC