Musical features and interactional functions of echolalia in children with autism within the music therapy dyad

The purpose of this study was to examine the phenomenon of echolalia in children with autism spectrum disorder (ASD) through a musical and intersubjective prism. Echolalia, a parrot-like speech symptom, where the child repeats others’ current or past words, is frequently used by children on the spectrum. In only a few studies in the literature is echolalia considered as part of the child’s behavior within a dyad. Moreover, the musical aspects of this phenomenon have rarely been considered. Thus, we documented echolalia expressions in the context of music therapy, which combines musical and social interactions. We qualitatively micro-analyzed the intersubjective characteristics of 40 echoes of three children with ASD, and their musical attributes (pitch, volume, and rhythmic elements). Six interactive functions of echolalia were found: (1) echoing to regain emotional equilibrium, (2) echoing while maintaining focus, (3) echoing to explore sounds and words, (4) echoing to block or mask the other, (5) echoing to express strong emotional content, and (6) echoing as an attempt to initiate or maintain communication. These functions differ in their musical attributes for each child. An understanding of the experience that may lead a child to echo, and being acquainted with the recurring musical patterns in his or her echoing, can help clinicians who are puzzled by their clients’ echolalia in terms of both assessment and treatment. These findings are discussed in relation to those of previous studies on functions of autistic echolalia.