Sign Language Echolalia in Deaf Children With Autism Spectrum Disorder.

Purpose: We present the first study of echolalia in deaf, signing children with autism spectrum disorder (ASD). We investigate the nature and prevalence of sign echolalia in native-signing children with ASD, the relationship between sign echolalia and receptive language, and potential modality differences between sign and speech. Method: Seventeen deaf children with ASD and 18 typically developing (TD) deaf children were video-recorded in a series of tasks. Data were coded for type of signs produced (spontaneous, elicited, echo, or nonecho repetition). Echoes were coded as pure or partial, and timing and reduplication of echoes were coded. Results: Seven of the 17 deaf children with ASD produced signed echoes, but none of the TD deaf children did. The echoic children had significantly lower receptive language scores than did both the nonechoic children with ASD and the TD children. Modality differences also were found in terms of the directionality, timing, and reduplication of echoes. Conclusions: Deaf children with ASD sometimes echo signs, just as hearing children with ASD sometimes echo words, and TD deaf children and those with ASD do so at similar stages of linguistic development, when comprehension is relatively low. The sign language modality might provide a powerful new framework for analyzing the purpose and function of echolalia in deaf children with ASD.

A Multidimensional Reappraisal of Language in Autism: Insights from a Discourse Analytic Study.

In this article, we leverage theoretical insights and methodological guidelines of discourse analytic scholarship to re-examine language phenomena typically associated with autism. Through empirical analysis of the verbal behavior of three children with autism, we engage the question of how prototypical features of autistic language-notably pronoun atypicality, pragmatic deficit, and echolalia-might conceal competencies and interactional processes that are largely invisible in mainstream research. Our findings offer a complex picture of children with autism in their use of language to communicate, interact and experience others. Such a picture also deepens our understanding of the interactional underpinnings of autistic children's speech. Finally, we describe how our findings offer fruitful suggestions for clinical intervention.

Ecolalia y parálisis supranuclear progresiva, una asociación inesperada / Echolalia and progressive supranuclear palsy, an unexpected association

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Neumomediastino espontáneo tras accidente de motocicleta. Caso clínico y revisión de la literatura / Spontaneous pneumomediastinum following a motorcycle accident. Report on a case and review of the literature

Introducción: el neumomediastino espontáneo es una entidad muy rara. Presentamos un caso de esta enfermedad. Caso clínico: varón de 17 años de edad que, tras sufrir un accidente de motocicleta de baja energía, acudió a urgencias por cefalea relacionada con dolor en el cuello. En la exploración física se apreciaba ecolalia, así como amnesia retrógrada del episodio. Destacaba una crepitación a la palpación en la región anterior y lateral derecha del cuello. El resto de la exploración física por aparatos fue normal. Las pruebas de imagen realizadas mostraron aire en el trayecto de la vena yugular derecha. Con el diagnóstico de neumomediastino espontáneo, el paciente quedó ingresado en observación. Con el reposo y la medicación analgésica mejoró en las horas siguientes y se pudo darle el alta sin incidencias. Se presenta el caso y se hace una revisión de la literatura. Conclusiones: el neumomediastino espontáneo normalmente es una enfermedad benigna que suele resolverse favorablemente sin tratamiento(AU)

Introduction: The spontaneous pneumomediastinum is an extremely rare condition. We hereby present a case of this pathology.Clinical case17 year-old man who suffered a low-energy motorcycle accident and came into the emergency department complaining of headache and neck pain. Physical examination showed echolalia and retrograde amnesia and crepitation on the anterior and right lateral part of the neck. No other physical signs were found. Plain radiographs and a CT-scan showed air in the right jugular vein. With the diagnosis of spontaneous pneumomediastinum, the patient remained under observation. With rest and analgesia the patient improved within the next hours and was discharged without any complication. The case is presented and the literature is reviewed.ConclusionsSpontaneous pneumomediastinum is a normally benign pathology that tends to resolve favourably without any treatment (AU)

Two forms of spoken repetition in a girl with autism.

BACKGROUND: The talk of persons with autistic spectrum disorders (ASD) often features distinctive forms of repetition (echophenomena). Although often characterized as meaningless or inappropriate, there is evidence that such practices can sometimes have communicative functions. AIMS: To investigate the interactional organization of repetition practices found in the talk of an adolescent girl with an ASD. METHODS & PROCEDURES: As part of a project examining the interactional practices of children with ASD, we video-recorded 6 hours of activity in a school classroom for severe learning difficulty (SLD) children. This paper considers instances of repeated talk produced by a class pupil, 'Helen'. The analysis involved assembling a collection of examples of the repeated talk which were then transcribed in detail. Conversation Analysis was used to explore the sequential contexts in which they occur and precisely how they are produced. OUTCOMES & RESULTS: Two forms of repetition occur very frequently in Helen's talk: first, repeats of turn-final lexical items from another speaker's immediately before talk (prior-turn repeats, a form of immediate echolalia), and second, repeats of the first item within a turn such that a turn is produced consisting entirely of repeated items (within-turn repeats). The latter appears to be a form of palilalia (repeats of one's own prior talk) that has not been widely reported in ASD. The prior turn repeats follow other speaker's initiating actions (e.g. questions) that are addressed specifically to Helen and make a response from her relevant. Helen apparently uses these to demonstrate that she has nevertheless heard, and is orienting to, that prior turn. Within-turn repeats are tied to and bounded by the accomplishment of non-vocal activities, e.g. handing an object to a co-participant, such that the repetitions cease when the object has reached its recipient. The two forms of repetition frequently co-occur to display on-going engagement with a recipient's prior turn. CONCLUSIONS: Although Helen has limited verbal resources she is more interactionally competent than this may initially suggest. We propose that these repetition practices may constitute an adaptation to interacting with a limited lexicon. We discuss the relevance of Conversational Analysis for understanding autistic children's pragmatic competence, and the implications for remediation and further research.

Phenomenology of tics and natural history of tic disorders.

Tic symptoms, the hallmark of Tourette's syndrome (TS), may simply be fragments of innate behavior. As such, the sensory urges that precede tics may illuminate some of the normal internal cues that are intimately involved in the assembly of behavioral sequences. The occurrence of tics in time appears to have fractal characteristics that may help to explain the waxing and waning course of tic disorders. Longitudinal studies are currently underway that should permit a close examination of the natural fluctuations in tic severity using valid and reliable clinician-rated scales of tic severity. The natural history of tics typically shows a marked decline during the course of adolescence. However, TS can also be associated with social, emotional, and academic difficulties in early adulthood. Comorbid attention deficit/hyperactivity disorder and obsessive-compulsive disorder are likely to influence the long-term adaptive outcomes of individuals with TS. Future progress may also be expected as endophenotypes, and possibly genetic markers, are identified that are associated with specific comorbid conditions and etiologically distinct forms of TS.

Echolalic responses by a child with autism to four experimental conditions of sociolinguistic input.

Studies of the immediate verbal imitations (IVIs) of subjects with echolalia report that features of linguistic or social input alone affect the number of IVIs elicited. This experimental study of a child with echolalia and autism controlled each of these variables while introducing a systematic change in the other. The subject produced more (p less than .05) IVIs in response to unknown lexical words presented with a high degree of directiveness (Condition D) than in response to three other conditions of stimulus presentation (e.g., unknown lexical words, minimally directive style.) Thus, an interaction between the effects of linguistic and social input was demonstrated. IVIs were produced across all conditions, primarily during first presentations of lexical stimuli. Only the IVIs elicited by first presentations of the lexical stimuli during Condition D differed significantly (p less than .05) from the number of IVIs elicited by first presentations of lexical stimuli in other conditions. These findings viewed together suggest that the occurrence of IVIs was related, at least for this child, to an uncertain or informative event and that this response was significantly greater when the lexical stimuli were unknown and presented in a highly directive style.

Using structured discourse as a language intervention technique with autistic children.

A structured discourse strategy, employing child echoic imitations and adult expansion, was used to teach 5 autistic children two-term semantic relations. The 5 male preschoolers in late Stage I of linguistic development were exposed systematically to two-term semantic relations in a structured dialogue with a clinician. A combined multiple baseline and AB(A) design was used to examine the relationship between the clinician expansions and the children's subsequent spontaneous imitations and spontaneous productions. The results showed that an increase in modeling and expansion was related to an increase in the children's initial spontaneous imitations of two-term relations. Further, following the increase in spontaneous imitations, spontaneous productions of the two-term relations increased and were maintained, whereas spontaneous imitations subsequently decreased.

Echolalia and comprehension in autistic children.

The research reported in this paper investigates the phenomenon of echolalia in the speech of autistic children by examining the relationship between the frequency of echolalia and receptive language ability. The receptive language skills of 10 autistic children were assessed, and spontaneous speech samples were recorded. Analysis of these data showed that those children with poor receptive language skills produced significantly more echolalic utterances than those children whose receptive skills were more age-appropriate. Children who produced fewer echolalic utterances, and had more advanced receptive language ability, evidenced a higher proportion of mitigated echolalia. The most common type of mitigation was echo plus affirmation or denial.

The functions of immediate echolalia in autistic children: a developmental perspective.

This study examined differences in the use of immediate echolalia by autistic children at different stages of language development. Eighteen autistic children, aged 4 to 12 years, were videotaped in play sessions with a parent and with an examiner. Data were collected on frequency of echolalia, percentage of language that was echolalic, functions of echolalia (Prizant & Duchan, 1981), chronological age, nonverbal mental age, and language level. Frequency of immediate echolalia varied with expressive language level but not with nonverbal mental age or chronological age. The percentage of language that was echolalic was high at early stages of language development but decreased as language skills improved. No significant relationships were found between number of functions and language level, chronological age, or nonverbal mental age. Although coding of functions was reliable, the validity of functional categories for echolalia was not strongly supported. Implications for autistic language development and for methodology in this area are discussed.

Asperger's syndrome: a case report.

A case report is presented of an 11-year-old boy who has been diagnosed as having Asperger's syndrome. There follows a review of the clinical features, course, prognosis and management of this condition.

Setting effects on the occurrence of autistic children's immediate echolalia.

This study was designed to assess the effects of setting familiarity on autistic children's immediate echolalia. Six autistic boys were presented with a receptive labeling task in several settings varying in familiarity of person, room, and task stimuli. The amount of immediate echolalia emitted during the task in each of the settings was recorded. The results indicated that the greatest amount of echolalia occurred in settings in which an unfamiliar person presented unfamiliar task stimuli. The second greatest amount of echolalia occurred when a familiar person presented the unfamiliar stimuli. The results are discussed in terms of previous literature, classroom design, and treatment procedures for autistic children.

Learning and self-stimulation in mute and echolalic autistic children.

The effects of self-stimulation on task acquisition were studied in three mute low-functioning autistic and three echolalic higher-functioning autistic children in multiple-baseline designs. The study found that (a) the echolalic children were able to learn the task without external suppression of their self-stimulation and (b) the mute children were unable to learn the task until their self-stimulation was externally suppressed. It was suggested that the echolalic children may have acquired the ability to discriminate when to self-stimulate, so that their self-stimulation does not interfere with correct responding.

Language processing and forms of immediate echolalia in autistic children.

Several aspects of echolalic speech produced by five autistic children were investigated. We found that the incidence of echolalia was influenced by the type of question addressed to the child and, to a lesser extent, by the child's comprehension of the specific relationships expressed in the question. Additionally, acoustic analysis showed that a substantial proportion of echoes involved a prosodic modification of the examiner's question. Further analyses indicated that some of these modified echoes represent more than just a primitive conversational strategy. Specifically, they seem to reflect a higher level of processing and serve a semantic function, that of affirming the examiner's question.