A person with attention deficit hyperactivity disorder (ADHD) can present with a variety of symptoms, including issues with language. One such language issue is echolalia, which refers to the repetition of words or phrases spoken by others.

In addition to issues with attention, impulsivity, and hyperactivity, people with ADHD may also experience language difficulties that can affect verbal and nonverbal communication.

Although speech and language disorders are not diagnostic features of ADHD, some evidence notes a prevalence of them among children with ADHD.

One such language issue is echolalia, also known as echophrasia or parroting. Echolalia is the repetition of words or phrases spoken by others. While this behavior is normal in young children, many outgrow it as their language skills develop.

In this article, we discuss echolalia, including how it relates to ADHD.

A caregiver playing with a child.Share on Pinterest
Silke Enkelmann/EyeEm/Getty Images

The term echolalia derives from the Greek roots “echo” (to repeat) and “lalia” (speech). Individuals with echolalia repeat words or phrases they hear someone else say.

Echolalia is a normal part of language development in toddlers. However, echolalia in older children may be a sign of another condition. For example, nearly 75% of children with autism spectrum disorder (ASD) may exhibit signs of echolalia.

After hearing an adult ask, “Do you want to go outside?” a child with echolalia may mimic them and repeat the last part of speech in the same intonation, saying, “Go outside?”

A child experiencing typical language development would be more likely to state, “Go outside!” This expression would sound more like a declaration in response to the adult’s question.

Echolalia is often associated with ASD, but some individuals with ADHD may also engage in echolalia. The symptoms of ASD and ADHD are similar, which often makes diagnosis difficult. Additionally, some evidence notes that 50–70% of individuals with ASD also present with ADHD.

Although echolalia is more common in individuals with ASD, it can also occur with ADHD. The ADHD symptoms of impulsivity, inattention, and hyperactivity may negatively affect language development.

People with ADHD often have difficulty following verbal instructions. They may find it challenging to follow along during long conversations or classroom lectures. The sensory sensitivities associated with ADHD may also play a role. Some research suggests that people with ADHD are especially sensitive to sounds.

This sensitivity, combined with impulsivity, may lead to echolalia. Difficulty processing language and following conversations could also lead individuals with ADHD to repeat phrases they hear.

The two main types of echolalia are immediate and delayed echolalia. Immediate echolalia involves the immediate repetition of speech. With delayed echolalia, an individual will repeat speech they have heard at a later time.

People with echolalia may repeat exactly what they hear, or they may alter the speech before repeating it. Unmitigated echolalia refers to exact repetition, while mitigated echolalia refers to altered repetition.

In some cases, people may repeat sounds they hear in a particular environment. This could include speech from a television show or sounds heard while driving in a car. This type of echolalia is ambient echolalia. These individuals may also exhibit echoing. Unlike ambient echolalia, echoing involves the exact repetition of phrases and intonations they hear.

Developmental conditions such as ASD may cause echolalia. However, echolalia is also a normal part of speech acquisition in young children.

Causes of echolalia with ADHD

Children with ADHD may have issues with attention, working memory, and executive function. These skills are all important for healthy language development. Difficulties in these areas may lead to language disorders, such as echolalia.

To learn a new word, a child must be able to focus on that word while associating the word with its meaning. Children with ADHD may have difficulty sustaining the attention needed for this process.

Symptoms of echolalia

An individual with echolalia may repeat certain words or expressions again and again. This could happen immediately after hearing these phrases or after a delay.

They may also repeat certain noises that they have heard during conversations or while exploring different environments. Instead of answering a question, they may repeat that question. During repetition, they may use the same intonation patterns they originally heard.

Because echolalia can be a sign of a developmental condition, children with echolalia may be repeating phrases as a way of engaging in conversation. If this is the case, they could become more easily frustrated when trying to join conversations. They may also avoid speaking in conversations altogether.

A medical professional can provide a diagnosis of echolalia after performing an evaluation. During this evaluation, they will look for signs of echolalia that may include:

  • repeating speech without directing it at another person
  • rehearsing phrases or “thinking out loud”
  • directing commands at themselves
  • repeating questions instead of answering them

Depending on the individual, echolalia may indicate the presence of ASD, ADHD, or both. If a medical professional suspects either of these conditions, they can refer an individual for further testing.

Individuals with ADHD and echolalia, or other speech and language problems, often benefit from working with a speech-language pathologist (SLP). An SLP can help an individual work through challenges with language, social communication, and speech. They can also help children learn about taking turns and how to listen during conversations.

Researchers have found that music therapy can help in treating echolalia. People with language difficulties may have an easier time communicating through music than through words. Many SLPs also use music therapy in their work. Learning communication and self-expression through music may help people with echolalia improve their language skills.

Individuals with ADHD may experience speech and language difficulties. These may include echolalia, or the repeating of words or phrases spoken by others. While echolalia is more common in individuals with ASD, it can also occur in those with ADHD. The attention difficulties faced with ADHD may cause additional challenges during language acquisition.

An SLP can help people with echolalia improve their language skills. With the proper support, individuals dealing with echolalia can become more proficient and confident in their speech and language abilities.