1. Lisa R. Audet, Ph.D., CCC-SLP Kent State University laudet@kent.edu
Expressive Language Assessment and Intervention for Children with Echolalia
Lisa R. Audet, Ph.D., CCC-SLP
Kent State University

2. Language Defined A generative, shared, rule governed symbol system.
Generative: novel utterances can always be produced
Shared: A culture or community agrees to the system
Rule Governed: sentence structure and pragmatic rules are intrinsic to all languages
Symbol: words are arbitrarily assigned to represent ideas/concepts

3. Echolalia Defined
Immediate or deferred expressive production of what has been said before where both the linguistic and non-linguistic features are repeated
May reflect lack of comprehension skills
May serve a pragmatic function
May serve as a practice or self-calming tool

4. Research Design
Purpose: To compare the spontaneous language to echolalic language in children with autism
Assessment: CARS (Schopler); REEL (Bzoche-League); CSBS Parent Interview; MacAuthor Scale.
Method: language samples were collected on 6 children dx with autism ages 5-9 who demonstrated echolalia in a variety of contexts:
10 minutes sensory motor play
10 minutes cause effect play
10 minutes pretend play
10 minutes shared book reading
10 minutes child choice

5. Language Sample Analysis
Samples were transcribed and analyzed using SALT (Miller)
Spontaneous utterances were separated from echolalia utterances
Average Sentence Length (MLU) was calculated for spontaneous
MLU was calculated for echolalic utterances

6. Findings All children had higher echolalic MLUs than spontaneous MLUs
Echolalic Mean=3.412; ELA=37.9m
Spontaneous Mean= 2.343; ELA= 29.3m
5 out of 6 children produced the most spontaneous utterances during pretend play

7. Questions
Can Spontaneous MLU be compared to scores on assessment given?
What type of assessment would be appropriate to use to compare receptive and expressive language age with MLU? How would spontaneous and echolalic MLUs compare with receptive and expressive language functioning?
How does MLU compare with performance on the CARS? How would it compare to performance on ADOS, ADI?
Why did so many children produce more language during pretend play?
What type of context would elicit the most reliable language samples from children with autism?

8. Additional Questions
If language sampling proves to be a viable assessment instrument for children with autism who have echolalia…
What type of intervention would increase spontaneous language?
When would the focus of intervention be to increase frequency of spontaneous without regard to length or grammar?
When would the focus of intervention be to increase spontaneous MLU?

9. A Case for Language Sampling
Evidenced Based Practice principles encourages continuous evaluation of intervention.
In absence of a full body of research data collection becomes the Evidence
NRC evaluation of the literature indicates limited assessment of treatment and targeted skills in naturalistic/generalized context
Individuals with ASD are known to have difficulties with generalization

10. A Case for Language Sampling Cont.
Language Sampling is Data
Language Sampling when done at regular intervals is representative
Language Sampling allows for assessment of skills in a generalized context

11. Principles of Language Sampling
Use time or number of utterances for the sample and keep this consistent
Calculate MLU and do other analyses when at least 50% of spontaneous utterances are single words
Use Rescorlia Vocabulary Checklist when child has fewer than 50 spontaneous single words
Child must have at least 75 words on the Rescorlia to begin to combine words spontaneously
Use the Rescorlia as the data collection system at regular intervals

12. Using Assigned Structural Stages
Developed by Jon Miller (based on N=123)
Based on Brown’s Stages
Once MLU is identified using A.S.S. correlate other goals with morphological and syntactic expectations

13. Application
Use language sample to evaluate expressive language of children with autism
Analyze sample for:
% spontaneous v. % echolalic
MLU spontaneous v. MLU echolalic
Use language sample as a pre-post assessment instrument
Focus on increasing frequency v. increasing length for children who have more echolalic v. spontaneous productions
Keep data on how MLUs change as frequencies change

14. Sample
Randy produces 5 utterances in a 20 minute interval during a supervised peer play activity.
4 of the utterances are echolalic; 1 is spontaneous.
The echolalic utterances are 5 words in length. The spontaneous utterance is a single word
All utterances serve the pragmatic function of requesting

15. Sample
Objectives:
Randy will use verbal means to protest, request, greet, and comment 7 times in a 20 minute period.
Randy will respond to other’s verbal initiated acts with a single word on 7/10 occasions during a 20 minute interval
Focus: Increasing pragmatic functions
Increasing frequency of productions

16. Sample 2 Jacob produces 30 utterances in a 20 minute
MLU for spontaneous is 1.5
MLU for echolalic is 2.7
Frequency of spontaneous is 18
Frequency of echolalic is 12
Functions of productions is to request, protest

17. Sample 2 Objectives: Jacob will increase spontaneous MLU to 2.0
Jacob will use spontaneous language to provide information answering “What doing” questions
Jacob will increase frequency of spontaneous utterances to 75% of a sample collected during a 20 minutes supervised peer play session

18. Considerations
Continue to use echolalic productions to increase readability of communicative act
However, use caution in teaching and reinforcing rote utterances as sole intervention (Avoid the “I want more X please” Syndrome)
Reinforce spontaneous utterances using responsive elaboration and expansion techniques

19. Linguistic Mapping Method to increase receptive language
Method to code communicative intent
Method to increase spontaneous language
Grounded in information processing, semantic-cognitive, and social pragmatic theory
Developed by Lisa Audet

20. Linguistic Mapping Sequence
Initial Phase
Child communicates via echolalia or non-verbal means; adult codes the intent with carrier phrase: “(child’s name) says” 1-3 words to express the intent (e.g. get top) and meets the child’s needs.

21. Second Phase Child communicates via echolalia or non-verbal means;
Adult responds with carrier phrase: “(child’s name) says”
Adult uses expectant wait.
Meets the child’s needs after the child produces an utterance.
Accepts and shapes all productions.

22. Final Phase Child signals intent,
Adult uses expectant wait and meets the child’s need following production.
Adult uses elaboration and expansion to shape productions.

23. Final Phase Child signals intent,
Adult uses expectant wait and meets the child’s need following production.
Adult uses elaboration and expansion to shape productions.