Ecolalia: what is it, causes and associated disorders

Alterations and injuries that affect brain structures involved in language, mimicry behaviors, and behavioral inhibition can cause the symptoms we know as ecophenomena, consisting of the repetition of movements or words that the no one has ever seen or heard it.

One of these symptoms is echolalia, in which words or phrases are imitated. In this article we will describe what is echolalia, what are its most common causes and what psychological and medical conditions are normally associated.

    What is echolalia?

    The term “echolalia” is used to denote the involuntary repetition of words spoken by other people. It is a characteristic symptom of various psychological disorders, both organic and functional, such as autism, aphasia and schizophrenia.

    The repetition can consist of a single word or, on the contrary, of very long messages; sometimes not only words or phrases are repeated, but monologues, conversations or entire songs. When the person imitates the others, we speak of palilalia.

    Ecolalia it is an ecophenomenonThat is, imitative behavior which occurs without conscious control. Two very common ecophenomena are ecopraxy, in which the actions or gestures of others are repeated, and ecomimic, consisting of imitating facial expressions.

    Types of echolalia

    The symptoms of echolalia are classified according to two criteria: the latency of the response (that is, the time it takes for recurrence to appear) and the intentionality of the behavior. So we can talk about immediate or delayed echolalia and functional or non-functional echolalia.

    Immediate echolalia, as the name suggests, occurs right after the person hears the vocalization. Delayed echolalia can occur at any time, sometimes there is a temporary distance of years between the original verbalization and imitation.

    According to the criterion of intentionality, we divide the ecological manifestations into functional ones, when the person has a communicative or self-regulating intention, And not functional, if the above conditions are not met.

    The causes of this phenomenon

    Imitative behavior, including echolalia, it is normal and adaptive in boys and girls, As they use it to acquire and internalize new behaviors. However, as language develops and the child learns cognitive self-regulatory skills, this phenomenon becomes less common.

    From the age of 3, echolalia can be a sign of an underlying disorder that affects language progression or behavioral inhibition; in this way, echolalia often appears in blind children, With learning difficulties or with a generalized developmental disorder.

    Echolalia in adults is generally considered pathological because it tends to be a manifestation of brain injury; is particularly associated with damage to the frontal lobe of the left hemisphere caused by genetic factors, trauma, stroke or other causes.

    In this sense, the supplementary motor area and the medial part of the frontal lobe seem particularly relevant. The role of so-called “mirror neurons”, which are triggered when one imitates the behavior of others, both outwardly and in the imaginary, has also been highlighted.

    related disorders

    There are many disorders they alter the functioning of language and behavioral inhibition and which are therefore likely to cause echolalia. Below, we will briefly describe the alterations most frequently associated with this phenomenon.

    1. Autism spectrum

    The concept of “autism spectrum disorders”, which was introduced in DSM-5, encompasses Asperger’s syndrome, childhood disintegrating disorder and Rett’s syndrome, in addition to Kanner’s autism and d. other common developmental disorders.

    This set of syndromes was probably a dysfunctions in mirror neurons derived from genetic causes. Autism spectrum disorders affect communication, social interactions and the extent of the behavioral repertoire and, in many cases, are accompanied by intellectual deficits.

    In the context of autism, the type of echolalia may vary depending on the intensity of the disorder and the specific situation. Thus, non-functional echolalia is more likely to occur in people with autism who cannot understand speech, while functional echolalia can be used to compensate for language difficulties. In these cases, immediate echolalia is common.

      2. Tourette syndrome

      Gilles de la Tourette syndrome is characterized by chronic and simultaneous presence of motor and vocal tics. One of the most well-known symptoms of Tourette’s syndrome is coprolalia, which is the impulsive uttering of obscene or socially incorrect words, although it only occurs in about 10% of cases.

      Likewise, and although less common than coprolalia, ecophenomena such as echolalia and ecopraxia also occur in this disorder. Palilalia is another possible symptom of Tourette’s syndrome.

      3. Aphasia

      Injuries from a stroke or head trauma often cause aphasia, a set of language disorders associated with brain damage. In these cases, echolalia it is usually compulsive and non-functional.

      Echolalia is particularly common in sensory transcortical aphasia, which occurs as a result of damage to the temporal lobe. In addition to echolalia, other characteristics of this type of aphasia are the presence of paraphasia (substitution of words with incorrect words) and the maintenance of verbal comprehension.

      4. Dementia

      Dementias are neurodegenerative diseases that cause progressive loss of cognitive faculties, especially memory. When the lesions affect areas of the brain involved in language and self-regulation, they can cause symptoms of echolalia similar to those of aphasia.

      Ecolalia is special common in frontotemporal dementias, Especially in Pick’s disease. Degenerative disorders affecting the basal ganglia, such as Parkinson’s disease, Huntington’s disease, and progressive supranuclear palsy, also frequently cause ecophenomena.

        5. Schizophrenia

        The DSM-IV defines schizophrenia as a chronic disorder characterized by the presence of hallucinations, delusions, disorganized language and / or emotional flattening, among other symptoms.

        One of the subtypes of schizophrenia is catatonic, Which implies alterations by excess or lack of movement. Echolalia and ecopraxia are common in catatonic schizophrenia.

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