Conversations on echolalia: A qualitative inquiry into autistic adults’ views on echolalia, language, and music

ABSTRACT

Introduction

Considering the growing influence of the Neurodiversity movement on the literature on autism, we attempted to shed a new light on autistic echolalia in music therapy by exploring the topic from an identity-first viewpoint. We interviewed autistic adults and studied this phenomenon from their perspective.

Method

Five adults on the autism spectrum were interviewed. For the data collection phase, Reductive Phenomenology was used. The participants were asked to reflect on the need to echo as they understand it and discuss possible reasons that may lead autistic clients to echo during music therapy. They were also asked about musical aspects that echolalia may have. For the analysis of the data, the guidelines of Interpretative Phenomenological Analysis were followed to extract themes and categories from the data.

Results

The interviewees pointed at two main reasons for echolalia in their opinion: (a) intra-personal reasons that mainly function to self-regulate the echoing person; and the much less frequently mentioned (b) inter-personal reasons that relate to interactions with others. They also pointed at several connections between music and echolalia, for example, the heightened awareness to the prosody of words rather than their content and the use of songs as echolalia.

Discussion

The information provided by the interviewees is compared to descriptions of echolalia in the literature. Enabling the participants to share their autistic experience, we believe, is an opportunity to hold back preconceived assumptions about echolalia made by non-autistic music therapists and other professionals, and to help them improve their clinical understanding of echolalia.

KEYWORDS:

• Autism spectrum
• echolalia
• interpretative phenomenological analysis
• reductive phenomenology
• neurodiversity movement
• music therapy

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

¹ We use the term “echolalia” to describe the phenomenon in general, whereas the term “echoing” is used as a verb, to describe the action itself.

² In recent years there has been a growing discontent within the autism self-advocacy community regarding the tendency of non-autistic people to use person-first language when referring to people on the autism spectrum (i.e. to say “a person with autism”, rather than “autistic person”). One compelling argument against such “politically correct” labelling is that it belittles the autistic component of people’s identity, ignoring the unique ways they experience the world due to their neurological makeup (e.g. Brown, 2011; Hector, 2021; Ryan, 2019). In light of that, in this article we shall refer to people diagnosed with ASD using identity-first language, namely, we shall refer to them as “autistic people” or as “people on the autism spectrum” interchangeably and not as “people with autism.”

³ Gestalt language-processing style is one form of language development (which is not necessarily unique to autism), in which some children learn “chunks” of language first, before learning the individual words of which they are comprised. Only later on, Gestalt learners learn to break down the phrases, realize the meanings of words within them, and build new, creative, and spontaneous utterances of their own (American Speech-Language-Hearing Association [ASHA], n.d.).

⁴ This study was part of a doctoral dissertation of the first author of this study, supervised by authors 2 and 3.

⁵ Bibliotherapy is a form of therapy which aims to promote mental health through the use of guided reading of literary texts such as books, short stories, poetry, and more (Pettersson, 2018). In our country it is considered one of the main Expressive Arts Therapies, thus, music therapists and bibliotherapists often work alongside each other as colleagues in various institutions.

Additional information

Funding

No funding was received for this study.

Notes on contributors

Maya K. Marom

Maya Kressel Marom has been a music therapist since 1998, with experience in working with various client populations: adolescents with learning disabilities, adult psychiatry, oncology, older adults, and hospice. In 2005, she started working with clients on the autism spectrum, and it had since become her preferred, and sole, client population. She works with elementary school children who are diagnosed with ASD, and also supervises music therapy practicum students at her school. She is currently a level 3 DIR® practitioner and works towards completing the final stage of certification in this model. This paper summarizes one part of her doctoral research from Bar Ilan University, Ramat Gan, Israel. Since graduating from Bar Ilan’s PhD program, she has been teaching music therapy courses at the David Yellin Academic College of Education in Jerusalem.

Avi Gilboa

Avi Gilboa is a music therapist with experience working with various clinical populations. He is head of the music department at Bar-Ilan University and head of the music therapy program in this department. He is involved in many community-based projects, among which are the school of dialogue, and “Mus-Equality” – an academic musical program for adults with disabilities and passion for music-making. Prof. Gilboa supervises many MA and PhD students, some of which are part of the music therapy program, others – in the more general fields of music psychology and music education. Prof. Gilboa publishes articles in various music therapy journals and recently published a co-edited book about mistakes in music therapy.

Ehud Bodner

Ehud Bodner is a full professor of psychology at the Department of Social and Health Sciences and the Music Department, Bar Ilan University, Ramat Gan, Israel. He is also a Clinical and a Medical Psychologist and a supervisor in both fields. He is working in private practice with younger and older patients, suffering from various anxiety disorders, somatization, depression, and personality disorders. In the field of psychology of music, he is studying emotion regulation through music in younger and older adults. In the field of Gerontology, his research concentrates on models delineating the relationship between ageism and other perceptions of aging, personal resources and various aspects of health and mental health among older adults. An additional aim of his studies is to uncover factors which are associated among older adults with end of life anxieties, and with subjective perceptions of time (such as subjective age and subjective nearness to death).