My 5 year old son

[May_1976]

Dear Doctor,

I have a son who is almost five. He can speak and understand but defiantly below the level of someone his age. He is defiantly improving and is even starting to write.
His teacher told me that she underestimated him when he started school but she complaines that he has a short attention span.
I have never felt that there was anything wrong with him. He was always a happy kid, loves to play, very passionate, loves to hug, kiss, cuddle, and loves his friends at nursery and school. (No apparent signs of autism at least not for me)
He started walking at 14 months of age. I felt he was always a little bit behind.
My concern these days is that he sometimes repeats things he heard, conversations, songs he learned from school.
I thought it was a sign that he has a good memory but sometimes it concerns me. Is this "delayed echolalia"?
No one has ever suspected anything wrong with him or even asked me to evaluate him.
Some people told me to take his to speech therapy, which I did. The therapist didn’t suspect anything either.
Should I be worried? Any concerns?

[Sally44]

I am a parent of a 7 year old high functioning autistic child and I would disagree with the expert when she says the repeating of dialogue is inappropriate for the situation.  That is not true.  Indeed the higher the cognitive level of the child the more appropriate it is and in some circumstances it can fool professionals into thinking that they have advanced verbal skills.  An experienced Speech and Language Therapist who has experience of autistic spectrum disorders as well as speech impairments should be able to assess his speech and communication and social interaction skills.
Out of interest, also google Semantic Pragmatic Speech Disorder to see if that is relevant.
Other indications are speaking with an accent.  For example my son is English but speaks with an American accent.  Also strange voice intonation or inflextion or emphasis or how words are pronounced.
Echolalia is also an indication of a top down learning style rather than a bottom up learning style.  It means they learn things whole or in chunks rather than putting pieces of information together and analysing it.  If that is the case then his school work needs to be differentiated to take this different learning style into account.  

[Eileen Roscoe, PhD]

Delayed echolalia involves repeating words, sounds, or phrases that are inappropriate to the current context. Delayed echolalia often interferes with learning and may serve as a form of self stimulation. I recommend that you identify a hospital in an urban area where they specialize in diagnosis of children with autism and other developmental delays. A comprehensive evaluation by a team of specialists will result in diagnostic information as well as treatment recommendations. You can then take these recommendations to your local school system. I also recommend that you seek the support of a Board Certified Behavior Analyst, who would be able to conduct the appropriate assessments and to assist in developing an assessment and treatment plan for decreasing echolalia and increasing appropriate communication. Please visit the website of the Behavior Analysis Certification Board (http://www.bacb.com/) where you will find a directory of service providers.