Imitative Therapy: What Works for Us
By Kandie Demarest
Our son would repeat words after he heard them, referred to in language terminology as “echolalia”. He would parrot the last word of the sentence if asked a question and occasionally would let loose with an entire script from a video tape or computer game (delayed echolalia) as if talking to himself while in his car seat and even in his sleep. This led me to think that there was nothing wrong with his ability to speak but perhaps with the understanding of words.
I thought perhaps he heard words and sentences more as neurologically typical people may hear music or other sounds; more of a whole pattern of noises than individual words carrying meaning on their own. This hunch appears to be right on since now at the age of 7 he is beginning to ask what various, ordinary words mean. It is almost as if he is learning a foreign language.
I found this very interesting and used this as the basis for the in-home individualized therapy program we have developed for him. After his halt in language and emotional development at about 18 months of age he interacted less with other people and his play routines were limited to trains, balls, sand and water. Other than those four activities the only other thing he liked to do was to sit on my lap and watch one of his favorite video tapes or computer games. During this time between 18 months and 3.5 years of age I tried to interest him in as many things as possible but the most intriguing options were always things that were related to one of his own intense interests. So… we played with trains, we painted trains, we read about trains, we sang about trains, we counted trains and pretended to be trains! (Well, I should say I did all these things while he watched most of the time. He preferred watching at first but after seeing the actions enough times IF he found it interesting he would eventually start imitating the behavior, much as he did language.)
Since he was so into video tapes and computers I selected programs that would model appropriate play behaviors and positive phrases in hopes of widening his verbal and social skills base. I pictured it as loading his mind (database) full of words and phrases and play skills that he might be able to access in the future. The thing I didn’t know was whether these phrases would eventually be able to be used in appropriate situations. At about the age of 4.5 years I noticed he was able to use phrases from videos and computer programs to express himself as needed at times. For instance, when he wanted to eat something he might say, “I’m so hungry I could eat a horse!” from one of his favorite videos instead of saying “Mom, I’m hungry!” or even a more simple, “Eat”. He continued with the repetitive scripting in unrelated situations too, almost like he was reading a story to himself but as he grew, so did his ability to use the memorized phrases in appropriate situations as a real method of communication.
As we continued to see progress we simply refined the selection process for video programs. When we saw a gap in his skills I would search for a decent role model with an inviting theme. We were lucky that he enjoyed The Magic School Bus, Little Bear and Blue’s Clues by age 5 because much of his language acquisition came from educational programming like those. We did a lot of re-enacting skits from these programs, especially Little Bear and Blue’s Clues.
Over time I noticed there were some skills that programs couldn’t focus on enough, so I started taping some older children in specific situations as role models. These situations were mostly social behaviors like sharing a toy or comforting a hurt playmate. I started out making video tapes of our excursions to interesting places so that we could go over them verbally later after the excitement of the trip was over. (these “field trips” were to places like train rides, museums, bus rides, subways, or any of his obsessional interests) I sandwiched small clips of role modeling in between segments of our field trips to keep his interest. Later I discovered an easier way to keep his interest was to simply add a high interest object to the role modeling tape. (One segment is a trip to the park playing in sand (obsessional interest) where 2 children role model taking turns politely with the shovel and pail. Here the obsessional interest is built in but in other cases we have to add it…. we may be showing how to say “hello, how are you today?” and we would start the tape by showing a toy fire truck or a clip of one of his favorite video tapes then do the role modeling followed by another clip of his video tape. This keeps his attention throughout the tape.)