Hadano, K; Nakamura, H; Hamanaka, T
We report three cases of effortful echolalia in patients with cerebral infarction. The clinical picture of speech disturbance is associated with Type 1 Transcortical Motor Aphasia (TCMA, Goldstein, 1915). The patients always spoke nonfluently with loss of speech initiative, dysarthria, dysprosody, agrammatism, and increased effort and were unable to repeat sentences longer than those containing four or six words. In conversation, they first repeated a few words spoken to them, and then produced self initiated speech. The initial repetition as well as the subsequent self initiated speech, which were realized equally laboriously, can be regarded as mitigated echolalia (Pick, 1924). They were always aware of their own echolalia and tried to control it without effect. These cases demonstrate that neither the ability to repeat nor fluent speech are always necessary for echolalia. The possibility that a lesion in the left medial frontal lobe, including the supplementary motor area, plays an important role in effortful echolalia is discussed.
Schuler, A L
Echolalic behaviors have been reported within the context of various pathologies but have remained poorly defined. Consequently, it is not easy to determine whether and to what extent normal repetition can be separated from pathological echoing. Hence, it is unclear whether the occurrence of echolalic behavior may be useful for differential diagnostic purposes. Also, much room is left for controversies about the clinical management of echolalic behavior. This article reviews the various conditions associated with echolalia and the role of repetitions in normal language behavior. Suggestions are made in terms of the various dimensions along which echolalic behavior should be assessed, as well as of the desirability of particular intervention techniques.
Shield, Aaron; Cooley, Frances; Meier, Richard P.
Purpose: We present the first study of echolalia in deaf, signing children with autism spectrum disorder (ASD). We investigate the nature and prevalence of sign echolalia in native-signing children with ASD, the relationship between sign echolalia and receptive language, and potential modality differences between sign and speech. Method: Seventeen…
Błeszyński, Jacek Jarosław
Speech of people with autism is recognised as one of the basic diagnostic, therapeutic and theoretical problems. One of the most common symptoms of autism in children is echolalia, described here as being of different types and severity. This paper presents the results of studies into different levels of echolalia, both in normally developing children and in children diagnosed with autism, discusses the differences between simple echolalia and echolalic speech - which can be considered to b...
Zoniou-Sideri, Athina; Karayianni, Panagiota
A case study of a Greek child (age 5) with visual impairment and echolalia is presented to illustrate the symptoms of echolalia in inclusive settings, the forms that echolalia can take, and how echolalia is differentiated from the kinds of speech repetitions observed in conditions of normal language acquisition. (Contains references.) (CR)
Edelstein, Matthew Lawrence
Echolalia is a linguistic phenomenon common in individuals with Autism Spectrum Disorder. This study examined the relationship between demand complexity and immediate echolalia in 4 students with an autism diagnosis in a university-based academic setting. Mastered and novel antecedent verbal demands that required an intraverbal response were…
Prizant, Barry M.; Rydell, Patrick J.
Fourteen functional categories of delayed echolalia in three autistic children (4-14 years old) were derived from videotape analyses. Individual differences in functional usage were apparent across Ss. Delayed echolalia varied along the dimensions of interactiveness, comprehension of the utterance produced, and relevance to linguistic or…
Prizant, Barry M.; Duchan, Judith F.
A multilevel analysis of verbal and nonverbal factors, response latency, and intonation, in four autistic boys (4 to 9 years old) revealed that immediate echolalia is far more than a meaningless behavior. Seven functional categories of echolalia were discovered and are discussed in reference to behavioral and linguistic features of each category.…
Zapor, M; Murphy, F T; Enzenauer, R
"That tongue of yours, by which I have been tricked, shall have its power curtailed and enjoy the briefest use of speech." With these words, Hera, of Greek mythology, deprived the nymph Echo of spontaneous speech, constraining her instead to merely repeating the words of others. Echolalia, which derives from the word "echo," is disordered speech in which an individual persistently repeats what is heard. Echolalia has been described in patients with a number of neuropsychiatric illnesses including autism and Tourette's syndrome. Neuropsychiatric systemic lupus erythematosus (NPSLE) is a heterogeneous disease with protean manifestations that may occur in approximately 25% to 50% of patients with systemic lupus erythematosus (SLE). Although the most common manifestations include cognitive dysfunction (50%) and seizures (20%), NPSLE may also present as peripheral neuropathy (15%), psychosis (10%), or other central nervous system abnormalities. We report the case of a 57-year-old woman with SLE and echolalia.
Charlop, Marjorie H.
Six autistic boys (ages 3-11) were presented with a receptive labeling task in several settings which varied in familiarity of person, room, and task stimuli. Results indicated that the greatest amount of echolalia occurred in settings in which an unfamiliar person presented unfamiliar task stimuli. (Author)
Saad, Andressa Gouveia de Faria; Goldfeld, Marcia
echolalia is one of the most common symptoms among the language characteristics in Autism. to provide a detailed literature revision about the role of echolalia in the language development process of autistic individuals, and to discuss the use of this language feature in the speech-language clinical practice. The researches show classifications and analysis criterions of echolalia in a discursive context. A few of the analyzed studies are against the use of echolalia, pointing that it has no communicative function, and therefore should be discouraged. On the other hand, other studies indicate that echolalia has a communicative value and can be used as a communicative in speech-language intervention. this bibliographical review raises the issue about the importance of evaluating the conditions in which echolalia might occur before considering it as having a communicative value or not.
Charlop, M H
This investigation, consisting of two experiments, was designed to assess the effects of autistic immediate echolalia on acquisition and generalization of receptive labeling tasks. Experiment 1 addressed whether autistic children could use their echolalia to facilitate acquisition. The results indicated that incorporating echolalia (echo of the requested object's label) into the task before manual response (handing the requested object to the experimenter) facilitated receptive labeling. Expe...
Suzuki, Tadashi; Itoh, Shouichi; Arai, Noritoshi; Kouno, Masako; Noguchi, Makoto; Takatsu, Masami; Takeda, Katsuhiko
Ambient echolalia is a rare condition with few reported cases. We report the case of a 20-year-old man with a germinoma around the bilateral ventriculus lateralis who exhibited ambient echolalia. Clinical features included instinctive grasp reaction and compulsive manipulation of tools in his right hand. Speech or mental deterioration has been cited as a cause of ambient echolalia, but neither dementia nor aphasia was present. We propose that ambient echolalia in our case could be interpreted as a disinhibition of pre-existing essentially intact motor subroutines due to damage of the medial frontal lobe.
Charlop, Marjorie H.
Two experiments, with about five autistic children (two to 14 years old) in each experiment, assessed the effects of autistic immediate echolalia on acquisition and generalization of receptive labeling tasks. These results indicated that echolalia faciliated generalization for echolalic autistic children but not for functionally mute autistic…
Foxx, R. M.; Faw, Gerald D.
A long-term followup (from 26 to 57 months) of echolalia and correct question-answering was conducted with six mentally retarded adult subjects identified from three previously published studies. Echolalia was lower than in baseline in 80.6 percent of the followups. Issues related to the study of maintenance are discussed. (Author/DB)
Leung, Jin-Pang; Wu, Kit-I
The facilitative effect of incorporating echolalia on teaching receptive naming of Chinese characters to four Hong Kong children (ages 8-10) with autism was assessed. Results from two experiments indicated echolalia was the active component contributing to the successful acquisition and maintenance of receptive naming of Chinese characters.…
McMorrow, Martin J.; Foxx, R. M.
The use of operant procedures was extended to decrease immediate echolalia and increase appropriate responding to questions of a 21-year-old autistic man. Multiple baseline designs demonstrated that echolalia was rapidly replaced with correct stimulus-specific responses. A variety of generalized improvements were observed in verbal responses to…
Transcortical aphasia accompanied by echolalia occurs with malacias involving the postero-median part of the frontal lobe which includes the supplementary motor field of Penfield and is nourished by the anterior cerebral artery. The syndrome manifests itself in such cases even in fine detials in the same form as does in Pick's atrophy. The same also holds true for cases in which a tumour involves the region mentioned. Sentences or fragments of sentences are echolalised; tendency to perseveration is very marked. It is hardly, if at all, possible to evaluate the verbal understanding of these patients. Analysis of their behaviour supports the assumption that they have not lost the adaptation to some situations. Echolalia is often associated with forced grasping and other compulsory phenomena. Therefore, it may be interpreted as a sign of disinhibition of the acusticomotor reflex present during the development of the speech. Competition between the intentionality and the appearance of compulsory phenomena greatly depends on the general condition of the patient, particularly on the clarity of consciousness. The integrity of the postero-median part of the frontal lobe is indespensable for a normal reaction by speech to stimuli received from the sensory areas. The influence of the supplementary motor field on speech intention seems to be linked to the dominant hemisphere. In case lesions of the territory of the anterior cerebral artery and the cortico-bulbar neuron system are coexisting in the dominant hemisphere, the speech disturbance shifts to complete motor aphasia. In such cases the pathomechanism is analogous to that of the syndrome of Liepmann, i.e., right-sided hemiparesis with left-sided apraxia. So-called transcortical motor aphasia without echolalia can be caused by loss of stimuli from the sensory fields.
Paccia, J M; Curcio, F
Several aspects of echolalic speech produced by five autistic children were investigated. We found that the incidence of echolalia was influenced by the type of question addressed to the child and, to a lesser extent, by the child's comprehension of the specific relationships expressed in the question. Additionally, acoustic analysis showed that a substantial proportion of echoes involved a prosodic modification of the examiner's question. Further analyses indicated that some of these modified echoes represent more than just a primitive conversational strategy. Specifically, they seem to reflect a higher level of processing and serve a semantic function, that of affirming the examiner's question.
Foxx, R M; Faw, G D
A long-term follow-up of echolalia and correct question answering was conducted for 6 subjects from three previously published studies. The follow-up periods ranged from 26 to 57 months. In a training site follow-up, subjects were exposed to baseline/posttraining conditions in which the original trainer and/or a novel person(s) presented trained and untrained questions. Four subjects displayed echolalia below baseline levels, and another did so in some assessments. Overall, echolalia was lowe...
Stiegler, Lillian N
Echolalia is a common element in the communication of individuals with autism spectrum disorders. Recent contributions to the literature reflect significant disagreement regarding how echolalia should be defined, understood, and managed. The purpose of this review article is to give speech-language pathologists and others a comprehensive view of the available perspectives on echolalia. Published literature from the disciplines of behavioral intervention, linguistics, and speech-language intervention is discussed. Special areas of focus include operational definitions, rationales associated with various approaches, specific procedures used to treat or study echolalic behavior, and reported conclusions. Dissimilarities in the definition and understanding of echolalia have led to vastly different approaches to management. Evidence-based practice protocols are available to guide speech-language interventionists in their work with individuals with autism spectrum disorders.
Leung, J P; Wu, K I
The facilitative effect of incorporating echolalia on teaching receptive naming of Chinese characters to children with autism was assessed. In Experiment 1, echoing the requested character name prior to the receptive naming task facilitated matching a character to its name. In addition, task performance was consistently maintained only when echolalia preceded the receptive manual response. Positive results from generalization tests suggested that learned responses occurred across various nove...
Chung, Bo In
Discusses the successful treatment of echolalia in a 15-year-old girl with Rubinstein-Tabyi syndrome, a congenital anomaly characterized by mental and growth retardation. Intervention included a functional assessment of varied echolalic conditions, provision of a therapeutic environment that minimized echolalic responses, and reinforcement of…
Bebko, James M.
Review of literature on indicators of the effectiveness of language intervention programs for autistic children showed that mitigation in echolalia was a critical characteristic, as it implied that the prerequisites for language were accessible through speech. Children whose speech ranged from mutism to unmitigated echolalia had a more negative…
Grossi, D; Marcone, R; Cinquegrana, T; Gallucci, M
Echolalia is a verbal disorder, defined as 'a meaningless repetition of the words of others'. It is pathological, automatic and non-intentional behaviour, often observed in a variety of neurological and psychiatric disorders and above all in autism. We assume that echolalia is an imitative behaviour that is due to difficulties in inhibiting automatic repetition as seen in patients with frontal lobe damage. Our aim is to study the occurrence of echolalia under experimental conditions to investigate the nature of the phenomenon and its relationship with the severity of autism. Eighteen participants with autism from 17 to 36 years old were recruited; they were administrated the Vineland scale, the Observational Rating Scale of Basic Functions and the Echolalia Questionnaire. In the Echolalia Questionnaire, questions were directly addressed to the autistic subject (induced procedure) or to the subject's caregiver while the subject was free to do what he wanted (incidental procedure). The data were analysed by multivariate regressions and Pearson's correlations. The results showed that echolalia occurred in both experimental situations; the mean value was significantly higher in the induced procedure, but results did not support the correlation with Vineland's score in the incidental procedure. It is likely that the two situations activated different processes. In particular, echolalia was statistically higher in the induced procedure as compared with the incidental one only for subjects with low score on Vineland, but in the incidental procedure, the presence of echolalia appeared to be uninfluenced by the functional capacity of subjects. The two experimental conditions require different monitoring systems to control this verbal behaviour. The echolalic phenomenon is an expression of dependence on the environment and may occur in a situation in which the autistic person is participating in a communicative act and, lacking inhibitory control, repeats the other
Full Text Available Echolalia are subsets of imitative behavior which repetition of sounds and language. Topiramate is an effective drug for treatment several types of seizures. It is generally tolerated well. We reported the case of a 44-year old man patient who presented with a history of a epilepsy disorder, He had been maintained with 1000 mg/day sodium valproate for seizure episode. But this recently did not control his seizure episode. Then he was placed on topiramate (600mg/day. Following treatment, he had no seizure episode. subsequently He became incoherence, confusion, disorientation, and significant speech impairments including echolalia Thereby, we present a case of echolalia in a rapidly titrated topiramate induced in a epilepsy disorder patient. J Clin Exp Invest 2014; 5 (4: 620-622
S. E. McPherson
Full Text Available Aphasia is a common manifestation of Creutzfeldt-Jakob disease (CJD, and investigation of the linguistic disorders of CJD patients may provide insights into the neurobiological mechanisms of language and aphasia. We report an autopsy-confirmed case of CJD in which the presenting symptom was change in language abilities. The patient ultimately evidenced mixed transcortical aphasia (MTA with echolalia. Disruption of frontal-subcortical circuits with environmental dependency accounts for the symptoms in MTA, including intact repetition and echolalia. Observation in this patient and a review of the literature suggest that frontal-subcortical circuit dysfunction may contribute to the syndrome of echolalia. This hypothesis offers an alternative explanation to “isolation” of the speech area as the cause of MTA.
McPherson, S E; Kuratani, J D; Cummings, J L; Shih, J; Mischel, P S; Vinters, H V
Aphasia is a common manifestation of Creutzfeldt-Jakob disease (CJD), and investigation of the linguistic disorders of CJD patients may provide insights into the neurobiological mechanisms of language and aphasia. We report an autopsy-confirmed case of CJD in which the presenting symptom was change in language abilities. The patient ultimately evidenced mixed transcortical aphasia (MTA) with echolalia. Disruption of frontal-subcortical circuits with environmental dependency accounts for the symptoms in MTA, including intact repetition and echolalia. Observation in this patient and a review of the literature suggest that frontal-subcortical circuit dysfunction may contribute to the syndrome of echolalia. This hypothesis offers an alternative explanation to "isolation" of the speech area as the cause of MTA.
McEvoy, Robin E.; And Others
The study examined differences in the use of immediate echolalia by 18 children (ages 4-12) with autism at different stages of language development. Percentage of echolalic language was high at early stages of language development but decreased as language skills improved. (Author/DB)
Dyer, C; Hadden, A J
Attention has recently focused on the need to build up a corpus of case observations relating to the function of delayed echolalia in various handicapping conditions but especially in early childhood autism. This present article offers six functional categories as an aid to clear reporting of observation and, thus clarification of this little-understood facet of deviant language development.
Sterponi, Laura; Shankey, Jennifer
Echolalia is a pervasive phenomenon in verbal children with autism, traditionally conceived of as an automatic behavior with no communicative function. However, recently it has been shown that echoes may serve interactional goals. This article, which presents a case study of a six-year-old child with autism, examines how social interaction…
Wallesch, C W; Brunner, R J; Seemüller, E
Repetitive phenomena in spontaneous speech were investigated in 30 patients with chronic infarctions of the left hemisphere which included Broca's and/or Wernicke's area and/or the basal ganglia. Perseverations, stereotypies, and echolalias occurred with all types of brain lesions, automatisms and recurring utterances only with those patients, whose infarctions involved Wernicke's area and basal ganglia. These patients also showed more echolalic responses. The results are discussed in view of the role of the basal ganglia as motor program generators.
McPherson, S. E.; Kuratani, J. D.; Cummings, J. L.; Shih, J.; Mischel, P. S.; Vinters, H. V.
Aphasia is a common manifestation of Creutzfeldt-Jakob disease (CJD), and investigation of the linguistic disorders of CJD patients may provide insights into the neurobiological mechanisms of language and aphasia. We report an autopsy-confirmed case of CJD in which the presenting symptom was change in language abilities. The patient ultimately evidenced mixed transcortical aphasia (MTA) with echolalia. Disruption of frontal-subcortical circuits with environmental dependency accounts for the s...
Ganos, Christos; Ogrzal, Timo; Schnitzler, Alfons; Münchau, Alexander
Echopraxia and echolalia are subsets of imitative behavior. They are essential developmental elements in social learning. Their persistence or reemergence after a certain age, though, can be a sign of underlying brain dysfunction. Although echophenomena have been acknowledged as a typical sign in Gilles de la Tourette syndrome (GTS) since its first description, their clinical significance and neural correlates are largely unknown. Here, we review the course of their scientific historical development and focus on their clinical phenomenology and differential diagnosis with a particular view to GTS. The neural basis of echophenomena will also be addressed. © 2012 Movement Disorder Society. Copyright © 2012 Movement Disorder Society.
Eşref Akıl; Rezan Alp; Abdullah Atli; Abdullah Acar; Hasan H Özdemir
Echolalia are subsets of imitative behavior which repetition of sounds and language. Topiramate is an effective drug for treatment several types of seizures. It is generally tolerated well. We reported the case of a 44-year old man patient who presented with a history of a epilepsy disorder, He had been maintained with 1000 mg/day sodium valproate for seizure episode. But this recently did not control his seizure episode. Then he was placed on topiramate (600mg/day). Following treatment, he h...
Lee, Joseph W Y
Logorrhea, verbigeration and echolalia persisted unremittingly for 3 years, with occasional short periods of motoric excitement, in a patient with mild intellectual handicap suffering from chronic schizophrenia. The speech catatonic symptoms, previously refractory to various antipsychotics, responded promptly to lorazepam, a benzodiazepine with documented efficacy in the treatment of acute catatonia but not chronic catatonia. It is suggested that pathways in speech production were selectively involved in the genesis of the chronic speech catatonic syndrome, possibly a rare form of chronic catatonia not previously described.
Rydell, Patrick J.; Mirenda, Pat
This study of 3 boys (ages 5-6) with autism found that adult high-constraint antecedent utterances elicited more verbal utterances in general, including subjects' echolalia; adult low-constraint utterances elicited more subject high-constraint utterances; and the degree of adult-utterance constraint did not influence the mean lengths of subjects'…
Rydell, Patrick J.; Mirenda, Pat
Examination of the effects of adult antecedent utterances on echolalia in seven male children with autism (ages five and six) during free play found that most immediate echoes followed high constraint utterances and were used as responsives, organizational devices, and cognitives. Most delayed echoes followed low constraint utterances and were…
Valentino, Amber L.; Shillingsburg, M. Alice; Conine, Daniel E.; Powell, Nicole M.
Echolalia is common in children with autism and may interfere with the development of functional language. Given the variety of vocal stimuli included in teaching language to children with autism, it is possible that discrimination between instructions and targeted responses may not always occur. Thus, children may engage in very high rates of…
Dierckx, R A; Saerens, J; De Deyn, P P; Verslegers, W; Marien, P; Vandevivere, J
A 78-yr-old woman presented with transient echolalia and palilalia. She had suffered from Parkinson's disease for 2 yr. Routine laboratory examination showed hypotonic hyponatremia, but was otherwise unremarkable. Brain mapping revealed a bifrontal delta focus, more pronounced on the right. Single photon emission computed tomography (SPECT) of the brain with technetium-99m labeled d,l hexamethylpropylene-amine oxime (99mTc-HMPAO), performed during the acute episode showed relative frontoparietal hypoactivity. Brain mapping performed after disappearance of the echolalia and palilalia, which persisted only for 1 day, was normal. By contrast, SPECT findings persisted for more than 3 wk. Features of particular interest in the presented patient are the extensive defects seen on brain SPECT despite the absence of morphologic lesions, the congruent electrophysiologic changes and their temporal relationship with the clinical evolution.
Cho, Yang-Je; Han, Sang-Don; Song, Sook Keun; Lee, Byung In; Heo, Kyoung
Palilalia is a relatively rare pathologic speech behavior and has been reported in various neurologic and psychiatric disorders. We encountered a case of palilalia, echolalia, and echopraxia-palipraxia as ictal phenomena of left frontal lobe epilepsy. A 55-year-old, right-handed man was admitted because of frequent episodes of rapid reiteration of syllables. Video-electroencephalography monitoring revealed stereotypical episodes of palilalia accompanied by rhythmic head nodding and right-arm posturing with ictal discharges over the left frontocentral area. He also displayed echolalia or echopraxia-palipraxia, partially responding to an examiner's stimulus. Magnetic resonance imaging revealed encephalomalacia on the left superior frontal gyrus and ictal single photon emission computed tomography showed hyperperfusion just above the lesion, corresponding to the left supplementary motor area (SMA), and subcortical nuclei. This result suggests that the neuroanatomic substrate involved in the generation of these behaviors as ictal phenomena might exist in the SMA of the left frontal lobe.
Endo, K; Suzuki, K; Yamadori, A; Kumabe, T; Seki, K; Fujii, T
We report a right-handed woman, who developed a non-fluent aphasia after resection of astrocytoma (grade III) in the right medial frontal lobe. On admission to the rehabilitation department, neurological examination revealed mild left hemiparesis, hyperreflexia on the left side and grasp reflex on the left hand. Neuropsychologically she showed general inattention, non-fluent aphasia, acalculia, constructional disability, and mild buccofacial apraxia. No other apraxia, unilateral spatial neglect or extinction phenomena were observed. An MRI demonstrated resected areas in the right superior frontal gyrus, subcortical region in the right middle frontal gyrus, anterior part of the cingulate gyrus, a part of supplementary motor area. Surrounding area in the right frontal lobe showed diffuse signal change. She demonstrated non-fluent aprosodic speech with word finding difficulty. No phonemic paraphasia, or anarthria was observed. Auditory comprehension was fair with some difficulty in comprehending complex commands. Naming was good, but verbal fluency tests for a category or phonemic cuing was severely impaired. She could repeat words but not sentences. Reading comprehension was disturbed by semantic paralexia and writing words was poor for both Kana (syllabogram) and Kanji(logogram) characters. A significant feature of her speech was mitigated echolalia. In both free conversation and examination setting, she often repeated phrases spoken to her which she used to start her speech. In addition, she repeated words spoken to others which were totally irrelevant to her conversation. She was aware of her echoing, which always embarrassed her. She described her echolalic tendency as a great nuisance. However, once echoing being forbidden, she could not initiate her speech and made incorrect responses after long delay. Thus, her compulsive echolalia helped to start her speech. Only four patients with crossed aphasia demonstrated echolalia in the literature. They showed severe
Saldert, Charlotta; Hartelius, Lena
In this case study, we investigated the use of repetition in an individual with a neurogenic communication disorder. We present an analysis of interaction in natural conversations between a woman with advanced Huntington's disease (HD), whose speech had been described as sometimes characterised by echolalia, and her personal assistant. The conversational interaction is analysed on a sequential level, and recurrent patterns are explored. Although the ability of the person with HD to interact is affected by chorea, word retrieval problems and reduced comprehension, she takes an active part in conversation. The conversational partner's contributions are often adapted to her communicative ability as they are formulated as questions or suggestions that can be elaborated on or responded to with a simple 'yes' or 'no'. The person with HD often repeats the words of her conversational partner in a way that extends her contributions and shows listenership, and this use of repetition is also frequent in ordinary conversations between non-brain-damaged individuals. The results show that the conversation partners in this case cooperate in making the conversation proceed and evolve, and that verbal repetition is used in a way that works as a strategy for compensating for the impairment.
Suzuki, Tadashi; Itoh, Shouichi; Hayashi, Mototaka; Kouno, Masako; Takeda, Katsuhiko
We report the case of a 69-year-old woman with cerebral infarction in the left anterior cingulate cortex and corpus callosum. She showed hyperlexia, which was a distinctive reading phenomenon, as well as ambient echolalia. Clinical features also included complex disorders such as visual groping, compulsive manipulation of tools, and callosal disconnection syndrome. She read words written on the cover of a book and repeated words emanating from unrelated conversations around her or from hospital announcements. The combination of these two features due to a focal lesion has never been reported previously. The supplementary motor area may control the execution of established subroutines according to external and internal inputs. Hyperlexia as well as the compulsive manipulation of tools could be interpreted as faulty inhibition of preexisting essentially intact motor subroutines by damage to the anterior cingulate cortex reciprocally interconnected with the supplementary motor area.
Roberts, Jacqueline M. A.
The study with 10 autistic children (ages 4-17) found that those children with poor receptive language skills produced significantly more echolalic utterances than those children whose receptive skills were more age-appropriate. (Author/DB)
Garber, Norman B.; David, Leigh E.
Two mentally retarded preschool children, both of whom echoed all forms of yes-no questions, were subjected to different treatment procedures varied according to the semantic function of the antecedent verbal stimulus. (Author)
Da Cruz, Fernanda Miranda
This article reports on an investigation of echolalic repetition in Alzheimer's disease (AD). A qualitative analysis of data from spontaneous conversations with MHI, a woman with AD, is presented. The data come from the DALI Corpus, a corpus of spontaneous conversations involving subjects with AD. This study argues that echolalic effects can be…
Diesfeldt, H F
Language is often impaired in patients with a primary degenerative dementia syndrome. Severe dementia may even lead to mutism, a condition in which the person does not produce any spontaneous speech, despite preservation of consciousness. The question is if there are any language abilities left in patients who do not speak. In this single case-study the echolalic behaviour of a patient with severe dementia and mixed transcortical aphasia (or isolation of the speech area) was analysed by means of special linguistic tasks. In repeating sentences violating number agreement, the patient spontaneously corrected the pronoun, the noun or the verb. Furthermore, her verbal output during repetition tasks was highly constrained to lexically acceptable Dutch nouns. Despite extremely poor comprehension, this patient did not repeat verbal utterances in a parrot-like fashion. There are not many reports in the literature of patients who develop a mixed transcortical aphasia as a consequence of primary degenerative dementia. A comparable case was described by H. Whitaker. Single case-studies, such as these, are essential to our insight into the course of language breakdown in senile dementia. The preserved repetition ability of this patient demonstrates the robustness of the articulatory loop system, even if there is a severe comprehension deficit.
... vocal tics including coprolalia (uttering swear words) or echolalia (repeating the words or phrases of others). Many ... vocal tics including coprolalia (uttering swear words) or echolalia (repeating the words or phrases of others). Many ...
This study was conducted to determine the effectiveness of using the high-tech speech-generating device with Proloquo2Go app to reduce echolalic utterances in a student with autism during conversational speech. After observing that the iPad device with several apps was used by the students and that it served as a communication device, language…
echolalia , and negative vocalizations). Within these same 16 trials, we further challenged the technician by having the confederate display one of the...researcher directed the confederate to engage in each of the following problem behaviors twice: (a) aggression, (b) disruption, (c) echolalia , (d...instructional materials Echolalia Repeating one or several words said by the technician Negative vocalization Crying or screaming at a volume above
Hetzroni, Orit E.; Tannous, Juman
This study investigated the use of computer-based intervention for enhancing communication functions of children with autism. The software program was developed based on daily life activities in the areas of play, food, and hygiene. The following variables were investigated: delayed echolalia, immediate echolalia, irrelevant speech, relevant…
Prizant, Barry M.
The paper examines theoretical issues regarding the symptomatology of echolalia in the language of visually impaired children. Literature on echolalia is reviewed from a variety of perspectives and clinical work and research with visual impairment and with autism is discussed. Problems of definition are cited, and explanations for occurrence of…
intonation 67% 65% - 2 % ADOSa4: immediate echolalia 67% 65% -2 % ADOSa5: stereotyped language 71% 75% 4 % ADOSa6: contact gestures 86% 80% - 6 % ADOSa7...76% 91% 15% ADI35: reciprocal conversation 81% 76% -5% ADI33: stereotyped lang/ echolalia 76% 86% 10% ADI36: inappropriate questions 91% 91% No
Local, John; Wootton, Tony
A case study analyzed the echolalia behavior of an autistic 11-year-old boy, based on recordings made in his home and school. Focus was on the subset of immediate echolalia referred to as pure echoing. Using an approach informed by conversation analysis and descriptive phonetics, distinctions are drawn between different forms of pure echo. It is…
Ballin, Nicola Hvidt; Pagsberg, Anne Katrine
Catatonia is a common but often overlooked motor syndrome in child and adolescent psychiatry. It is characterized by a variety of symptoms, most often excitement, immobility, stupor, catalepsy, grimacing, echolalia, echopraxia, stereotypies, mannerisms, logorrhoea, verbigeration, negativism...
... and contributes to delayed development and impairment of motor skills, including sitting and walking. Babies with isodicentric ... have backflow of acidic stomach contents into the esophagus (gastroesophageal reflux). ... spectrum disorders, such as repeating the words of others (echolalia), ...
Spengler, S.; Bird, G.; Brass, M.
Background - Anecdotal evidence has noted that individuals with autism spectrum conditions (ASC) frequently exhibit heightened spontaneous imitative behavior, with symptoms of echolalia and echopraxia. This is contrasted by empiric reports that ASC results in decreased imitation and an underlying
Carr, Edward G.; And Others
Immediate echolalia (repeating what someone has just said) was studied in a series of replicated single-subject designs across six schizophrenic and five normal children (all ranging in age from 2 to 15 years). (Author/SBH)
Findings from a review of recent empirical studies on autism in the areas of behavioral characteristics (stimulus overselectivity, echolalia, imitation) and treatment interventions (social language development, stereotypic behavior, instructional design) are presented. (Author/CL)
Fay, Warren H.
Discussed are problems in the verbal comprehension and production of personal pronouns by learning disabled children. A learning approach based on echolalia and favoring a focus on the pronoun you which the child hears is advocated. (KW)
van Santen, Jan P H; Sproat, Richard W; Hill, Alison Presmanes
We report on an automatic technique for quantifying two types of repetitive speech: repetitions of what the child says him/herself (self-repeats) and of what is uttered by an interlocutor (echolalia). We apply this technique to a sample of 111 children between the ages of four and eight: 42 typically developing children (TD), 19 children with specific language impairment (SLI), 25 children with autism spectrum disorders (ASD) plus language impairment (ALI), and 25 children with ASD with normal, non-impaired language (ALN). The results indicate robust differences in echolalia between the TD and ASD groups as a whole (ALN + ALI), and between TD and ALN children. There were no significant differences between ALI and SLI children for echolalia or self-repetitions. The results confirm previous findings that children with ASD repeat the language of others more than other populations of children. On the other hand, self-repetition does not appear to be significantly more frequent in ASD, nor does it matter whether the child's echolalia occurred within one (immediate) or two turns (near-immediate) of the adult's original utterance. Furthermore, non-significant differences between ALN and SLI, between TD and SLI, and between ALI and TD are suggestive that echolalia may not be specific to ALN or to ASD in general. One important innovation of this work is an objective fully automatic technique for assessing the amount of repetition in a transcript of a child's utterances. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.
Dobbinson, Sushie; Perkins, Mick; Boucher, Jill
The phenomenon of echolalia in autistic language is well documented. Whilst much early research dismissed echolalia as merely an indicator of cognitive limitation, later work identified particular discourse functions of echolalic utterances. The work reported here extends the study of the interactional significance of echolalia to formulaic utterances. Audio and video recordings of conversations between the first author and two research participants were transcribed and analysed according to a Conversation Analysis framework and a multi-layered linguistic framework. Formulaic language was found to have predictable interactional significance within the language of an individual with autism, and the generic phenomenon of formulaicity in company with predictable discourse function was seen to hold across the research participants, regardless of cognitive ability. The implications of formulaicity in autistic language for acquisition and processing mechanisms are discussed.
Nientimp, Edward G.; Cole, Christine L.
Evaluated effects of procedure to teach appropriate social responses to adolescents with severe disabilities by employing ABA withdrawal design, replicated twice with two students, and AB design with third student. Results showed increases in correct responding and decreases in echolalia following intervention. Generalization of appropriate…
Klykylo, William M.; And Others
Use of the drug Fenfluramine, which reduces blood serotonin levels and possible problem behaviors, was evaluated. Nine of 10 Ss showed reduced serotonin; none showed significant differences on intelligence tests; and at least two Ss showed marked behavioral changes in less echolalia, perseveration, and motoric disturbance and more increases in…
Atlas, Jeffrey A.; Lapidus, Leah Blumberg
A total of 48 children (aged 4-14) with severe pervasive developmental disturbance, exhibiting mutism, echolalia, or nonecholalic speech, were observed in their communicative behaviors across modalities. Levels of symbolization in gesture, play, and drawing were significantly intercorrelated and were most strongly correlated with the criterion…
Charlop, Marjorie H.; And Others
Three experiments assessed the efficacy of various reinforcers to increase correct task responding in a total of 10 autistic children, aged 6-9. Of the reinforcers used (stereotypy, delayed echolalia, perseverative behavior, and food), task performance was highest with opportunities to engage in aberrant behaviors, and lowest with edible…
Deaton, Ann Virginia
Discussed is the language impairment of children with infantile autism. The speech patterns of autistic children, including echolalia, pronomial reversal, silent language, and voice imitation, are described. The clinical picture of the autistic child is compared to that of children with such other disorders as deafness, retardation, and…
Fay, Warren H.
An alternative to the ego-based explanations for the autistic child's characteristic patterns of pronominal reversals and avoidances is an approach based on studies of echolalia which considers grammatical aspects of acquisition, reversal, and nonreversal. Focus is consequently shifted from primacy of expressive I to comprehension of you/me…
McMorrow, Martin J.; And Others
A cues-pause-point procedure was used to train two severely retarded females to remain quiet before, during, and briefly after the presentation of questions and then to verbalize on the basis of environmental cues whose labels represented the correct responses. Echolalia was rapidly replaced by correct responding on the trained stimuli. (Author/JW)
Tokyo Gakugei Univ. (Japan). Research Inst. for the Education of Exceptional Children.
This Japanese research report, with English abstracts, presents the following papers: "The Deterioration of the Intelligence with Age in Mental Retardation" (Atsushi Kanno and Souichi Hasimoto); "Development of Janken Skills in Autistic Children--Additional Data on Janken Echolalia in Normal Children" (Tohsuke Nomura);…
Wetherby, Amy Miller; And Others
The results showed that all the Ss had normal hearing on the monaural speech tests; however, there was indication of central auditory nervous system dysfunction in the language dominant hemisphere, inferred from the dichotic tests, for those Ss displaying echolalia. (Author)
Evans, C. J.; Johnson, C. J.
A blind multiply handicapped preschooler was taught to respond appropriately to two adjacency pair types ("where question-answer" and "comment-acknowledgement"). The two alternative language acquisition strategies available to blind children were encouraged: echolalia to maintain communicative interactions and manual searching…
Full Text Available A case of the Gilles de la Tourette syndrome from Guyana in South America is presented. The patient had a positive family history as well as coprolalia, echolalia, and attention deficit disorder with hyperactivity. The family history and cross-cultural similarity emphasise the biological factors in the aetiology of the syndrome.
Fay, Warren H.
Current theory and research in development of self and of language in autistic children is considered, with emphasis on studies of normal development of personal pronouns and the roles played in that process by listening, echoic memory, mitigated echolalia (recording), and person deixis. (Author)
R. A. Ford
Full Text Available Conditions in which echolalia and echopraxia occur are reviewed, followed by an attempt to elicit possible mechanisms of these phenomena. A brief description of stereotypical and perseverative behaviour and obsessional phenomena is given. It is suggested that abnormal repetitive behaviour may occur partly as a result of central dopaminergic dysfunction.
Violette, Joseph; Swisher, Linda
The immediate verbal imitations (IVIs) of a boy (age five) with autism and echolalia were studied, with variables of linguistic familiarity and instructor's style of directiveness being manipulated. The occurrence of IVIs was related to uncertain or informative events, and was significantly greater when lexical stimuli were unknown and presented…
A study examined the use of sensory integration techniques to reduce the maladaptive behaviors that interfered with the learning of nine high school students with mental impairments attending a special school. Maladaptive behaviors identified included rocking, toe walking, echolalia, resistance to change, compulsive behaviors, aggression,…
Gupta, Sudhir; And Others
Children (ages 3-12) with autism (n=25) were given intravenous immune globulin (IVIG) treatments at 4-week intervals for at least 6 months. Marked abnormality of immune parameters was observed in subjects, compared to age-matched controls. IVIG treatment resulted in improved eye contact, speech, behavior, echolalia, and other autistic features.…
Losinski, Mickey; Cook, Katie; Hirsch, Shanna; Sanders, Sara
In the past decade, the number of children diagnosed with an autism spectrum disorder (ASD) has steadily increased. A common characteristic of ASD is the presence of stereotypical behaviors (e.g., hand flapping, echolalia), which some have suggested may be associated with heightened arousal and/or anxiety. The purpose of this study is to compare…
Marin, Robert S; Gorovoy, Ian R
Echothymia is stimulus-bound affective behavior, an echophenomenon in the domain of affect. Like echolalia and echopraxia, it is a concomitant of the environmental dependency associated with dysfunction of the frontal-striatal systems that mediate so-called frontal lobe functions. The authors introduce the definition and phenomenology of echothymia, overview its differential diagnosis and clinical significance, and suggest ways in which understanding echothymia may contribute to clinical management.
萱村, 俊哉; Toshiya, Kayamura
The significance of the autism echolalia and vocal imitations in 1- year- old normal children is considered from Jacksonistic point of view. In this study, through the observations of the replies or utterances in 1-yearold normal children, it was revealed that the automatic vocal imitations frequently existed immediately before the appearance of the intentional replies or utterances in them. Such automatic responses were thought to play a fixed role in language acquisition and development of ...
Mary M. Robertson
Full Text Available Gilles de la Tourette gained eponymous fame when he described nine cases of multiple tics, coprolalia and echolalia, and later he, Guinon and Grasset were the first to document the psychopathology of the Gilles de la Tourette syndrome. In particular, they noted the association between obsessional thoughts and behaviours and the tic disorder. In this paper we present the first English translations of their works referring to the psychopathology, comparing and contrasting their ideas to current concepts.
Tajima-Pozo, Kazuhiro; Zambrano-Enriquez, Diana; De Anta, Laura; Zelmanova, Julie; De Dios Vega, Jose Luis; Lopez-Ibor, Juan Jose
The case of a 5-year-old child diagnosed as having pervasive developmental disorder (PDD), autistic type, from age 1 is reported. After surgery of vegetation in middle ear for repetitive otitis, the child presented an improvement in autistic behaviours, previously expressed as impaired social interactions, qualitative abnormalities in communication, a marked delay in language development, echolalia, stereotypies and self-aggressive behaviours. The aim of this paper is to bring attention to oc...
Williams, Justin H.G.; Whiten, Andrew; Suddendorf, Thomas; Perrett, David I.
Various deficits in the cognitive functioning of people with autism have been documented in recent years but these provide only partial explanations for the condition. We focus instead on an imitative disturbance involving difficulties both in copying actions and in inhibiting more stereotyped mimicking, such as echolalia. A candidate for the neural basis of this disturbance may be found in a recently discovered class of neurons in frontal cortex, 'mirror neurons' (MNs). These neurons show ac...
Schuch, Jaqueline Bohrer; Muller, Diana; Endres, Renata Giuliani; Bosa, Cleonice Alves; Longo, Dânae; Schuler-Faccini, Lavinia; Ranzan, Josiane; Becker, Michele Michelin; dos Santos Riesgo, Rudimar; Roman, Tatiana
Autism Spectrum Disorders (ASDs) represent a group of very complex early-onset neurodevelopmental diseases. In this study, we analyzed 5 SNPs (rs2317385, rs5918, rs15908, rs12603582, rs3809865) at the β3 integrin locus (ITGB3), which has been suggested as a possible susceptibility gene, both as single markers and as part of haplotypes in 209 ASD children and their biological parents. We tested for association with the following: a) DSM-IV ASD diagnosis; b) clinical symptoms common in ASD patients (repetitive behaviors, echolalia, seizures and epilepsy, mood instability, aggression, psychomotor agitation, sleep disorders); and c) dimensional scores obtained with the Autism Screening Questionnaire and the Childhood Autism Rating Scale. These hypotheses were investigated using family-based tests, logistic regression models and analysis of covariance. The family-based tests showed an association with the H5 haplotype (composed by GTCGA alleles, the order of SNPs as above), which was transmitted less often than expected by chance (P=0.006; Pcorr=0.036). The analyses of the clinical symptoms showed a trend for an association with rs12603582 (P=0.008; Pcorr=0.064) and positive results for the haplotype composed of rs15908 and rs12603582 (Pglcorr=0.048; Pindcorr=0.015), both in symptoms of echolalia. Other nominal associations with different variants were found and involved epilepsy/seizures, aggression symptoms and higher ASQ scores. Although our positive results are not definitive, they suggest small effect associations of the ITGB3 gene with both ASD diagnosis and symptoms of echolalia. Other studies are nonetheless needed to fully understand the involvement of this locus on the etiology of ASDs and its different clinical aspects. Copyright © 2014 Elsevier B.V. All rights reserved.
Walker, Gareth; Local, John
The analysis of language use in real-world contexts poses particular methodological challenges. We codify responses to these challenges as a series of methodological imperatives. To demonstrate the relevance of these imperatives to clinical investigation, we present analyses of single episodes of interaction where one participant has a speech and/or language impairment: atypical prosody, echolalia and dysarthria. We demonstrate there is considerable heuristic and analytic value in taking this approach to analysing the organization of interaction involving individuals with a speech and/or language impairment.
Full Text Available The present article is a review of English_language literature on the topic of development of language and communication in people with autism spectrum disorders (ASD. It is shown that language in ASD often differs from the one in typical development, particularly in terms of pragmatics, unusual intonation and echolalia, and difficulties in speech perception and comprehension may also be present. Nevertheless, it should be noted that the results of many studies in this area are controversial due to a variety of reasons and it is hardly possible to reach agreement on many questions in this area.
Sukhija, Gagandeep; Singh, Harpreet
Isoniazid as part of Directly Observed Treatment-Short course (DOTS) regimen is universally used. Although, associated psychosis in certain cases is documented earlier, type of symptoms and onset of symptoms remains highly variable. We describe a case of 54-year-old female on anti-tubercular therapy with onset of psychosis within three days of Isoniazid initiation characterised by agitation, loosening of association, echolalia with spontaneous remission after drug stoppage. This case highlights the importance of remaining vigilant and considering isoniazid as possible causative agent for psychosis even within days of its intiation and avoiding delay in management. PMID:26266198
Full Text Available Personal pronoun reversal (PPR, characterised by inverse use of personal pronouns (typically first and second person is a hallmark of an autism spectrum disorder diagnosis (ASD; American Psychiatric Association, 2013. This literature review examines different theories accounting for the occurrence of PPR, in particular Kanner’s (1943 original view of PPR as echolalia, PPR as a result of impaired understanding of discourse roles (e.g. Tager-Flusberg, 1994, and PPR due to impaired theory of mind (Boucher, 2003. These existing theories are critiqued as overly simplistic, and the review argues that more complex theories are required to adequately explain the available evidence on PPR.
Ferrari, P; Marescot, M R; Moulias, R; Bursztejn, C; Deville Chabrolle, A; Thiollet, M; Lesourd, B; Braconnier, A; Dreux, C; Zarifian, E
In sixteen autistic children high values of IgG and a high level of lymphocyte stimulation with PHA were observed. Principal component analysis showed: 1) a significant correlation between basic lymphocyte mitogenic activity and the clinical symptoms opposition and hyperactivity, 2) a significant correlation between high Ig levels, high PHA stimulation responses and the main autistic symptoms (withdrawal, inaffectivity, hypoactivity, mannerism, stereotypy and negatively echolalia), 3) a significant correlation with serotonin uptake by platelets and high immunological responses. Such correlations are strongly in favor of an immunologic component in autistic disease.
Gernsbacher, Morton Ann; Morson, Emily M; Grace, Elizabeth J
Autism is a developmental disability characterized by atypical social interaction, interests or body movements, and communication. Our review examines the empirical status of three communication phenomena believed to be unique to autism: pronoun reversal (using the pronoun you when the pronoun I is intended, and vice versa), echolalia (repeating what someone has said), and a reduced or even reversed production-comprehension lag (a reduction or reversal of the well-established finding that speakers produce less sophisticated language than they can comprehend). Each of these three phenomena has been claimed to be unique to autism; therefore, each has been proposed to be diagnostic of autism, and each has been interpreted in autism-centric ways (psychoanalytic interpretations of pronoun reversal, behaviorist interpretations of echolalia, and clinical lore about the production-comprehension lag). However, as our review demonstrates, none of these three phenomena is in fact unique to autism; none can or should serve as diagnostic of autism, and all call into question unwarranted assumptions about autistic persons and their language development and use.
Noori, Soudabeh; Nedaeifard, Leila; Agarasouli, Zahra; Koohpaiehzadeh, Jalil; Kermani, Ramin Mozafari; Fazeli, Abolhasan Shahzadeh
Objective The aim of this study is assessment of effects of different assisted reproductive techniques (ART) like in vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI) on prelinguistic behavior of infants conceived by these techniques. Methods In this descriptive, cross sectional study, prelinguistic behavior of 151 full term ART infants of Royan Institute have been assessed in Children's Health and Development Research Center of Tehran from August 2007 until August 2009. Questionnaires were completed by parents at 9 months old. The questionnaire was standard according to Early Language Milestone Scale-2 (ELM-2). Data were analyzed by SPSS version 16 and using chi-square test. Findings Twenty-two (14.5%) of infants were conceived by IVF and 129 (85.4%) by ICSI. Number of infants with delay in reduplicated babbling in ICSI method was more than in IVF. There was only a significant difference in echolalia delay in the two sexes. Echolalia was delayed more in boys. Delay of reduplicated babbling was more in infants of younger mothers. There was no relation between speech and language defect of parents and infants. Conclusion This study showed that prelingustic behavior of ART infants are affected by kind of ART method, infant sex, and mother's age at the time of pregnancy. PMID:23431035
Ungvari, G S; White, E; Pang, A H
Over the past decade there has been an upsurge of interest in the prevalence, nosological position, treatment response and pathophysiology of catatonia. However, the psychopathology of catatonia has received only scant attention. Once the hallmark of catatonia, speech disorders--particularly logorrhoea, verbigeration and echolalia--seem to have been neglected in modern literature. The aims of the present paper are to outline the conceptual history of catatonic speech disorders and to follow their development in contemporary clinical research. The English-language psychiatric literature for the last 60 years on logorrhoea, verbigeration and echolalia was searched through Medline and cross-referencing. Kahlbaum, Wernicke, Jaspers, Kraepelin, Bleuler, Kleist and Leonhard's oft cited classical texts supplemented the search. In contrast to classical psychopathological sources, very few recent papers were found on catatonic speech disorders. Current clinical research failed to incorporate the observations of traditional descriptive psychopathology. Modern catatonia research operates with simplified versions of psychopathological terms devised and refined by generations of classical writers.
Violette, J; Swisher, L
Studies of the immediate verbal imitations (IVIs) of subjects with echolalia report that features of linguistic or social input alone affect the number of IVIs elicited. This experimental study of a child with echolalia and autism controlled each of these variables while introducing a systematic change in the other. The subject produced more (p less than .05) IVIs in response to unknown lexical words presented with a high degree of directiveness (Condition D) than in response to three other conditions of stimulus presentation (e.g., unknown lexical words, minimally directive style.) Thus, an interaction between the effects of linguistic and social input was demonstrated. IVIs were produced across all conditions, primarily during first presentations of lexical stimuli. Only the IVIs elicited by first presentations of the lexical stimuli during Condition D differed significantly (p less than .05) from the number of IVIs elicited by first presentations of lexical stimuli in other conditions. These findings viewed together suggest that the occurrence of IVIs was related, at least for this child, to an uncertain or informative event and that this response was significantly greater when the lexical stimuli were unknown and presented in a highly directive style.
Tajima-Pozo, Kazuhiro; Zambrano-Enriquez, Diana; De Anta, Laura; Zelmanova, Julie; De Dios Vega, Jose Luis; Lopez-Ibor, Juan Jose
The case of a 5-year-old child diagnosed as having pervasive developmental disorder (PDD), autistic type, from age 1 is reported. After surgery of vegetation in middle ear for repetitive otitis, the child presented an improvement in autistic behaviours, previously expressed as impaired social interactions, qualitative abnormalities in communication, a marked delay in language development, echolalia, stereotypies and self-aggressive behaviours. The aim of this paper is to bring attention to occurrences of misdiagnosis of PDD, which can occur when an adequate screening of the autistic syndrome is not realised. The result of the surgery was an improvement in autistic behaviours, despite the persistence of less severe autistic traits that may be more closely related to Asperger’s syndrome. PMID:22736729
Catatonia, originally described by Karl Kahlbaum in 1874, may be regarded as a set of clinical features found in a subtype of schizophrenia, but the syndrome may also stem from organic causes including vascular parkinsonism, brain masses, globus pallidus lesions, metabolic derangements, and pharmacologic agents, especially first generation antipsychotics. Catatonia may include paratonia, waxy flexibility (cerea flexibilitas), stupor, mutism, echolalia, and catalepsy (abnormal posturing). A case of catatonia as a result of acute renal failure in a patient with dementia with Lewy bodies is described. This patient recovered after intravenous fluid administration and reinstitution of the atypical dopamine receptor blocking agent quetiapine, but benzodiazepines and amantadine are additional possible treatments. Recognition of organic causes of catatonia leads to timely treatment and resolution of the syndrome. PMID:23466522
Cardoso, F; Veado, C C; de Oliveira, J T
The clinical features of 32 patients (24 males) with Tourette's syndrome in Brazil were studied. The mean age at onset was 7.1 years, tics being the first symptom in 71% and hyperactivity in 29%. Blinking, grimacing, and shoulder elevation were the most common motor tics and sniffing, throat clearing, and grunting noises, the most frequent vocal tics. Coprolalia was present in 28%, echolalia in 16%, palilalia in 9%, and copropraxia in 25% of patients. Attention deficit and hyperactivity disorder was diagnosed in 63%, and obsessive compulsive behaviour in 44% of patients. In 84% of patients there was a family history of tics whereas attention deficit and hyperactivity disorder and obsessive compulsive behaviour were respectively present in relatives of 19% and 53% of the patients studied. These data suggest that Tourette's syndrome in Brazil is not clinically different from other countries, supporting the notion that genetic factors play the most important part in its aetiology. PMID:8708658
Full Text Available Catatonia, originally described by Karl Kahlbaum in 1874, may be regarded as a set of clinical features found in a subtype of schizophrenia, but the syndrome may also stem from organic causes including vascular parkinsonism, brain masses, globus pallidus lesions, metabolic derangements, and pharmacologic agents, especially first generation antipsychotics. Catatonia may include paratonia, waxy flexibility (cerea flexibilitas, stupor, mutism, echolalia, and catalepsy (abnormal posturing. A case of catatonia as a result of acute renal failure in a patient with dementia with Lewy bodies is described. This patient recovered after intravenous fluid administration and reinstitution of the atypical dopamine receptor blocking agent quetiapine, but benzodiazepines and amantadine are additional possible treatments. Recognition of organic causes of catatonia leads to timely treatment and resolution of the syndrome.
Christman, Sarah S; Boutsen, Frank R; Buckingham, Hugh W
This article will review types of perseveration from a neurolinguistic perspective. During the course of the article, continuous, stuck-in-set, and recurrent perseveration will be placed in contradistinction to several other types of repetitive behaviors commonly associated with neurogenic communication disorders. These include echolalia in mixed transcortical aphasia; conduite d'approche and conduite d'ecart in fluent aphasias; lexical and nonlexical automatisms in nonfluent aphasias; palilalia in neuromotor disorders, such as Parkinson's disease (PD); and sound, syllable, word, and phrase repetitions in neurogenic stuttering. When differentiating these phenomena from perseveration, it is helpful to consider the salient factors that condition observed behaviors in individual patients, such as overall speech fluency, inventory of available utterances, nature of eliciting tasks, and propositionality of responses. Information such as communication disorder diagnosis, underlying etiology, and known sites of lesion from each patient's total clinical profile may also assist with differentiation.
Williams, J H; Whiten, A; Suddendorf, T; Perrett, D I
Various deficits in the cognitive functioning of people with autism have been documented in recent years but these provide only partial explanations for the condition. We focus instead on an imitative disturbance involving difficulties both in copying actions and in inhibiting more stereotyped mimicking, such as echolalia. A candidate for the neural basis of this disturbance may be found in a recently discovered class of neurons in frontal cortex, 'mirror neurons' (MNs). These neurons show activity in relation both to specific actions performed by self and matching actions performed by others, providing a potential bridge between minds. MN systems exist in primates without imitative and 'theory of mind' abilities and we suggest that in order for them to have become utilized to perform social cognitive functions, sophisticated cortical neuronal systems have evolved in which MNs function as key elements. Early developmental failures of MN systems are likely to result in a consequent cascade of developmental impairments characterised by the clinical syndrome of autism.
Suzuki, K; Yamadori, A; Kumabe, T; Endo, K; Fujii, T; Yoshimoto, T
A 69-year-old right-handed woman developed a transcortical motor aphasia with hyperlexia following resection of a glioma in the left medial frontal lobe. Neurological examination revealed grasp reflex in the right hand and underutilization of the right upper extremity. An MRI demonstrated lesions in the left medial frontal lobe including the supplementary motor area and the anterior part of the cingulate gyrus, which extended to the anterior part of the body of corpus callosum. Neuropsychologically she was alert and cooperative. She demonstrated transcortical motor aphasia. Her verbal output began with echolalia. Furthermore hyperlexia was observed in daily activities and during examinations. During conversation she suddenly read words written on objects around her which were totally irrelevant to the talk. When she was walking in the ward with an examiner she read words written on a trash bag that passed by and signboards which indicated a name of a room. Her conversation while walking was intermingled with reading words, which was irrelevant to the conversation. She also read time on analog clocks, which were hung on a wall in a watch store. In a naming task, she read words written on objects first and named them upon repeated question about their names. When an examiner opened a newspaper in front of her without any instructions she began reading until the examiner prohibited it. Then she began reading again when an examiner turned the page, although she remembered that she should not read it aloud. She showed mild ideomotor apraxia of a left hand. Utilization behavior, imitation behavior, hypergraphia, or compulsive use of objects was not observed throughout the course. Hyperlexic tendency is a prominent feature of this patient's language output. Hyperlexia was often reported in children with pervasive developmental disorders including autism. There are only a few reports about hyperlexia in adults and some of them were related to diffuse brain dysfunction
Isabela Barbosa do Rêgo Barros
Full Text Available Associated often in autism by virtue of the similarity of symptoms (SCHWARTZMAN et al., 1995; DIAMENT; CYPEL, 1996, Fragile X Syndrome (FXS is characterized mainly by cognitive impairment accompanied by behavioral changes and sensorimotor, learning disability, physical impairment and language. This is marked by delay in its acquisition, omissions, substitutions and phonetic distortion, echolalia, holophrase, short sentences, pauses and hesitations, interjections and frequent monologues. This article aims to discuss the contemporary character of the Portuguese language and the identification process in the language in a multilingual context as key to the appropriation of a language by a subject diagnosed with FXS. We base our discussions on Enunciation theory of Emile Benveniste (2005, 2006 and studies of Silva (2009 which analyzes for a stated perspective regarding the language, language and subject. We realized that the Portuguese language was used on specific occasions, marking unique productions in Portuguese, classical German and German dialect Schwäbisch as effects of the operations of subject, indicating that education and ownership of a language is established in an identification relationship to the subject that makes use of it.
Murugan Selvaraj Karthik
Full Text Available Hashimoto’s encephalopathy (HE is a rare autoimmune disorder with neurological and neuropsychiatric manifestations and elevated titres of anti-thyroid antibodies. Here we are reporting a case of HE in a 19-year-old girl who presented with seizure-like episodes, confusion, and behavioural disturbances with catatonic symptoms such as posturing, echopraxia, echolalia, and ambivalence. Patient did not respond to antipsychotics and anticonvulsants. On further investigation, patient was found to have high serum anti-TPO antibodies of about 1261 U/mL with euthyroid status, which supported a suspicion of HE. Our consultant neurologist confirmed the diagnosis and she was started on injection of methylprednisolone 750 mg OD. Since patient started showing clinical improvement, her antipsychotic medications were tapered off. On follow-up, patient has recovered and is functioning well. Since HE is a diagnosis of exclusion, very high anti-TPO antibodies and good response to steroids supported the diagnosis of HE in this patient after excluding other etiological possibilities. This case has been reported because the clinical presentation was predominantly neurobehavioural manifestations which is uncommon with HE.
Subashini, Viswanath; Balakrishnan, Ramasamy
Hashimoto's encephalopathy (HE) is a rare autoimmune disorder with neurological and neuropsychiatric manifestations and elevated titres of anti-thyroid antibodies. Here we are reporting a case of HE in a 19-year-old girl who presented with seizure-like episodes, confusion, and behavioural disturbances with catatonic symptoms such as posturing, echopraxia, echolalia, and ambivalence. Patient did not respond to antipsychotics and anticonvulsants. On further investigation, patient was found to have high serum anti-TPO antibodies of about 1261 U/mL with euthyroid status, which supported a suspicion of HE. Our consultant neurologist confirmed the diagnosis and she was started on injection of methylprednisolone 750 mg OD. Since patient started showing clinical improvement, her antipsychotic medications were tapered off. On follow-up, patient has recovered and is functioning well. Since HE is a diagnosis of exclusion, very high anti-TPO antibodies and good response to steroids supported the diagnosis of HE in this patient after excluding other etiological possibilities. This case has been reported because the clinical presentation was predominantly neurobehavioural manifestations which is uncommon with HE. PMID:28607558
Lees, A J; Robertson, M; Trimble, M R; Murray, N M
The clinical features of 53 British-born patients with Gilles de la Tourette syndrome are described. The mean age at onset of body tics was seven years and for vocalisations 11 years. Coprolalia was present in 39%, copropraxia in 21%, echolalia in 46% and echopraxia in 21%. Complicated antics and mannerisms were also common, often involving the compulsive touching of objects or self-injurious behaviour. Forty-six per cent of cases had a family history of tics in a single close relative and in two individuals a further member of the family had Gilles de la Tourette syndrome. Focal dystonia was present in four patients who had never received neuroleptics drugs and chorea was seen in two other untreated patients. In three patients acoustic startle consistently induced brief eye blink followed by a whole body jerk or jump. Rapid repetitive movements of the hands increased the frequency and severity of tics in 13 patients, but the performance of mental arithmetic under time pressure had a much more unpredictable effect. Electroencephalographic abnormalities occurred in eight (13%) but no definite CT brain scan abnormalities were detected. The incidence of left handedness did not differ from that in the general population and no evidence to suggest organic impairment was found on neuropsychological testing. This study provides no support for the notion that Gilles de la Tourette syndrome is a degenerative disorder of the central nervous system but provides some evidence for heterogeneity. PMID:6582230
Full Text Available Catatonia is a syndrome with any two of five core features: stupor/motoric immobility/catalepsy/waxy flexibility, excitement, negativism/mutism, posturing, and echolalia/echopraxia. We describe a case of delayed diagnosis of pulmonary embolism with an atypical presentation in an elderly schizophrenia male patient, which led to a life-threatening brain infarction. A 75-year-old male was hospitalized in a psychiatric ward because of stupor, poor intake and mutism under a diagnosis of recurrent catatonia. His inability to express his suffering, dehydration, exacerbation of chronic obstructive pulmonary disease, and upper gastrointestinal bleeding, however, made an accurate diagnosis difficult. Finally, the high D-dimer level and further chest computed tomography confirmed pulmonary embolism in the trunk of the bilateral main pulmonary arteries. The brain computed tomography also confirmed brain infarcts. He was transferred to the cardiac intensive care unit and was eventually rescued from near death due to pulmonary embolism and brain infarction. A careful differential diagnosis for pulmonary embolism-induced delirium and catatonic state is important in the treatment of patients with a previous diagnosis of catatonic schizophrenia.
Baruffi, Marcelo Razera; de Souza, Deise Helena; Bicudo da Silva, Rosana Aparecida; Ramos, Ester Silveira; Moretti-Ferreira, Danilo
Balanced X-autosome translocations are rare, and female carriers are a clinically heterogeneous group of patients, with phenotypically normal women, history of recurrent miscarriage, gonadal dysfunction, X-linked disorders or congenital abnormalities, and/or developmental delay. We investigated a patient with a de novo X;19 translocation. The six-year-old girl has been evaluated due to hyperactivity, social interaction impairment, stereotypic and repetitive use of language with echolalia, failure to follow parents/caretakers orders, inconsolable outbursts, and persistent preoccupation with parts of objects. The girl has normal cognitive function. Her measurements are within normal range, and no other abnormalities were found during physical, neurological, or dysmorphological examinations. Conventional cytogenetic analysis showed a de novo balanced translocation, with the karyotype 46,X,t(X;19)(p21.2;q13.4). Replication banding showed a clear preference for inactivation of the normal X chromosome. The translocation was confirmed by FISH and Spectral Karyotyping (SKY). Although abnormal phenotypes associated with de novo balanced chromosomal rearrangements may be the result of disruption of a gene at one of the breakpoints, submicroscopic deletion or duplication, or a position effect, X; autosomal translocations are associated with additional unique risk factors including X-linked disorders, functional autosomal monosomy, or functional X chromosome disomy resulting from the complex X-inactivation process. PMID:23074688
Mazumdar, Pralay Kumar; Chaturvedi, S.K.; Gopinath, P.S.
SUMMARY This study examines in detail - i) the magnitude, nature and severity of thought disorder in schizophrenia, ii) the correlations between type and severity of thought disorder with socio-demographic and clinical variables, and iii) differences between different subtypes of schizophrenia. Forty five schizophrenics (Research Diagnostic Criteria) were assessed by ‘live’ interview as well as tape recorded interviews. Instruments used for assessment were (a) Scale for assessment of Thought, Language and Communication (Andreasen 1978), (b) Brief Psychiatric Rating Scale (Overall & Gorham 1962), (c) Mini Mental State (Folstein 1975), and (d) Clinical and demographic data recording proforma. The Schizophrenic patients were subdivided as (i) Acute and chronic (R.D.C.), (ii) Paranoid and non-paranoid; and (iii) Negative, positive, mixed (Andreasen's criteria) and intragroup and intergroup differences were computed. Poverty of speech, tangentiality, derailment, loss of goal, perseveration were found to be the commonest thought disorders. Positive and negative thought disorders were seen in equiproportion in both positive and negative schizophrenics. Significant differences were noted between thought disorders and education as well as habitat. Rural patients more often had negative formal thought disorders. Literates had more often clanging, neologism, circumstantiality and echolalia. This study provides ample information on the nature of thought disorder in Indian schizophrenic subjects. PMID:21927321
Marcelo Razera Baruffi
Full Text Available Balanced X-autosome translocations are rare, and female carriers are a clinically heterogeneous group of patients, with phenotypically normal women, history of recurrent miscarriage, gonadal dysfunction, X-linked disorders or congenital abnormalities, and/or developmental delay. We investigated a patient with a de novo X;19 translocation. The six-year-old girl has been evaluated due to hyperactivity, social interaction impairment, stereotypic and repetitive use of language with echolalia, failure to follow parents/caretakers orders, inconsolable outbursts, and persistent preoccupation with parts of objects. The girl has normal cognitive function. Her measurements are within normal range, and no other abnormalities were found during physical, neurological, or dysmorphological examinations. Conventional cytogenetic analysis showed a de novo balanced translocation, with the karyotype 46,X,t(X;19(p21.2;q13.4. Replication banding showed a clear preference for inactivation of the normal X chromosome. The translocation was confirmed by FISH and Spectral Karyotyping (SKY. Although abnormal phenotypes associated with de novo balanced chromosomal rearrangements may be the result of disruption of a gene at one of the breakpoints, submicroscopic deletion or duplication, or a position effect, X; autosomal translocations are associated with additional unique risk factors including X-linked disorders, functional autosomal monosomy, or functional X chromosome disomy resulting from the complex X-inactivation process.
Solomon, Marjorie; Olsen, Emily; Niendam, Tara; Ragland, J. Daniel; Yoon, Jong; Minzenberg, Michael; Carter, Cameron S.
Objective Individuals with autism and schizophrenia exhibit atypical language and social symptoms. The extent to which these symptoms are evident during development and in current functioning is unclear. Method Three groups of patients aged 11–20 diagnosed as clinical-high-risk for psychosis (CHR; n = 15), first episode psychosis (FEP; n = 16), and autism spectrum disorders (ASD; n = 20), plus typically developing individuals (TYP; n = 20) were compared on common autism parent-report questionnaires assessing social and language development and current functioning including the Social Communication Questionnaire, the Children’s Communication Checklist, and the Social Reciprocity Scale. Results All clinical groups demonstrated atypical social and language development, with social impairment highest in ASD. Twenty percent of participants with CHR and FEP met diagnostic criteria for ASD as assessed by parent-report. ASD exhibited greater current syntactic, and pragmatic language symptoms including delayed echolalia, pedantic speech, and deficits in appreciating irony and sarcasm. All clinical groups exhibited current deficits in social functioning. CHR and FE had similar and intermediate levels of functioning relative to ASD and TYP, with CHR generally scoring closer to TYP, providing construct validity for the CHR diagnostic label. Conclusions The results of this study suggest that ASDs, CHR, and FEP share common features of atypical neurodevelopment of language and social function. Evidence of impaired social reciprocity across both disorders and distinct language symptoms in ASDs provides important information for differential diagnosis and psychosis prevention, as well as leads for future investigations of comparative genetics and pathophysiology. PMID:21458242
Full Text Available A series of 75 cases of Gilles de la Tourette syndrome (GTS from Argentina, whose ages ranged from 6 to 55 with a mean of 20.02, were evaluated to compare findings with those reported for other countries. Mean age at onset was 7.44 years and mean overall duration of symptoms was 12.58 years; 6.7% of cases were mild, 49% moderate and 44.3% severe. Most frequent presenting motor tics were excessive blinking in 41 followed by head jerking in 16 and eye winking in six, while phonic tics included coprolalia in 28.0%, echolalia in 17.5% and palilalia in 10.8%. Abnormal perinatal events were reported in 40.5%, while positive family history for tics was present in 26.66%. Obsessive–compulsive behaviour was evident in 66% and attention deficit disorder in 16% of cases. Self-injurious behaviour comprised onychophagia in 28 patients, lip-biting in seven and self-slapping in eight cases. Almost half of our patients were initially interpreted as having a psychogenic disorder indicating that GTS in Argentina is most likely underdiagnosed. It may be concluded that the overall pattern of GTS is not dissimilar to that described for European, Asian and American populations, thus highlighting the previously recognized cross-cultural uniformity.
Lovaas, O. Ivar; Koegel, Robert; Simmons, James Q.; Long, Judith Stevens
We have treated 20 autistic children with behavior therapy. At intake, most of the children were severely disturbed, having symptoms indicating an extremely poor prognosis. The children were treated in separate groups, and some were treated more than once, allowing for within- and between-subject replications of treatment effects. We have employed reliable measures of generalization across situations and behaviors as well as across time (follow-up). The findings can be summarized as follows: (1) Inappropriate behaviors (self-stimulation and echolalia) decreased during treatment, and appropriate behaviors (appropriate speech, appropriate play, and social non-verbal behaviors) increased. (2) Spontaneous social interactions and the spontaneous use of language occurred about eight months into treatment for some of the children. (3) IQs and social quotients reflected improvement during treatment. (4) There were no exceptions to the improvement, however, some of the children improved more than others. (5) Follow-up measures recorded 1 to 4 yr after treatment showed that large differences between groups of children depended upon the post-treatment environment (those groups whose parents were trained to carry out behavior therapy continued to improve, while children who were institutionalized regressed). (6) A brief reinstatement of behavior therapy could temporarily re-establish some of the original therapeutic gains made by the children who were subsequently institutionalized. PMID:16795385
Robertson, M M; Roberts, S; Pillai, S; Eapen, V
We present six patients with Gilles de la Tourette syndrome (TS) who are also deaf. TS has been observed previously, but rarely reported in deaf people, and to date, so called "unusual" phenomenology has been highlighted. TS occurs almost worldwide and in all cultures, and the clinical phenomenology is virtually identical. In our cohort of deaf patients (we suggest another culture) with TS, the phenomenology is the same as in hearing people, and as in all other cultures, with classic motor and vocal/phonic tics, as well as associated phenomena including echo-phenomena, pali-phenomena and rarer copro-phenomena. When "words" related to these phenomenon (e.g. echolalia, palilalia, coprolalia or mental coprolalia) are elicited in deaf people, they occur usually in British Sign Language (BSL): the more "basic" vocal/phonic tics such as throat clearing are the same phenomenologically as in hearing TS people. In our case series, there was a genetic predisposition to TS in all cases. We would argue that TS in deaf people is the same as TS in hearing people and in other cultures, highlighting the biological nature of the disorder. Copyright © 2015 Elsevier B.V. All rights reserved.
Goldberg, Ethan M; Titulaer, Maarten; de Blank, Peter M; Sievert, Angela; Ryan, Nicole
Anti-N-methyl-D-aspartate receptor encephalitis is an increasingly well-recognized inflammatory encephalitis in children and adults. We report a previously healthy 21-month-old girl who presented with behavioral change, self-mutilatory behavior, and echolalia. Over the ensuing weeks, symptoms progressed to include unilateral upper extremity dystonia, gait impairment, dysphagia, and mutism. Magnetic resonance imaging of the brain showed a tiny area of signal abnormality in the subcortical white matter, but was otherwise normal. Continuous video electroencephalography showed slowing of the background rhythm, but was without epileptiform discharges. Lumbar puncture showed a mild pleocytosis of mixed cellularity; bacterial culture and testing for various viral encephalitides were negative. Serum and cerebrospinal fluid was positive for autoantibodies directed against the N-methyl-D-aspartate receptor, and she was diagnosed with anti-N-methyl-D-aspartate receptor encephalitis. The patient was successfully treated with a regimen of immunotherapy that included dexamethasone, intravenous immunoglobulin, and rituximab. One year after initial presentation, the patient remained symptom-free. We further review the clinical characteristics, results of diagnostic studies, treatment, and outcome of infants and toddlers diagnosed with anti-N-methyl-D-aspartate receptor encephalitis that have been previously reported in the literature. Anti-N-methyl-D-aspartate receptor encephalitis is relatively common among infants and toddlers and often presents with a pattern of defining characteristics in this age group, particularly the absence of associated tumor. Copyright © 2014 Elsevier Inc. All rights reserved.
Paucar, Martin; Beniaminov, Stanislav; Paslawski, Wojciech; Svenningsson, Per
Premutations in the fragile X mental retardation 1 (FMR1) gene cause fragile X-associated tremor/ataxia syndrome (FXTAS) and FMR1-related primary ovarian insufficiency (POI). Female FMR1 premutation carriers rarely develop motor features. Dual pathology is an emerging phenomenon among FMR1 premutation carriers. Here, we describe a family affected by FMR1-related disorders in which the female index case has developed a rapidly progressive and disabling syndrome of atypical parkinsonism. This syndrome consists of early onset postural instability, echolalia, dystonia, and varying types of apraxia like early onset orobuccal apraxia and oculomotor apraxia. She has also developed supranuclear gaze palsy, increased latency of saccade initiation, and slow saccades. These features are compatible with progressive supranuclear palsy (PSP) of a corticobasal syndrome (CBS) variant. Imaging displays a marked reduction of presynaptic dopaminergic uptake and cerebrospinal fluid analysis showed reduced dopamine metabolism; however, the patient is unresponsive to levodopa. Midbrain atrophy ("hummingbird sign") and mild cerebellar atrophy were found on brain MRI. Her father was affected by a typical FXTAS presentation but also displayed dopamine deficiency along with the hummingbird sign. The mechanisms by which FMR1 premutations predispose to atypical parkinsonism and dopamine deficiency await further elucidation.
Lim, Hayoung A; Draper, Ellary
This study compared a common form of Applied Behavior Analysis Verbal Behavior (ABA VB) approach and music incorporated with ABA VB method as part of developmental speech-language training in the speech production of children with Autism Spectrum Disorders (ASD). This study explored how the perception of musical patterns incorporated in ABA VB operants impacted the production of speech in children with ASD. Participants were 22 children with ASD, age range 3 to 5 years, who were verbal or pre verbal with presence of immediate echolalia. They were randomly assigned a set of target words for each of the 3 training conditions: (a) music incorporated ABA VB, (b) speech (ABA VB) and (c) no-training. Results showed both music and speech trainings were effective for production of the four ABA verbal operants; however, the difference between music and speech training was not statistically different. Results also indicated that music incorporated ABA VB training was most effective in echoic production, and speech training was most effective in tact production. Music can be incorporated into the ABA VB training method, and musical stimuli can be used as successfully as ABA VB speech training to enhance the functional verbal production in children with ASD.
Collado-Vázquez, Susana; Carrillo, Jesús M
Different neurological diseases have often been portrayed in literature, cinema and television. Tics and Tourette syndrome, for example, are commonly represented from different perspectives, which are sometimes very realistic but in some cases are used for more dramatic purposes or to make a character look ridiculous. One of the main effects of these inadequate views is to further stigmatise those who suffer these movement disorders. To review the way tics and Tourette syndrome have been portrayed in certain literary works, films and television. Tics are rapid, stereotypic, involuntary, recurring, non-purposeful movements of the skeletal and pharyngeal-laryngeal muscles. In Gilles de la Tourette syndrome a number of tics are associated to involuntary vocalisations (echolalia, coprolalia). They begin in childhood and are usually associated to obsessive-compulsive behaviours. These disorders have appeared in literature in works such as Little Dorrit, Angel Guerra, La torre de los siete jorobados or Motherless Brooklyn. Film-makers have also shown an interest in tics and Tourette syndrome and they have been portrayed in films such as Young and Innocent, The Tic Code or Matchstick Men. Likewise, a number of television series also contain characters with these disorders, including Shameless, Ally McBeal, Quincy, M.E. or L.A. Law. Tics and Tourette syndrome have frequently been portrayed in literature, cinema and television, sometimes in a very realistic manner. In other cases, however, the way they are dealt with has only helped to create false beliefs and stereotyped images of the disorders.
Miyamoto, T; Miyamoto, M; Yokota, N; Kubo, J; Hirata, K
We present a 31-year-old woman of multiple sclerosis. At age 28, she was admitted with complaints of echolalia and a gradual onset of weakness affecting the right upper and bilateral lower limbs. Brain MRI showed high intensity areas in the bilateral frontal gyri, lobuli paracentralis, and left anterior thalamus. Although she had been in remission for 3 years, she developed dysesthesia of left upper and lower limbs. Cervical T2 weighted MRI showed a new high signal intensity lesion in the spinal cord from the C2 to C3 level. The combination of the cerebral, thalamic and spinal cord lesions with remission and excerbations allowed the diagnosis of clinically MS to be made. She suffered amenorrhea from the onset of her illness. Serum prolactin was within the normal range. The LH and FSH basal secretions were decreased and there were low delayed secretions of LH and FSH after intravenous injection of 100 micrograms LHRH. We consider that her amenorrhea was caused by the hypothalamic lesion, supported by MR findings of dilatation of the third ventricle.
De Jaegher, Hanne
In this article, I sketch an enactive account of autism. For the enactive approach to cognition, embodiment, experience, and social interaction are fundamental to understanding mind and subjectivity. Enaction defines cognition as sense-making: the way cognitive agents meaningfully connect with their world, based on their needs and goals as self-organizing, self-maintaining, embodied agents. In the social realm, the interactive coordination of embodied sense-making activities with others lets us participate in each other's sense-making (social understanding = participatory sense-making). The enactive approach provides new concepts to overcome the problems of traditional functionalist accounts of autism, which can only give a piecemeal and disintegrated view because they consider cognition, communication, and perception separately, do not take embodied into account, and are methodologically individualistic. Applying the concepts of enaction to autism, I show: How embodiment and sense-making connect, i.e., how autistic particularities of moving, perceiving, and emoting relate to how people with autism make sense of their world. For instance, restricted interests or preference for detail will have certain sensorimotor correlates, as well as specific meaning for autistic people.That reduced flexibility in interactional coordination correlates with difficulties in participatory sense-making. At the same time, seemingly irrelevant “autistic behaviors” can be quite attuned to the interactive context. I illustrate this complexity in the case of echolalia. An enactive account of autism starts from the embodiment, experience, and social interactions of autistic people. Enaction brings together the sensorimotor, cognitive, social, experiential, and affective aspects of autism in a coherent framework based on a complex non-linear multi-causality. This foundation allows to build new bridges between autistic people and their often non-autistic context, and to improve quality
Eapen, Valsamma; Robertson, Mary M
This study addressed several questions relating to the core features of Tourette syndrome (TS) including in particular coprolalia (involuntary utterance of obscene words) and copropraxia (involuntary and inappropriate rude gesturing). A cohort of 400 TS patients was investigated. We observed that coprolalia occurred in 39% of the full cohort of 400 patients and copropraxia occurred in 20% of the cohort. Those with coprolalia had significantly higher Yale Global Tic Severity Scale (YGTSS) and Diagnostic Confidence Index (DCI) total scores and a significantly higher proportion also experienced copropraxia and echolalia. A subgroup of 222 TS patients with full comorbidity data available were also compared based on whether they had pure-TS (motor and vocal tics only) or associated comorbidities and co-existent psychopathologies (TS-plus). Pure-TS and TS-plus groups were compared across a number of characteristics including TS severity, associated clinical features, and family history. In this subgroup, 13.5% had pure-TS, while the remainder had comorbidities and psychopathologies consistent with TS-plus. Thirty-nine percent of the TS-plus group displayed coprolalia, compared to (0%) of the pure-TS group and the difference in proportions was statistically significant. The only other significant difference found between the two groups was that pure-TS was associated with no family history of obsessive compulsive disorder which is an interesting finding that may suggest that additional genes or environmental factors may be at play when TS is associated with comorbidities. Finally, differences between individuals with simple versus complex vocal/motor tics were evaluated. Results indicated that individuals with complex motor/vocal tics were significantly more likely to report premonitory urges/sensations than individuals with simple tics and TS. The implications of these findings for the assessment and understanding of TS are discussed. PMID:26089672
Darrow, Sabrina M.; Hirschtritt, Matthew E.; Davis, Lea K.; Illmann, Cornelia; Osiecki, Lisa; Grados, Marco; Sandor, Paul; Dion, Yves; King, Robert; Pauls, David; Budman, Cathy L.; Cath, Danielle C.; Greenberg, Erica; Lyon, Gholson J.; Yu, Dongmei; McGrath, Lauren M.; McMahon, William M.; Lee, Paul C.; Delucchi, Kevin L.; Scharf, Jeremiah M.; Mathews, Carol A.
Objective Phenotypic heterogeneity in Tourette syndrome (TS) is partly due to complex genetic relationships between TS, obsessive-compulsive disorder (OCD) and attention deficit/hyperactivity disorder (ADHD). Identifying symptom-based endophenotypes across diagnoses may aid gene-finding efforts. Method 3494 individuals recruited for genetic studies were assessed for TS, OCD, and ADHD symptoms. Symptom-level factor and latent class analyses were conducted in TS families and replicated in an independent sample. Classes were characterized by comorbidity rates and proportion of parents. Heritability and TS-, OCD-, and ADHD-associated polygenic load were estimated. Results We identified two cross-disorder symptom-based phenotypes across analyses: symmetry (symmetry, evening up, checking obsessions; ordering, arranging, counting, writing-rewriting compulsions, repetitive writing tics) and disinhibition (uttering syllables/words, echolalia/palilalia, coprolalia/copropraxia and obsessive urges to offend/mutilate/be destructive). Heritability estimates for both endophenotypes were high (disinhibition factor= 0.35, SE=0.03, p= 4.2 ×10−34; symmetry factor= 0.39, SE=0.03, p= 7.2 ×10−31; symmetry class=0.38, SE=0.10, p=0.001). Mothers of TS probands had high rates of symmetry (49%) but not disinhibition (5%). Polygenic risk scores derived from a TS genome-wide association study (GWAS) were associated with symmetry (p= 0.02), while risk scores derived from an OCD GWAS were not. OCD polygenic risk scores were associated with disinhibition (p =0.03), while TS and ADHD risk scores were not. Conclusions We identified two heritable TS-related endophenotypes that cross traditional diagnostic boundaries. The symmetry phenotype correlated with TS polygenic load, and was present in otherwise “TS-unaffected” mothers, suggesting that this phenotype may reflect additional TS (rather than OCD) genetic liability that is not captured by traditional DSM-based diagnoses. PMID:27809572
Hanne eDe Jaegher
Full Text Available Traditional functionalist approaches to autism consider cognition, communication, and perception separately, and can only provide piecemeal accounts of autism. Basing an integrative explanation on a single cause or common factor has proven difficult. Traditional theories are also disembodied and methodologically individualistic. In order to overcome these problems, I propose an enactive account of autism.For the enactive approach to cognition embodiment, interaction, and personal experience are central to understanding mind and subjectivity. Enaction defines cognition as sense-making: the way cognitive agents meaningfully connect with their world, based on their needs and goals as self-organizing, self-maintaining, embodied agents. In the social realm, when we interactively coordinate our embodied sense-making, we participate in each other’s sense-making. Thus, social understanding is defined as participatory sense-making.Applying the concepts of enaction to autism, I propose that1Sensorimotor particularities in autism translate into a different sense-making and vice versa. Autistic behaviors, e.g. restricted interests, will have sensorimotor correlates, as well as specific significance for autistic people in their context. 2Socially, a reduced flexibility in interactional coordination can lead to difficulties in participatory sense-making. At the same time, however, seemingly irrelevant autistic behavior can be quite attuned to the interactive context. I illustrate this complexity in the case of echolalia. An enactive account of autism starts from the embodiment, experience, and social interactions of autistic people. Enaction brings together the cognitive, social, experiential, and affective aspects of autism in a coherent framework based on a complex, non-linear multi-causality. On this foundation, bridges can be built between autistic people and their often non-autistic context, and quality of life prospects can be improved.
De Jaegher, Hanne
In this article, I sketch an enactive account of autism. For the enactive approach to cognition, embodiment, experience, and social interaction are fundamental to understanding mind and subjectivity. Enaction defines cognition as sense-making: the way cognitive agents meaningfully connect with their world, based on their needs and goals as self-organizing, self-maintaining, embodied agents. In the social realm, the interactive coordination of embodied sense-making activities with others lets us participate in each other's sense-making (social understanding = participatory sense-making). The enactive approach provides new concepts to overcome the problems of traditional functionalist accounts of autism, which can only give a piecemeal and disintegrated view because they consider cognition, communication, and perception separately, do not take embodied into account, and are methodologically individualistic. Applying the concepts of enaction to autism, I show: How embodiment and sense-making connect, i.e., how autistic particularities of moving, perceiving, and emoting relate to how people with autism make sense of their world. For instance, restricted interests or preference for detail will have certain sensorimotor correlates, as well as specific meaning for autistic people.That reduced flexibility in interactional coordination correlates with difficulties in participatory sense-making. At the same time, seemingly irrelevant "autistic behaviors" can be quite attuned to the interactive context. I illustrate this complexity in the case of echolalia. An enactive account of autism starts from the embodiment, experience, and social interactions of autistic people. Enaction brings together the sensorimotor, cognitive, social, experiential, and affective aspects of autism in a coherent framework based on a complex non-linear multi-causality. This foundation allows to build new bridges between autistic people and their often non-autistic context, and to improve quality of
Full Text Available Valsamma Eapen,1,2 Mary M Robertson3,41School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; 2Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Ingham Institute, Liverpool, NSW, Australia; 3Neuropsychiatry, University College London, UK; 4St Georges Hospital and Medical School, London, UKAbstract: This study addressed several questions relating to the core features of Tourette syndrome (TS including in particular coprolalia (involuntary utterance of obscene words and copropraxia (involuntary and inappropriate rude gesturing. A cohort of 400 TS patients was investigated. We observed that coprolalia occurred in 39% of the full cohort of 400 patients and copropraxia occurred in 20% of the cohort. Those with coprolalia had significantly higher Yale Global Tic Severity Scale (YGTSS and Diagnostic Confidence Index (DCI total scores and a significantly higher proportion also experienced copropraxia and echolalia. A subgroup of 222 TS patients with full comorbidity data available were also compared based on whether they had pure-TS (motor and vocal tics only or associated comorbidities and co-existent psychopathologies (TS-plus. Pure-TS and TS-plus groups were compared across a number of characteristics including TS severity, associated clinical features, and family history. In this subgroup, 13.5% had pure-TS, while the remainder had comorbidities and psychopathologies consistent with TS-plus. Thirty-nine percent of the TS-plus group displayed coprolalia, compared to (0% of the pure-TS group and the difference in proportions was statistically significant. The only other significant difference found between the two groups was that pure-TS was associated with no family history of obsessive compulsive disorder which is an interesting finding that may suggest that additional genes or environmental factors may be at play when TS is associated with comorbidities. Finally, differences between individuals
Comings, D E; Comings, B G
To determine the frequency of obsessive, compulsive, and schizoid behaviors in Tourette syndrome (TS), we prospectively questioned 246 patients with TS, 17 with attention-deficit disorder (ADD), 15 with ADD due to a TS gene, and 47 random controls. The comparative frequency of obsessive, compulsive, and repetitive behaviors--such as obsessive unpleasant thoughts, obsessive silly thoughts, echolalia, palilalia, touching things excessively, touching things a specific number of times, touching others excessively, sexual touching, biting or hurting oneself, head banging, rocking, mimicking others, counting things, and occasional or frequent public exhibitionism--were significantly more common in TS patients than in controls. The frequency of each of these was much higher for grade 3 (severe) TS. Most of these behaviors also occurred significantly more often in individuals with ADD or in individuals with ADD secondary to TS (ADD 2(0) TS). When these features were combined into an obsessive-compulsive score, 45.4% of TS patients had a score of 4-15, whereas 8.5% of controls had a score of 4 or 5. These results indicate that obsessive-compulsive behaviors are an integral part of the expression of the TS gene and can be inherited as an autosomal dominant trait. Schizoid symptoms, such as thinking that people were watching them or plotting against them, were significantly more common in TS patients than in controls. Auditory hallucinations of hearing voices were present in 14.6% of TS patients, compared with 2.1% of controls (P = .02). These symptoms were absent in ADD patients but present in ADD 2(0) TS patients. These voices were often blamed for telling them to do bad things and were frequently identified with the devil. None of the controls had a total schizoid behavior score greater than 3, whereas 10.9% of the TS patients had scores of 4-10 (P = .02). This frequency increased to 20.6% in the grade 3 TS patients. These quantitative results confirm our clinical
Tierney, Cheryl D; Gupta, Vidya Bhushan; Angel, Alma Patricia Del; Augustyn, Marilyn
Marcus is a handsome, sweet, 7½-year-old boy with a significant history of delayed development, specifically in speech and language skills, as well as difficulties with social interactions that have led other specialists to be concerned about a diagnosis of an autism spectrum disorder.He has been seen in our primary care practice since birth. He was born full-term after vaginal delivery weighing 6 pounds, 6 ounces. There were no pregnancy or delivery complications noted. Genetic testing revealed normal chromosomes, fragile X, and microarray testing. Marcus was a picky eater and good sleeper and had delays in toilet training.There is no family history of attention-deficit hyperactivity disorder (ADHD), autism, or substance abuse. Maternal grandmother and mother have a history of learning difficulties, and his father and a paternal uncle have a history of depression and anxiety. Marcus lives in a supportive environment with his mother, father, and sister.Marcus was noted to have significantly delayed language, stuttering, and immediate echolalia as a toddler. Gross and fine motor milestones were met on time, but he did not talk or follow directions until 4 to 5 years old. As a younger child, he would pretend to talk on the phone or mow the grass with a pretend lawn mower, but other household activities were not of interest to Marcus.Currently, he enjoys puzzles, reading, and board games. He likes to play with other children and can interact with familiar adults. Marcus is reported to initiate social interactions, although he has difficulty in understanding personal space. Imaginative play is preferred over other types. He seeks out adult attention and will bring objects over to an adult especially to share his perceived accomplishment. Marcus has difficulty in playing cooperatively with his sister.He is independent with activities of daily living. Marcus is noted to have auditory defensiveness including covering his ears to loud noises and becoming distressed
on their own to ensure that language develops. Nor is simple exposure to language enough. What is important is the interaction, both linguistic and non-linguistic, which derives from the child’s need to communicate (Tavakoli, 2012: 323. Next factor is cognitive development which refers to “developmental changes in cognitive abilities, processes, and structures” (Tavakoli, 2012: 62. The best known theory of childhood cognitive development is that of Jean Piaget. For Piaget language was both a social and a cognitive phenomenon. It was not an independent modular faculty but part of general cognitive and perceptual processing. Language acquisition was thus dependent upon cognitive development. The child’s level of language was determined by whether it had acquired certain fundamental concepts and by the complexity of the processing operations of which it was capable. Piaget suggested that cognitive development fell into four phases. They constitute a gradual progression in which previous stages are revisited cyclically. The age at which a particular child goes through each stage varies considerably. Each stage has implications for linguistic development. 1 Sensorimotor (birth to 2 years. The child achieves recognition of object permanence (the fact that an object still exists even when it is not in view. This is a prerequisite to the formation of concepts (including lexical concepts. 2 Preoperational (2 to 6 or 7 years. The child’s behavior reflects egocentric thought: it is unable to identify with the views of others. The child’s language progresses through echolalia (repeating others’ utterances to monologues (speaking aloud what would normally be private thoughts. It may engage in collective monologues with other children, in which participants appear to be taking turns, but express their own ideas without responding to those of others. 3 Concrete operational (6/7 to 11/12. The child’s vocabulary shows signs of organization into