Echolalia and Profound Mental Retardation: Norman's Communication

I first met Norman in 1994, when I was hired to work for a human services agency in Portland, Maine that had awarded the contract to provide him with residential services. Along with a roommate, Norman was in the process of being transitioned out of the institution where both men had lived and been cared for their entire lives. It was a very important, confusing, and terrifying time for Norman.

Norman was born with profound mental retardation. He had been blind since early adulthood, when both his retinas were detached after hitting his head repeatedly against a wall during an extreme case of self-injurious behavior. He suffered from grand mal seizure disorder, and he was non-verbal. Norman's only form of verbal expression was the repetitive uttering and yelling of specific words and phrases. This was due to a communication disorder called echolalia.

Echolalia is the repetition or echoing of verbal utterances made by another person. (Wikipedia) There are two forms of echolalia: immediate echolalia and delayed echolalia. In immediate echolalia, the echolalic person will repeat back words, phrases, or entire sentances that another person has just spoken aloud to them or in their presence. In cases of delayed echolalia, words, phrases, or much, much longer recitations are repeated at intervals, some time after they are first introduced to the echolalic person. Often, in cases of delayed echolalia, a person will repeat some of the same utterances for years, even over the duration of a lifetime. In some cases, it is thought to be simply compulsive, and in others, the delayed echolalia appears to have some communicative value.

In Norman's case, the echolalia was delayed echolalia, and was considered to be compulsive, and not communicative. He had a very specific repetoire of utterances: "Norman," "hey!" "shit," "are you wet?" "truck!" "oh!" "awwwww," and "Jesus Christ!" Most of these words and phrases were thought to be the repetitions of things that had been said to him or in his presence by institution staff and fellow residents over the years, and got "stuck" in the auditory portion his long-term memory.