Echolalia

[Davey Do]

As someone else said in another thread about sitting with patients who are on 1:1 precautions, it can be reaaaaaaally boring. I would much rather be up, making rounds and providing care for patients than sit and watch a patient sleep. I feel more worn out after a night of sitting with a 1:1 patient than I do being up & about on a busy night.

I was sitting with Bob, a patient diagnosed with schizophrenia who is psychotic and can be a behavior problem, on one particular night. Bob was awake, yet resting quietly in bed when I took over the 1:1.

Bob acknowledged me when I came into the room: "Daaaaaave!", I smiled and nodded to him and said nothing more. So I sat there, feeling sleep-deprived, ready to hit the wall, when Bob again said "Daaaaaave!" So I said, "Boooooob!" and Bob repeated, "Boooooob!" I said, "No, you're Boooooob, and I'm Daaaaaave!" Bob repeated, "No, you're Boooooob, and I'm Daaaaaave!"

I soon found out that Bob would repeat anything I said, indicating he was manifesting a symptom of psychosis called echolalia.

So, from memory, I began reciting The Berenstains B Book, a book I had read perhaps a hundred times to Head Start children when I worked as a teacher's aid back in 1981. Bob repeated each portion:

"Big Brown Bear" "Big Brown Bear"... "Blue Bull" "Blue Bull" .... "Beauuuuuutiful Baboon" "Beauuuuuutiful Baboon"... "Blowing Bubbles"... all the way through the the Berenstain Bears "biking backwards, bumping Black Bugs banna boxes, Billy Bunny's bread baskets, Brother Bob's baseball bus, and Buster Beagle's Bagpipe bugle band (which) busted Baby Bird's balloon"!

For 45 minutes we repeated The Berenstains B Book, sometimes backwards, starting with Baby Bird's busted balloon and ending with Big Brown Bear. Bob seemed to enjoy echoing each portion, but he could not echo more than three words at a time. So, for example, I broke down Buster Beagle's bagpipe.... bugle band into two portions.

I mentioned that Bob was my echo and Bob said, "Bob is my echo", which eventually went to a "mellow echo" and then to a "cello echo".

I wondered aloud if a cello said "celllllo!" instead of "helllllo!" and kept repeating it, if that cello wasn't also manifesting a specialized symptom of psychosis:

Being sleep-deprived and sitting with a 1:1 psych patient on a MN shift will cause one to do and think such things.

[Waiting for Retirement]

Thank you for this, it was a much-needed smile in my day! Your patient was lucky for the interaction, and you got to stay more alert. Win-Win! ?

[smf0903]

LOL Davey ? This post made me smile...my daughter has high-functioning autism and had severe echolalia as a child. It made it challenging when we were trying to figure out if she knew how to read because she could recite a kid’s-sized book from memory after hearing it only once. That kid’s brain was like a vault, if she heard it once it was in there!

[amoLucia]

TY for the official term.

I remembered from way back that repetition was a real behavior. But I like to be reminded from time to time also.

Even though I've been retired for some time, I almost always learn something new or am reminded of something long forgotten here on AN.

There's another current post from a nurse asking about a customer service training film she watched a while back. It struck a 'Down Memory Lane' chord for me - I hadn't thought of that film in 30+ years. Now it's stuck in my brain!

[Davey Do]

8 hours ago, Waiting for Retirement said:

Thank you for this, it was a much-needed smile in my day! Your patient was lucky for the interaction, and you got to stay more alert. Win-Win! ?

Back atcha, WFR! Thank you for reinforcing my belief that both the patient and I benefitted.

It's work being positive. I'd much rather sit around and gripe and moan about how bad I've got it and play the part of a victim. Thank God for that little voice inside my head which always gives good advice.

16 hours ago, Davey Do said:

As someone else said in another thread about sitting with patients who are on 1:1 precautions, it can be reaaaaaaally boring.

My little voice said to me, "You're bored because you're boring". "Yeah", I replied, "There are no small parts in life. Only small actors". So I started interacting and playing around with Bob.

Something else: A phrase we often use in describing a patient with dementia is "pleasantly confused". Bob could be described as being "pleasantly psychotic", for he is typically animated and playful within his psychotic behavior.

If I ever become psychotic, I would want to follow Bob's path. So many other psychotic patients give mental illness a bad name.

You know?

[Davey Do]

6 hours ago, smf0903 said:

LOL Davey ? This post made me smile...my daughter has high-functioning autism and had severe echolalia as a child. It made it challenging when we were trying to figure out if she knew how to read because she could recite a kid’s-sized book from memory after hearing it only once. That kid’s brain was like a vault, if she heard it once it was in there!

Thanks, smf! Isn't it amazing how the brain works? Your daughter could recite an entire book from memory after hearing it only once, and I have to repeat something a hundred times to get it into my long term memory!

I enjoy learning through repetition as well as teaching through repetition. That's one reason why I didn't mind repeating The Berenstains B Book over and over for 45 minutes with Bob.

Another case in point is a situation where I was teaching a young in-law a bass picking part on the guitar. We sat for the longest time, taking turns picking out the part. Back and forth, back and forth until the young in-law picked it like a pro!

So, if your daughter's brain is like a vault, my brain is like a hamster on an exercise wheel!

[Davey Do]

5 hours ago, amoLucia said:

TY for the official term.

I put "TY" along with echolalia in Google and could find nothing Amolucia.

I'd be interested in learning more, because all I got was "Thank You".

YW.

[amoLucia]

TY = thank you

Uh, is echolalia the real term? I'm too lazy to look it up. Bad me!

You brought back memories of Hammy, the pet hamster, in the School Nsg Room.

[TriciaJ, RN]

The last patient I saw with echolalia had been transferred to psych from a medical floor for "psychosis". She was worsening despite receiving repeated doses of Trilafon. When she arrived on the unit she had severe echolalia as well as grossly elevated vital signs.

Turned out she had neuroleptic malignant syndrome.

[Davey Do]

13 minutes ago, amoLucia said:

Uh, is echolalia the real term? I'm too lazy to look it up. Bad me!

ech·o·la·li·a

PSYCHIATRY

meaningless repetition of another person's spoken words as a symptom of psychiatric disorder.

17 minutes ago, amoLucia said:

You brought back memories of Hammy, the pet hamster, in the School Nsg Room.

I couldn't find Hammy, Amolucia, so will Tina Turner do?

[amoLucia]

perseveration? My brain is foggy now but I'm thinking something along this line when pts repeat & repeat.

Hammy died over last summer if I remember right. Was kind of the group's collective pet.

[Davey Do]

12 minutes ago, TriciaJ said:

The last patient I saw with echolalia had been transferred to psych from a medical floor for "psychosis". She was worsening despite receiving repeated doses of Trilafon. When she arrived on the unit she had severe echolalia as well as grossly elevated vital signs.

Turned out she had neuroleptic malignant syndrome.

Interesting!

Bob was transferred to the medical floor during the week that I am off due to an elevated creatinine level/decreased kidney function believed to be a result of fluphenazine (Prolixin) toxicity. Bob was also on perphenazine (Trilafon) along with Depakote, Haldol, Ativan and Zyprexa!

All psych meds were stopped on the medical floor, Bob was administered IV fluids which improved his kidney function, and he was transferred back to geriatric psych.

I remember my first case of NMS back in the early 90's. I was working at the state hospital and was asked to evaluate a patient in a cottage other than the one where I worked. I had just learned about NMS, this patient was manifesting classic symptoms, and I followed through accordingly. Sure enough :The MD diagnosed and treated the patient for NMS.

I've known of only three cases in my career.

Bob's main symptoms were decreased intake and lethargy and those are the reasons he was evaluated and sent to medical.