Echopraxia in Schizophrenia, Autism, and Tourette Syndrome

Imitating others’ actions or gestures can be a natural human behavior, but when it happens frequently and involuntarily, it could be echopraxia.

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Mimicking or mirroring someone else’s actions can be a natural part of the human socialization and learning process. Young children often repeat the movements of adults or mirror social gestures while learning about social reciprocity.

Mirroring behaviors can also occur in adults, but it isn’t as common. For example, you may observe someone yawning and then have the urge to yawn.

However, when imitating others’ actions occurs frequently and involuntarily later in adolescence or as an adult, it could be echopraxia.

People with schizophrenia, Tourette syndrome, and those on the autism spectrum could be more likely to experience echopraxia, which may contribute to having social challenges.

What is echopraxia?

Echopraxia, also known as “echomotism,” is the involuntary repetition of another person’s movements or actions.

A person with this symptom may mimic your hand gestures during a conversation or copy how you walk.

This involuntary repetition of another person’s actions can also include harmful movements, such as kicking or biting themselves or others.

Although its cause is not completely understood, it often appears in autistic individuals, or people who have schizophrenia, Tourette syndrome, and other mental health conditions.

It can also occur in people with disorders of the brain or brain injury. In addition, echopraxia may appear in people with:

• autoimmune conditions
• epilepsy
• major neurocognitive disorder (previously known as dementia)
• culture-bound syndromes, including Latah, amurakh, and Imu

Furthermore, echopraxia can be a feature of catatonia found in some mental health conditions. It can also coexist with echolalia, which is the repetition of words or phrases another person says.

Scientists continue to investigate the causes of echopraxia. Still, according to a 2015 article, some researchers believe it may occur because of abnormalities in mirror neurons in the brain.

Mirror neurons are brain cells that direct you to copy what you’ve seen or heard and may be the reason behind contagious yawning.

Signs of echopraxia

Mimicking others can be a natural part of social development. However, people with echopraxia may be unable to control their body’s response to the physical movement of others.

A person with echopraxia may:

• copy the actions of teachers, which could lead to problems in school for some children
• mimic TV show or movie characters
• repeat potentially harmful actions, like kicking or punching

Because this occurs frequently, echopraxia might cause difficulties with social interactions and relationships. People unfamiliar with this symptom may not understand why they’re being imitated, which may lead to misunderstandings.

It may be a good idea to talk with a healthcare professional about echopraxia if mimicking or mirroring is occurring involuntarily, causing challenges in social interactions or daily functioning.

Connection to schizophrenia, autism spectrum disorder, and Tourette syndrome

Echopraxia can occur with several mental health conditions. Still, it may occur more frequently in autistic people and those with schizophrenia or Tourette syndrome.

Autism spectrum disorder (ASD)

Echopraxia can occur in autistic people. However, they typically mimic others less often than people with echopraxia in other conditions like schizophrenia.

It is more common for autistic people to experience echolalia — including copying accents and dialect styles.

Mimicking behavior can be reduced or excessive, depending on the individual. Some researchers say the “broken mirror” hypothesis explains the differences in repetitive and involuntary mimicking experienced by some autistic people.

Schizophrenia

For people with schizophrenia, a 2008 speculative paper suggests deficits in the mirror neuron system may play a role in echopraxia.

However, many people with schizophrenia are aware of their tendency to imitate others, which can occur more frequently when attempting to communicate.

Tourette syndrome

One of the first indications of Tourette syndrome is the presence of echopraxia, and it’s thought to be another variation of the tics associated with the condition.

A 2012 study suggests that echopraxia in people with Tourette syndrome is not the result of deficits in the mirror neuron system. Instead, it may result from interference in the frontal lobe of the brain that regulates imitation control.

Diagnosing echopraxia

Currently, there are no formal tests used to diagnose echopraxia. Instead, doctors and mental health professionals diagnose it based on a person’s medical and psychological history, alongside observation.

Because mimicking behavior can be a typical part of social development in children, echopraxia is generally not diagnosed in children younger than 3.

Additionally, part of the diagnostic process is determining whether the imitative behavior is intentional or involuntary.

Intentional mimicking can be a mechanism for learning new skills or social gestures, whereas involuntary copying of another person’s movements cannot be controlled and has no specific purpose. Identifying which type is occurring is easier in older children and adults.

Treatment options

Managing echopraxia often involves treating underlying mental health conditions, such as Tourette syndrome and schizophrenia.

Research on echopraxia treatment is limited. However, managing it is possible using:

• behavioral modification
• certain medications, especially for those with Tourette syndrome
• psychotherapy

Like all mental health conditions, you may need to try different things to find what works best for you.

If a brain injury or other neurological disorder is the reason behind a person experiencing echopraxia, treatment may include surgery or other methods to improve the underlying condition.

If echopraxia isn’t causing self-harm or the symptoms are mild, some people may choose to remain untreated.

Next steps

For some people, experiencing echopraxia can be uncomfortable, especially if symptoms are contributing to social difficulties and miscommunication.

Echopraxia is not your fault — you cannot control this mimicking behavior.

If you think you might have echopraxia, you’re not alone. There are actionable steps you can take to help manage this symptom.

You’ll first want to consider talking with a healthcare professional about anything you’re experiencing. You and a doctor can decide if there’s a need to pursue a diagnosis.

If you’re diagnosed with echopraxia, the next step is often to figure out the underlying condition, or try a new treatment for managing your condition if you already have a diagnosis.

If you know someone who’s diagnosed with echopraxia, being compassionate and understanding can help them feel safe and accepted.

It can also be helpful to advocate for someone with echopraxia around others who may not understand it. This can promote awareness and acceptance.

If you need some help finding a mental healthy professional, you can visit Psych Central’s hub.