Echolalia, a prevalent feature of Autism Spectrum Disorders (ASD), has been extensively debated among behaviourists and developmental researchers for decades, long segmenting clinical work within the context of autism. This qualitative study aimed to explore the interactive underpinnings of immediate echolalia naturally occurring in dyadic conversation between autistic individuals and clinicians, employing turn-by-turn and sequence-by-sequence analysis within the framework of Conversation Analysis (CA). The results revealed that varying the complete-incomplete-transformed format, echolalia helped participants a) express their emotions, b) automatically associate conversation, c) organise their response, d) maintain conversational reciprocity, and e) assist with request initiation. Within the context of echolalia, the dynamics of conversation exhibited blocking, diverting, or affiliating patterns. The current study provides insights into the interactive traits of immediate echolalia and underscores the potential utility for clinical therapists to employ the echoic sources in clinical intervention.