Trajectories of imitation skills in preschoolers with autism spectrum disorders

Martina Franchini,Marie Schaer,Nada Kojovic,Irène Pittet

doi:10.1186/s11689-021-09412-y

Abstract

BackgroundImitation skills play a crucial role in social cognitive development from early childhood. Many studies have shown a deficit in imitation skills in children with autism spectrum disorders (ASD). Little is known about the development of imitation behaviors in children with ASD. This study aims to measure the trajectories of early imitation skills in preschoolers with ASD and how these skills impact other areas of early development.MethodsFor this purpose, we assessed imitation, language, and cognition skills in 177 children with ASD and 43 typically developing children (TD) aged 2 to 5 years old, 126 of which were followed longitudinally, yielding a total of 396 time points.ResultsOur results confirmed the presence of an early imitation deficit in toddlers with ASD compared to TD children. The study of the trajectories showed that these difficulties were marked at the age of 2 years and gradually decreased until the age of 5 years old. Imitation skills were strongly linked with cognitive and language skills and level of symptoms in our ASD group at baseline. Moreover, the imitation skills at baseline were predictive of the language gains a year later in our ASD group. Using a data-driven clustering method, we delineated different developmental trajectories of imitation skills within the ASD group.ConclusionsThe clinical implications of the findings are discussed, particularly the impact of an early imitation deficit on other areas of competence of the young child.

Highlights

Imitation skills play a crucial role in social cognitive development from early childhood
Results within the autism spectrum disorders (ASD) group Relation of imitation with level of symptoms and developmental domains at baseline Within our ASD group for whom the Mullen Scales of Early Learning was available (n = 133, 113 males/20 females, age range 2.0–4.8 years old), imitation skills were moderately negatively related to the level of symptoms, as the children who show the most of symptoms are those with more imitation difficulties
Imitation skills were strongly positively correlated with the composite score of cognitive skills at baseline, as well as communication skills (Receptive and Expressive Language) (ELC: rs = 0.671, p < .001; receptive language (RL): rs= 0.778, p < .001, expressive language (EL): rs= 0.738, p < .001), that is, children with lower imitation skills were those with lower skills in these domains

Summary

Introduction

Imitation skills play a crucial role in social cognitive development from early childhood. During the 2 first years of life, children gradually increase their imitative behaviors both in frequency and complexity, along with the development of their cognitive and social abilities [1]. Imitation deficits were linked to difficulties in social communication skills, such as language [19, 20], joint attention [21], and social interaction difficulties [9]. Such a deficit could hinder the effectiveness of intervention methods for children with ASD, as many of them rely upon imitation to teach new abilities [22,23,24]. Given the critical role that the imitation skills play in typical development, precise characterization of the deficit in this domain in ASD is of utmost importance

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