Reciprocal Imitation Training Research Articles

Unleashing potential: Boosting physical activity in children with developmental disabilities via a family-dog-assisted intervention

Abstract In the context of a global crisis, where over 80% of children fail to meet minimum standards of physical activity, children with developmental disabilities may face an even greater health disparity. Despite being disproportionately less physically active than the broader population, those with developmental disabilities are often excluded from mainstream interventions. This study evaluated a novel animal-assisted intervention (AAI) that incorporated the family pet dog, with the goal of increasing physical activity in children with developmental disabilities. The intervention involved teaching child participants to engage in “Do as I Do” (DAID) reciprocal-imitation training with their dog over ten 60-min sessions. After enrollment, 45 child-dog pairs of children and their family dogs were randomly assigned to either the experimental intervention (DAID) group, the active control group (dog walking control [DWC]), or the passive control group (waitlist control [WC]). Physical activity was measured using a 7-day ActiGraph accelerometer monitoring process, and data were analyzed for children who wore the accelerometer for a minimum of 4 days at both assessment time points (N = 14). Participation in the intervention (DAID) group was found to significantly increase moderate-to-vigorous physical activity (MVPA) by 1.2 min/h ( p = 0.0087; Cohen’s d = 1.7) and significantly reduce sedentary behavior by 4.03 min/h ( p = 0.027; d = 1.3), outperforming the waitlist control group. Our findings demonstrate the potential of this novel dog-assisted intervention to improve physical activity in this population, thereby contributing to a reduction in health disparities.

Brief Report: Telehealth Music-Enhanced Reciprocal Imitation Training in Autism: A Single-Subject Feasibility Study of a Virtual Parent Coaching Intervention.

Telehealth delivery increases accessibility of parent-mediated interventions that teach parents skills and support autistic children's social communication. Reciprocal Imitation Training (RIT), an evidence-based Naturalistic Developmental Behavioral Intervention (NDBI) focused on imitation skills, a common difficulty in autism, holds promise for telehealth-based parent training. Imitation is also a core component of musical play during childhood and the affordances of musical play/song naturally shape parent-child interactions. We evaluate the feasibility of a music-based, telehealth adaptation of RIT-music-enhanced RIT (tele-meRIT)-as a novel format for coaching parents in NDBI strategies. This single-subject, multiple baseline design study included 4 autistic children (32-53months old) and their mothers. Parent-child dyads were recorded during 10-min free play probes at baseline, weekly tele-meRIT sessions, and one-week and one-month follow-up. Probes were coded for parents' RIT implementation fidelity, parent vocal musicality, and children's rate of spontaneous imitation. No parent demonstrated implementation fidelity during baseline. All parents increased their use of RIT strategies, met fidelity by the end of treatment, and maintained fidelity at follow-up. Parent vocal musicality also increased from baseline. Intervention did not consistently increase children's imitation skills. A post-intervention evaluation survey indicated high parent satisfaction with tele-meRIT and perceived benefits to their children's social and play skills more broadly. Implementing tele-meRIT is feasible. Although tele-meRIT additionally involved coaching in incorporating rhythmicity and song into play interactions, parents achieved fidelity in the RIT principles, suggesting one avenue by which music can be integrated within evidence-based parent-mediated NDBIs.

Behavioural and cognitive-behavioural interventions for outwardly directed aggressive behaviour in people with intellectual disabilities.

Behavioural and cognitive-behavioural interventions for outwardly directed aggressive behaviour in people with intellectual disabilities.

The Effect of Reciprocal Imitation Training on Increasing Expressive Vocabulary of Children with Autism Spectrum Disorders

"Objective: One of the areas of impairment in childhood autism spectrum disorders is delayed imitation. Due to the defect in the social function of imitation in these children and its negative consequences on lexical and verbal skills, Researchers in the field of educating autistic children consider increasing imitation skills to be a very important therapeutic goal. Previous studies have shown the effects of improving imitation on increasing the social, linguistic, and verbal skills of these children. In the present study, the effect of reciprocal imitation training on increasing the vocabulary of autistic children was investigated. Materials and Methods: This was an interventional study with a pretest-posttest design. 16 autistic children were trained in crossborder imitation based on expressive vocabulary in 96 sessions. After performing post-test and data collection in data analysis from the McNemar test to determine the changes of each word before and after the intervention and the Wilcoxon Marked Test was used to determine changes in vocabulary categories before and after the intervention and the level of statistical significance was considered (P> 0.05). Results: The results of data analysis show that the average number of responses ""expresses"" in each of the words after the intervention increased significantly in all vocabulary groups (P> 0.05). It seems that the intervention resulted in significant changes in participants. Conclusion: The results of this study show that teaching the method of reciprocal imitation has a significant effect on increasing the number of expressive words in autistic children. "

Examining a stepped-care telehealth program for parents of young children with autism: a proof-of-concept trial

BackgroundIntervention during the first years of life for children with autism spectrum disorder (ASD) may have the strongest impact on long-term brain development and functioning. Yet, barriers such as a shortage of trained professionals contribute to significant delays in service. The goal of this proof-of-concept study was to explore strategies that support timely and equitable deployment of ASD-specific interventions.MethodsThis 15-week, randomized proof-of-concept study explored the acceptability of a digital parent mediated intervention online reciprocal imitation training (RIT; a naturalistic developmental behavioral intervention) and compared it to a treatment as usual (TAU) control on parent and child outcomes. Eligible children were between 18 and 60 months, met the cutoff for ASD on the Autism Diagnostic Observation Schedule-2nd Edition and demonstrate significant social imitation deficits. Primary outcomes include the acceptability of RIT (Scale of Treatment Perceptions) and the feasibility of the Online RIT digital intervention (online RIT attributes). Secondary outcomes included parent fidelity (RIT parent fidelity form) and parental self-efficacy (Early Intervention Parenting Self-Efficacy Scale). Exploratory outcome measures included child social communication (Social Communication Checklist), child imitation skills (Unstructured Imitation Assessment), and family quality of life (Beach Center Family Quality of Life Scale).ResultsTwenty participants were randomized in a 1:1 fashion. The acceptability and feasibility of RIT and the Online RIT digital intervention were rated highly. Among the secondary outcomes, there were significant group differences in parent fidelity (p < .001) and self-efficacy (p = .029). On exploratory outcomes, there were group differences in child social communication (p = .048). There were no significant group differences in imitation ability (p = .05) or family quality of life (p = .22).LimitationsThere are several limitations with this study, including the small sample size as well as lack of data on enactment and website engagement. This study was not able to address questions related to which variables predict program engagement and treatment response, which will be critical for determining which families may benefit from such a stepped-care delivery model.ConclusionsOverall, the Online RIT program delivered in a stepped-care format shows strong acceptability and holds promise as an innovative delivery model.Trial registration ClinicalTrials.gov, NCT04467073. Registered 10 July 2020- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04467073

The implementation of reciprocal imitation training in a Part C early intervention setting: A stepped-wedge pragmatic trial.

Despite the development of several evidence-based Naturalistic Developmental Behavioral Interventions (NDBIs), very few have been adapted for use in community-based settings. This study examines the implementation of Reciprocal Imitation Training (RIT)-an NDBI-by community Early Intervention (EI; IDEA Part C) providers serving toddlers from birth to 3 years. Of the 87 EI providers enrolled from 9 agencies in 4 counties across Washington State, 66 were included in the current sample. A stepped-wedge design was used to randomly assign counties to the timing of RIT training workshops. Self-report measures of practice and self-efficacy regarding ASD care were collected at baseline (T1, T2) and 6-months and 12-months post-training (T3, T4). At T3 and T4, providers reported on RIT adoption and rated items about RIT feasibility and perceived RIT effectiveness; at T4, they also reported on child characteristics that led to RIT use and modifications. From pre-training to post-training, there were significant increases in providers' self-efficacy in providing services to children with ASD or suspected ASD. At T3 and T4, provider ratings indicated high levels of RIT adoption, feasibility, and perceived RIT effectiveness. At T4, providers indicated that they most commonly: (a) initiated RIT when there were social-communication or motor imitation delays, or an ASD diagnosis; and (b) made modifications to RIT by repeating elements, blending it with other therapies, and loosening its structure. While additional research is needed, RIT may help families get an early start on accessing specialized treatment within an established infrastructure available across the United States. LAY SUMMARY: Reciprocal imitation training (RIT) is an evidence-based treatment for ASD that might be a good fit for use by intervention providers in widely accessible community-based settings. After attending an educational workshop on RIT, providers reported feeling more comfortable providing services to families with ASD concerns, used RIT with over 400 families, and believed that RIT improved important social communication behaviors.

The Effect of Reciprocal Imitation Training on the Function of Upper Limbs and Motor Skills of Children with Cerebral Palsy

The Effect of Reciprocal Imitation Training on the Function of Upper Limbs and Motor Skills of Children with Cerebral Palsy

The effect of contingent imitation intervention on children with autism spectrum disorder and co-occurring intellectual disabilities

BackgroundImitation plays a crucial role in the development of social communication, and it is a skill that is often missing in children with autism spectrum disorder and co-occurring intellectual disabilities. Contingent imitation (CI) results in increased social eye gaze, an imitation cue for children with ASD. A series of studies on Reciprocal Imitation Training (RIT) intervention that included CI has demonstrated an increase in imitation frequency. However, little is known about CI intervention’s effects on motor, object, and vocal imitation accuracy in children with ASD-ID. MethodThe participants in this study were six 4-year-old children with ASD-ID. A single case experimental design with multiple probes across target behaviors was used to identify CI intervention's efficacy on the motor, object, and vocal imitation. Moreover, pre-and post-assessment analysis evaluated socially engaged imitation and imitation turn-taking. ResultsMost motor, object, and vocal imitation accuracy increased through the CI intervention. However, individual adaptations such as prompting for looking behaviors and motor responses were required to increase specific target behaviors. Moreover, all children increased socially engaged imitation and imitation turn-taking through CI intervention and CI + prompting intervention. ConclusionsCI intervention is an efficacious intervention method for increasing the accuracy of imitation in children with ASD-ID. Furthermore, CI + prompting intervention is effective when CI intervention alone does not improve imitation accuracy. CI + prompting interventions using a decision tree tailored for each child could identify the intervention strategies for improving imitation accuracy during play activities and increase the understanding of ASD-ID children's imitation accuracy difficulties.

Effects of Reciprocal Imitation Training on Social Communication Skills of Young Children with Autism Spectrum Disorder

The aim of the current study was firstly to examine the effectiveness of Reciprocal Imitation Training (RIT) on a) imitation of object actions and gestures and b) maintenance of these skills in children with Autism Spectrum Disorder (ASD). Secondly, the purpose was to explore the effectiveness of object and gesture imitation teaching with RIT on motor imitation skills, initiating and responding to initiations of joint attention, play and verbal imitation skills, communicative behaviors and vocabulary, and contextually appropriate use of language. The design of this study was Modified Multiple Baseline Design Across Subjects. The study group consisted of three children with ASD. The results of this study showed that for all subjects there was an increase in the object and gesture imitation. Also, the findings showed that RIT increased motor imitation, verbal imitation, and play skills as well as the frequency of initiating and responding to initiations of joint attention, communicative behaviors, and vocabulary. The results are discussed in line with the literature related to teaching imitation in early childhood period.

Parents training parents: Lessons learned from a study of reciprocal imitation training in young children with autism spectrum disorder.

Parent-mediated interventions are cost-effective ways to increase access to appropriate treatment services to children with autism spectrum disorder. We aimed to engage parents working as partners within rural autism identification teams to facilitate prompt initiation of autism-specific treatment services and expand the amount of treatment available to young children with autism spectrum disorder. To do this, we sought to employ a two-phase training approach: (Phase 1) train parents to fidelity in an evidence-based parent-mediated intervention (reciprocal imitation training), and (Phase 2) evaluate the extent to which parents could effectively coach other parents of newly diagnosed children to implement reciprocal imitation training with their child. We experienced several unexpected barriers to completing all aspects of the Phase 1 training workflow. This led us to pivot toward a process evaluation. We used qualitative interviewing with our partner parents to systematically identify barriers and enhance the likelihood for successful future efforts at such an approach. The lessons we learned and recommendations for others attempting this type of research are presented.

Effects of coaching on the fidelity of parent implementation of reciprocal imitation training.

Imitation is an important early social communicative skill that is often impaired in young children with autism. Reciprocal imitation training is an easy-to-implement intervention that targets social imitation and can be taught to parents or other caregivers to implement at home and in the community. In this study, parents of children with autism were taught to implement reciprocal imitation training. The quality of parent fidelity of intervention implementation and rates of child spontaneous imitation were examined in three phases: baseline, post-didactic training, and after the introduction of 1:1 coaching. The results suggest that coaching improved parent fidelity with all parent participants, and this correlated to an increase in spontaneous imitation with some of the child participants.

Improving social functioning and challenging behaviors in adolescents with ASD and significant ID: A randomized pilot feasibility trial of reciprocal imitation training in a residential setting

ABSTRACTThere is a lack of effective social interventions for youths with ASD and co-morbid intellectual disability (ID). A previous single-case design study indicated that reciprocal imitation training (RIT) may improve social interaction and challenging behavior in this population. The current pilot study examined the feasibility of conducting an RCT to investigate the effectiveness of RIT for improving social functioning and challenging behaviors in 20 adolescents with ASD and severe ID in a residential program. The assessment protocol was feasible. RIT was well-tolerated by the adolescents and implemented with fidelity by teaching staff. Preliminary findings indicate that treatment had moderate to large effects on social functioning and challenging behavior, with mixed findings for imitation skills. A larger RCT of RIT for this population is feasible and warranted.

A Parent-Implemented Intervention to Improve Imitation Skills by Children with Autism: A Pilot Study

The purpose of this exploratory study was to examine the effects of a modified reciprocal imitation training (RIT) on the imitation skills of children with autism. Two parents were trained and coached to use the modified RIT with their young children with autism in home settings. The modified RIT was composed of contingent imitation, descriptive language, object imitation, and gestural imitation strategies. A multiple baseline design across strategies was used to examine the parents’ competence in learning and implementing the modified RIT. Results indicated that both parents learned to use the intervention strategies, and children showed improvements in their imitation skills.

Prospective Social Entrainment: Imitation Interventions in Children With Autism

Imitation provides the basis for acquiring knowledge, as well as providing a foundation for the development of reciprocal social skills. Children with autism spectrum disorders (ASD) do not naturally imitate others, and it is hypothesized that deficits in imitation may impede their ability to develop both academically and socially. Early imitation intervention studies, using traditional direct teaching (e.g., teacher-directed discrete trial training), focused on the learning function of imitation and were successful in improving skill acquisition but had little impact on the development of socially successful interactions. More recently, imitation interventions have targeted reciprocal or synchronous imitation (e.g., child-directed reciprocal imitation training), focused on the social function of imitation and have resulted in gains in imitation abilities and concomitant improvements in social engagement. This article explores imitation deficits in individuals with ASD, describes basic and applied research focusing on improving imitation skills, discusses implications for clinical intervention, and provides a synthesis of the current literature within the framework of prospective cognition.

Social Intervention for Adolescents With Autism and Significant Intellectual Disability: Initial Efficacy of Reciprocal Imitation Training

Individuals with autism have difficulty with social skills across the lifespan. Few social interventions have been examined for older individuals with autism who also have significant intellectual disabilities (ID). Previous research suggests that reciprocal imitation training (RIT) improves imitation and social engagement in young children with autism. This study used a multiple-baseline design to examine whether RIT could improve social behaviors in four adolescents with autism and significant ID. All adolescents improved their spontaneous imitation and two improved their joint engagement. In addition, two adolescents decreased their rate of self-stimulatory behaviors over the course of treatment. Overall, these results suggest that RIT may be effective at improving social interaction and decreasing self-stimulatory behavior in adolescents with autism and significant ID.

Disseminating ASD Interventions: A Pilot Study of a Distance Learning Program for Parents and Professionals

There is a need for the adaptation of training in evidence-based interventions to non-traditional methods, particularly for individuals working with children with autism spectrum disorders (ASD). An internet-based self-directed distance learning program was created to teach reciprocal imitation training, a naturalistic behavioral intervention aimed at increasing imitation in children with ASD. A single-subject multiple-baseline design study evaluated the effect of the program on changes in therapist (sample 1) and parent (sample 2) knowledge and behavior, and changes in child behavior. Adult participants improved their knowledge and use of the intervention techniques, and child participants improved their rates of imitation. Results suggest that a self-directed distance learning program may be effective for disseminating evidence-based practices to individuals working with children with ASD.

Evaluation of a Sibling-Mediated Imitation Intervention for Young Children with Autism.

Parents and peers have been successful at implementing interventions targeting social interactions in children with autism; however, few interventions have trained siblings as treatment providers. This study used a multiple-baseline design across six sibling dyads (four children with autism) to evaluate the efficacy of sibling-implemented reciprocal imitation training. All six typically developing siblings were able to learn and use contingent imitation, four of the six siblings were able to learn and use linguistic mapping, and all six siblings increased their use of at least one component of the imitation training procedure. Three of the four children with autism showed increases in overall imitation and all four showed evidence of increases in joint engagement. Parents and siblings reported high satisfaction with the intervention and ratings by naïve observers indicated significant changes from pre- to post-treatment. These results suggest that sibling-implemented reciprocal imitation training may be a promising intervention for young children with autism.

Promoting Imitation in Young Children with Autism: A Comparison of Reciprocal Imitation Training and Video Modeling

The inability to imitate is a salient diagnostic marker for autism. It has been suggested that for children with autism, imitation may be a prerequisite skill that can assist in the development of various skills. Using a multiple baseline design across subjects, the purpose of this research was to determine if two interventions, reciprocal imitation training and video modeling were effective in promoting imitation acquisition in young children with autism. Six boys were matched across various features (i.e., age, language, autism severity) and randomly placed in a treatment condition. Results indicated that all six participants increased their imitation skills to varying degrees in both conditions, and imitation maintained and generalized at higher than baseline levels post treatment.

Pilot randomized controlled trial of Reciprocal Imitation Training for teaching elicited and spontaneous imitation to children with autism.

Children with autism exhibit significant deficits in imitation skills. Reciprocal Imitation Training (RIT), a naturalistic imitation intervention, was developed to teach young children with autism to imitate during play. This study used a randomized controlled trial to evaluate the efficacy of RIT on elicited and spontaneous imitation skills in 21 young children with autism. Results found that children in the treatment group made significantly more gains in elicited and spontaneous imitation, replicating previous single-subject design studies. Number of spontaneous play acts at pre-treatment was related to improvements in imitation during the intervention, suggesting that children with a greater play repertoire make greater gains during RIT.

Teaching reciprocal imitation skills to parents of young children with autism supports socially valid parent engagement with their children1

What is the effectiveness of parent-implemented reciprocal imitation training (RIT) with young children with autism. Abstracted from: Ingersoll B. & Gergans S. (2007). The effect of a parent-implem...