Which Approach Should You Use?
Whether you’re a parent or a therapist it can be challenging at times to know which interventions or strategies are best to use to increase joint attention, engagement, imitation, and communication skills in autistic children.
One intervention that I have found extremely beneficial for my clients in my practice is Reciprocal Imitation Training (RIT). RIT is an evidence-based naturalistic developmental behavior intervention (NDBI) that teaches generalized, spontaneous imitation to young children with autism spectrum disorder (ASD) within a social-communicative context. Improvements in the areas of gestural and object imitation using RIT have been associated with increases in verbal imitation and spontaneous language.
We know that imitation is a foundational skill in early development by which children learn new skills and engage in social interactions with others. Specifically, imitation plays a critical role in the development of social communication, including language, pretend play, social interaction, and emotional exchange. Most autistic children have difficulty with imitating others.
The basis of RIT relies on imitating your child’s gestures, vocalizations, and actions with objects/toys. Imitating your child’s play promotes shared attention and social responsiveness and increases the number of different play ideas your child has. Imitating your child’s speech or preverbal vocalizations promotes the use of spontaneous language and vocalizations. Imitating your child also paves the road for teaching reciprocal imitation because your child learns that imitation is a back-and-forth interaction.
The great thing about RIT is that it can be implemented in a variety of play settings (e.g., inside, outside) as well as during daily routines (e.g., bath time). This technique uses several strategies to teach imitation skills, some of which include:
Being face to face at your child’s level
Imitating play with toys
Imitating gestures and body movements
Using simplified language
Stressing key words
Expanding your child’s language
Using these strategies, RIT is broken down into different phases, including:
Imitating your child
Teaching object imitation
Expanding your child’s play skills
Teaching gesture imitation
Teaching imitation during daily routines
Teaching different actions
Putting it all together, RIT is basically comprised of 5 steps:
Imitate your Child – imitate their actions, movements, and vocalizations
Describe Play – narrate using simple repetitive language at your child’s level
Model Actions or Gestures – model up to 3 times and use a verbal label with your model
Follow Through – ensure your child imitates, use physical cues, and supports as needed
Praise – provide praise when your child imitates spontaneously or with support
To learn more about Reciprocal Imitation Training (RIT), check out my 90-minute ASHA and BACB approved course, Bridging the Gap where you will learn how to analyze and teach a generalized imitative repertoire using the evidence-based interventions of Reciprocal Imitation Training (RIT) and Rapid Motor Imitation Antecedent (RMIA) Training as the basis for teaching language to young pre-verbal children with autism.
If you are interested in the research that supports the efficacy of this intervention, check out the research findings:
Cardon, T. A., & Wilcox, M. J. (2011). Promoting imitation in young children with autism: A comparison of reciprocal imitation training and video modeling. Journal of Autism and Developmental Disorders, 41(5), 654-666.
Ingersoll, B. (2012). Brief report: Effect of a focused imitation intervention on social functioning in children with autism. Journal of autism and developmental disorders, 42(8), 1768-1773.
Ingersoll, B. (2010). Brief report: Pilot randomized controlled trial of reciprocal imitation training for teaching elicited and spontaneous imitation to children with autism. Journal of autism and developmental disorders, 40(9), 1154-1160.
Ingersoll, B., & Gergans, S. (2007). The effect of a parent-implemented imitation intervention on spontaneous imitation skills in young children with autism. Research in developmental disabilities, 28(2), 163-175.Ingersoll, B., & Lalonde, K. (2010).
Ingersoll, B., & Lalonde, K. (2010). The impact of object and gesture imitation training on language use in children with autism spectrum disorder. Journal of Speech, Language, and Hearing Research, 53(4), 1040-1051.
Ingersoll, B., Lewis, E., & Kroman, E. (2007). Teaching the imitation and spontaneous use of descriptive gestures in young children with autism using a naturalistic behavioral intervention. Journal of autism and developmental disorders, 37(8), 1446-1456.
Ingersoll, B., & Schreibman, L. (2006). Teaching reciprocal imitation skills to young children with autism using a naturalistic behavioral approach: Effects on language, pretend play, and joint attention. Journal of autism and developmental disorders, 36(4), 487-505.
Ingersoll, B., Walton, K., Carlsen, D., & Hamlin, T. (2013). Social intervention for adolescents with autism and significant intellectual disability: initial efficacy of reciprocal imitation training. American journal on intellectual and developmental disabilities, 118(4), 247-261.
Wainer, A. L., & Ingersoll, B. R. (2013). Disseminating ASD interventions: a pilot study of a distance learning program for parents and professionals. Journal of autism and developmental disorders, 43(1), 11-24.
Wainer, A. L., & Ingersoll, B. R. (2015). Increasing access to an ASD imitation intervention via a Telehealth parent training program. Journal of autism and developmental disorders, 45(12), 3877-3890.
Walton, K. M., & Ingersoll, B. R. (2012). Evaluation of a sibling-mediated imitation intervention for young children with autism. Journal of positive behavior interventions, 14(4), 241-253.