Reciprocal Imitation Teaching for Autism

Overseen By Daina Tagavi, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Washington

Disqualifiers: Severe impairments, serious conditions, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aims to improve support for children showing early signs of Autism Spectrum Disorder (ASD) by training early intervention providers. It tests the effectiveness of a training called Reciprocal Imitation Teaching (RIT), which helps providers coach caregivers, boosting family and child outcomes. Two groups participate: one receives RIT training, while the other focuses on coaching for daily routines without using RIT. This study suits families with children aged 18 to 30 months who have ASD or social communication issues and receive services from participating agencies. Additionally, early intervention providers must have at least two children with ASD in their caseload and be willing to invite families to the trial. As an unphased trial, this study offers families the opportunity to contribute to innovative research that could enhance early intervention strategies for ASD.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Reciprocal Imitation Teaching (RIT) safely helps children with early signs of Autism Spectrum Disorder (ASD) improve their social skills. RIT functions more as a teaching method than a medical treatment. It trains caregivers to interact with children in specific ways to enhance communication and engagement.

Since RIT is neither a drug nor a medical procedure, reports of physical side effects or negative reactions, common with some medications, do not exist. Instead, it focuses on improving communication and interaction through guided activities. Evidence indicates that RIT enhances support for children with ASD without any safety concerns.

Prospective participants in a study involving RIT can feel confident that it emphasizes learning and interaction, rather than anything invasive or risky. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Reciprocal Imitation Teaching (RIT) because it introduces a fresh approach to enhancing social engagement in young children, particularly those with developmental delays. Unlike standard early intervention methods that often involve traditional therapist-led sessions, RIT actively engages caregivers by coaching them to use imitation during everyday routines like snack time and playtime. This hands-on approach empowers families to integrate learning into daily life, potentially leading to more natural and sustained social interactions for the child.

What evidence suggests that this trial's treatments could be effective for children with early signs of ASD?

Research has shown that Reciprocal Imitation Teaching (RIT), studied in this trial, can significantly improve imitation skills in children with autism. Studies found that children who participated in RIT improved in copying actions both spontaneously and when prompted. This play-based method aims to engage children in natural interactions. In this trial, some providers will receive RIT training to coach families, while others will focus on enhancing children's participation during daily routines. Providers trained in RIT reported increased confidence in setting and discussing treatment goals with families. Overall, early evidence supports RIT as an effective way to boost social communication skills in young children with autism. ^{4 6 7 8 9}

Who Is on the Research Team?

Wendy L Stone, PhD

Principal Investigator

University of Washington

Are You a Good Fit for This Trial?

Inclusion Criteria

Child is between 18 and 30 months of age at study entry

The child has difficulty with social communication skills that are typical in those with Autism Spectrum Disorder.

You are fluent in English.

Exclusion Criteria

Child has no severe visual, auditory, or physical impairments and no serious medical, genetic, or neurological conditions that would impede their ability to engage in RIT.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

EI providers receive training workshops on RIT or Daily Routines

1 week

1 virtual workshop

Caregiver Participation

Caregivers participate in videotaped sessions and complete surveys at multiple time points

6 months

3 visits (in-home)

Follow-up

Participants are monitored for safety and effectiveness after training

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Daily Routines
• Reciprocal Intervention Teaching (RIT)

How Is the Trial Designed?

Group I: RIT Training Group Experimental Treatment 1 Intervention

Providers in the RIT group (n=30) will receive an 8-hour virtual workshop (2 half-days) on RIT implementation and caregiver coaching. Each provider will invite 2 families in their caseload to participate in the study. Providers will coach families in the use of RIT. One intervention session for each enrolled family will be videotaped and scored for RIT fidelity.

Group II: Daily Routines Active Control 1 Intervention

Providers in the Routines Control group (n=30) will receive a 3-hour virtual workshop focused on helping providers coach caregivers on how to increase children's participation and social engagement during everyday home routines (i.e., snack time, bedtime, bath time, and family playtime). Each provider will invite 2 families in their caseload to participate in the study. One intervention session for each enrolled family will be videotaped and scored for RIT fidelity to ensure contamination has not occurred and the control condition providers are not utilizing RIT strategies.

Who Is Running the Clinical Trial?

University of Washington

Lead Sponsor

Trials

1,858

Recruited

2,023,000+

Congressionally Directed Medical Research Programs

Collaborator

Trials

59

Recruited

10,600+

Published Research Related to This Trial

Reciprocal imitation training (RIT) effectively teaches children with autism spectrum disorder (ASD) to imitate gestures and objects, leading to improvements in spontaneous language use.

In a study involving 4 children, adding gesture imitation training resulted in greater language use for 3 of the participants, indicating that combining gesture and object imitation training can enhance language development in children with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of object and gesture imitation training on language use in children with autism spectrum disorder. Ingersoll, B., Lalonde, K.[2023]

The study demonstrated that three individuals with classic Rett syndrome, aged 15 to 47, were able to learn new communication behaviors using functional assessment and functional communication training methods.

These findings suggest that individuals with Rett syndrome can effectively use voice-output switches to communicate, highlighting the potential for developing evidence-based communication interventions for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional communication training in rett syndrome: a preliminary study. Byiers, BJ., Dimian, A., Symons, FJ.[2014]

After training in Reciprocal Imitation Training (RIT), 66 Early Intervention providers reported significant increases in their confidence and self-efficacy in delivering services to children with Autism Spectrum Disorder (ASD).

Providers successfully adopted RIT with over 400 families, indicating high feasibility and perceived effectiveness, especially for children with social-communication or motor imitation delays, suggesting RIT could be a valuable early intervention in community settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The implementation of reciprocal imitation training in a Part C early intervention setting: A stepped-wedge pragmatic trial. Ibañez, LV., Scott, S., Stone, WL.[2022]

Citations

1. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/abs/10.1002/aur.2522

The implementation of reciprocal imitation training in a Part ... This study examines the implementation of Reciprocal Imitation Training (RIT)—an NDBI—by community Early Intervention (EI; IDEA Part C) ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3686149/

Pilot Randomized Controlled Trial of Reciprocal Imitation ... 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.

3. clinicaltrials.gov clinicaltrials.gov/study/NCT05425277

Assessing the Effectiveness of Reciprocal Imitation ... The long-term goal of this study is to improve services and outcomes for children with early signs of ASD by testing the effectiveness of training EI providers ...

4. insar.confex.com insar.confex.com/insar/2019/webprogram/Paper31755.html

The Implementation of Reciprocal Imitation Training (RIT) ... Results: There were significant increases in providers' self-efficacy in identifying and discussing treatment goals with families of children ...

5. uwo.ca uwo.ca/fhs/lwm/teaching/EBP/2013-14/Krupicz.pdf

Critical review: the efficacy of Reciprocal Imitation Training ... This critical review investigates the efficacy of Reciprocal Imitation Training (RIT): a play-based treatment protocol, intended to treat imitation deficits ...

6. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1471595323000276

Effect of patient safety education interventions on ... Our review provides empirical evidence on current efforts in patient safety education to improve a healthcare professional-patient safety culture.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11786348/

The effect of interactive learning methods and reflection on ... It has been demonstrated that 94.7% of nurses were found to have good knowledge of patient safety after the intervention. These results ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7479164/

Comparing the impacts of reciprocal peer teaching with ... This study aimed to compare the effectiveness of peer-led learning with faculty-led teaching activities in fifth-year students during their Internal Medicine II ...

9. ies.ed.gov ies.ed.gov/ncee/wwc/InterventionReport/626

WWC | Reciprocal Teaching - Institute of Education Sciences Reciprocal teaching is an interactive instructional practice that aims to improve students' reading comprehension by teaching strategies to obtain meaning from ...