Reciprocal Imitation Training for Autism

Recruiting at 4 trial locations

Overseen By Brooke Ingersoll, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Washington

Disqualifiers: Visual, hearing, motor conditions

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

Compensation: Varies

Number of Visits: 3

440 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a method called Reciprocal Imitation Training to help children with autism spectrum disorder (ASD) improve social skills. The goal is to train early intervention providers to use this strategy effectively during the crucial first three years of life. Children with ASD or early signs of social communication issues who regularly attend therapy sessions with a caregiver present might be suitable for this trial. As an unphased trial, this study offers families a unique 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.

What prior data suggests that Reciprocal Imitation Training is safe for children with autism?

Research has shown that Reciprocal Imitation Training (RIT) is generally safe for participants. Studies have examined its use for children showing early signs of autism spectrum disorder (ASD) and have found positive results without major safety concerns. For example, one study found that RIT helped young children with autism improve their imitation skills, with no reported negative effects. This suggests that RIT is a safe method to help children with autism enhance their communication and social skills.

Although the current trial phase isn't mentioned, previous research showing no safety issues offers reassurance about the treatment's safety. RIT is a behavioral method that focuses on learning through interaction, so it doesn't involve medications or physical treatments, which usually carry higher safety risks. Overall, the evidence supports that RIT is a safe and effective way to help children with ASD develop important social skills. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Reciprocal Imitation Training (RIT) is unique because it focuses on enhancing social interaction skills by teaching children with autism to imitate others, which is a foundational social skill often challenging for them. Unlike standard treatments like Applied Behavior Analysis (ABA) that primarily focus on reinforcing specific behaviors, RIT emphasizes naturalistic learning through play and social engagement. Researchers are excited about RIT because it empowers caregivers by involving them directly in the process and provides a more interactive and engaging way for children to learn crucial social skills, potentially leading to more meaningful improvements in their everyday interactions.

What evidence suggests that Reciprocal Imitation Training is effective for autism?

Research shows that Reciprocal Imitation Training (RIT) helps young children with autism improve their ability to copy gestures and play actions. Previous studies indicate that RIT effectively boosts imitation, play skills, and joint attention, which involves focusing together on an object or activity, in children showing early signs of autism spectrum disorder (ASD). In this trial, participants in the RIT Training Group will receive intensive training in RIT and parent coaching. A randomized controlled trial found that RIT improved both prompted and spontaneous imitation skills in young children with autism. These improvements in imitation and related skills can be crucial for better social interaction and communication in children with ASD. ^{2 3 4 6 7}

Who Is on the Research Team?

Wendy Stone, PhD

Principal Investigator

University of Washington

Are You a Good Fit for This Trial?

This trial is for children with Autism Spectrum Disorder (ASD) or social communication impairments who attend weekly sessions with a provider. Parents or guardians must be over 18, speak English or Spanish, and have not received Reciprocal Imitation Training (RIT) before. Children with visual, hearing, or motor conditions that affect RIT participation are excluded.

Inclusion Criteria

Parents are biological parents or custodial guardians

The child attends at minimum 1x/week sessions with the enrolled provider

My child has been diagnosed with autism or has trouble communicating socially.

Exclusion Criteria

My child or I have had therapy or coaching in a developmental intervention before.

My child has conditions affecting sight, hearing, or movement that may limit participation in the therapy or assessments.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training and Initial Assessment

EI providers receive intensive training in RIT and parent coaching, and baseline assessments are conducted for children and families.

4 weeks

1 visit (in-person) for training, multiple virtual assessments

Active Treatment

Providers use the CI-RIT intervention with enrolled families, with monthly videotaped sessions for fidelity scoring and monthly consultations.

3 months

Monthly in-person or virtual sessions

Follow-up

Participants are monitored for improvements in child and caregiver outcomes, with assessments at 4 and 9 months post-baseline.

5 months

2 visits (in-person or virtual) for assessments

What Are the Treatments Tested in This Trial?

Interventions

• Reciprocal Imitation Training

Trial Overview The study aims to improve early intervention services for children with ASD by training providers in the Part C Early Intervention system to use an evidence-based parent-mediated approach called Reciprocal Imitation Training (RIT).

How Is the Trial Designed?

Group I: RIT Training Group Experimental Treatment 1 Intervention

Providers in the RIT group (n=80) will receive intensive training (online tutorial, 2-day workshop, and virtual coaching and feedback in the field) in RIT and parent coaching and will be required to achieve fidelity prior to enrolling families from their caseload. They will then be asked to use the intervention with enrolled families for a minimum of 3 months. One intervention session per month for each enrolled family will be videotaped and scored for fidelity. Providers will receive monthly consultation from RIT trainers while these families are in the active treatment phase.

Group II: Treatment as Usual Active Control 1 Intervention

Providers in the TAU group (n=80) will have three sessions videotaped and scored for each enrolled family to assess treatment differentiation. To incentivize agency participation, RIT training will be provided to the TAU group and other providers when data collection is complete.

Who Is Running the Clinical Trial?

University of Washington

Lead Sponsor

Trials

1,858

Recruited

2,023,000+

Michigan State University

Collaborator

Trials

202

Recruited

687,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Rush University Medical Center

Collaborator

Trials

448

Recruited

247,000+

University of Massachusetts, Boston

Collaborator

Trials

42

Recruited

17,800+

Published Research Related to This Trial

Reciprocal Imitation Training (RIT) effectively improved the imitation of descriptive gestures in five young children with autism, as demonstrated by increased gesture imitation in both treatment settings and structured assessments.

The gains from RIT not only generalized to different therapists and settings but also maintained over a month, with some children showing increased spontaneous use of gestures, highlighting the intervention's potential for long-term benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching the imitation and spontaneous use of descriptive gestures in young children with autism using a naturalistic behavioral intervention. Ingersoll, B., Lewis, E., Kroman, E.[2019]

Reciprocal imitation training and video modeling were both effective interventions for improving imitation skills in young children with autism, as demonstrated in a study involving six boys matched by age, language, and autism severity.

All participants showed increased imitation abilities that not only improved during treatment but also maintained and generalized to higher levels after the interventions, highlighting the potential of these methods in skill development for children with autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting imitation in young children with autism: a comparison of reciprocal imitation training and video modeling. Cardon, TA., Wilcox, MJ.[2021]

Reciprocal Imitation Training (RIT) significantly improved both elicited and spontaneous imitation skills in 21 young children with autism, demonstrating its efficacy as a naturalistic intervention.

The study found that children with a larger repertoire of spontaneous play acts before treatment showed greater improvements in imitation skills during RIT, indicating that existing play skills may enhance the effectiveness of the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pilot randomized controlled trial of Reciprocal Imitation Training for teaching elicited and spontaneous imitation to children with autism. Ingersoll, B.[2023]

Reciprocal imitation training (RIT) effectively teaches spontaneous imitation skills to young children with autism, as demonstrated in a study involving three children and their mothers over 10 weeks.

Parents were able to successfully implement RIT techniques, leading to significant increases in their children's ability to imitate actions and gestures, showing that this intervention can be effectively used in naturalistic settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of a parent-implemented imitation intervention on spontaneous imitation skills in young children with autism. Ingersoll, B., Gergans, S.[2007]

Reciprocal imitation training is an effective intervention for improving social imitation skills in young children with autism, and it can be easily taught to parents and caregivers for home use.

The study found that providing 1:1 coaching to parents significantly improved their ability to implement the training, which in turn led to increased spontaneous imitation behaviors in some children with autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of coaching on the fidelity of parent implementation of reciprocal imitation training. Penney, A., Schwartz, I.[2020]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11959790/

A hybrid type I randomized effectiveness-implementation trial ... This study seeks to assess the effectiveness and fit of one NDBI, Caregiver Implemented Reciprocal Imitation Teaching (CI-RIT), within the Part C EI system.

2. clinicaltrials.gov clinicaltrials.gov/study/NCT05425277

Assessing the Effectiveness of Reciprocal Imitation ... The goal of this research project is to improve services and outcomes for children with early signs of ASD by testing the effectiveness of a brief, inexpensive ...

3. aucd.org aucd.org/nirs-project?id=57500

Project Previous research indicates that Reciprocal Imitation Training is an effective strategy for improving imitation, play skills, and joint attention skills in ...

4. withpower.com withpower.com/trial/phase-autism-spectrum-disorder-8-2021-ff693

Reciprocal Imitation Training for Autism Research shows that Reciprocal Imitation Training (RIT) helps young children with autism improve their ability to imitate gestures and play actions.

5. 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.

6. etheses.bham.ac.uk etheses.bham.ac.uk/6850/1/Malik16PhD_Redacted.pdf

The effects of reciprocal imitation training on behaviour and ... The work presented in this thesis comprises the execution and evaluation of a pilot quasi-. Randomised Controlled Trial of Reciprocal Imitation Training (RIT) ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT05880225

Reciprocal Imitation Training and Musical Rhythm ... Children's rhythm sensitivity is assessed via repeated eye-tracking sessions throughout baseline, intervention, and two-weeks after the intervention ends.