Music-Enhanced Reciprocal Imitation Training for Autism in Toddlers

Overseen By Miriam Lense

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Vanderbilt University Medical Center

Disqualifiers: Hearing impairment, Seizure disorder, others

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

Compensation: Varies

Number of Visits: 2

Duration: 10-15 weeks

40 Participants Needed

Trial Summary

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 data supports the effectiveness of the treatment Music-Enhanced Reciprocal Imitation Training for Autism in Toddlers?

Research shows that Reciprocal Imitation Training (RIT) helps children with autism improve their imitation skills, which are important for social interaction. Studies found that children who received RIT made significant gains in both elicited and spontaneous imitation, and these improvements were linked to better language use. ^{1 2 3 4 5}

Is Music-Enhanced Reciprocal Imitation Training safe for toddlers with autism?

The studies on Reciprocal Imitation Training (RIT) for children with autism do not report any safety concerns, suggesting it is generally safe. RIT is a naturalistic intervention used to improve imitation skills, and it has been successfully implemented by parents and community providers without reported adverse effects. ^{1 3 4 5 6}

How is Music-Enhanced Reciprocal Imitation Training different from other treatments for autism in toddlers?

Music-Enhanced Reciprocal Imitation Training is unique because it combines music with Reciprocal Imitation Training (RIT), a naturalistic intervention that focuses on improving imitation skills in children with autism. This approach leverages the natural connection between music and imitation to enhance social communication, and it can be delivered via telehealth, making it more accessible for parents to learn and implement with their children. ^{1 2 5 7 8}

What is the purpose of this trial?

The primary goal of this study is to examine rhythm sensitivity as a predictor of response to naturalistic developmental behavioral intervention (NDBIs) in autistic toddlers. Toddlers receive either Reciprocal Imitation Training (RIT), an evidence-based NDBI that supports children's imitation and social communication skills, or a music-enhanced version of RIT. Throughout their participation in the intervention, toddlers will complete study procedures of viewing naturalistic videos of infant-directed singing and other social scenes while eye gaze data is collected.

Research Team

Miriam Lense

Principal Investigator

Vanderbilt University Medical Center

Warren Jones

Principal Investigator

Emory University

Eligibility Criteria

This trial is for toddlers aged 18-36 months who have been diagnosed with autism or autism spectrum disorder. It's designed to help improve their imitation and social communication skills.

Inclusion Criteria

I have been diagnosed with autism or ASD.

I am between 18 and 36 months old.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Children's rhythm sensitivity is assessed via eye-tracking sessions

1-2 weeks

Treatment

Participants receive 30 sessions of either Reciprocal Imitation Training (RIT) or music-enhanced RIT (meRIT)

10-15 weeks

2-3 sessions per week

Follow-up

Participants are monitored for changes in rhythm sensitivity and imitation skills

2 weeks

Treatment Details

Interventions

• music-enhanced Reciprocal Imitation Training
• Reciprocal Imitation Training

Trial Overview The study tests two types of training: standard Reciprocal Imitation Training (RIT) and a music-enhanced version of RIT, to see which better supports the development of autistic toddlers.

Participant Groups

Group I: Music-Enhanced Reciprocal Imitation Training (meRIT) Experimental Treatment 1 Intervention

Children (n=20) receive 30 sessions of music-enhanced Reciprocal Imitation Training (meRIT), delivered in 40-60 minute sessions 2-3 times/week.

Group II: Reciprocal Imitation Training (RIT) Active Control 1 Intervention

Children (n=20) receive 30 sessions of Reciprocal Imitation Training (RIT), delivered in 40-60 minute sessions 2-3 times/week.

music-enhanced Reciprocal Imitation Training is already approved in United States, European Union for the following indications:

Approved in United States as Reciprocal Imitation Training for:

• Autism Spectrum Disorder (ASD)

Approved in European Union as Reciprocal Imitation Training for:

• Autism Spectrum Disorder (ASD)

Who Is Running the Clinical Trial?

Vanderbilt University Medical Center

Lead Sponsor

Trials

922

Recruited

939,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

National Center for Complementary and Integrative Health (NCCIH)

Collaborator

Trials

886

Recruited

677,000+

Findings from Research

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 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 (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]

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 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]

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]

The study demonstrated that a telehealth adaptation of Reciprocal Imitation Training (tele-meRIT) is feasible for coaching parents of autistic children, with all participating parents achieving implementation fidelity by the end of the treatment.

Parents reported high satisfaction with tele-meRIT, noting perceived improvements in their children's social and play skills, despite the intervention not consistently enhancing children's imitation skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief Report: Telehealth Music-Enhanced Reciprocal Imitation Training in Autism: A Single-Subject Feasibility Study of a Virtual Parent Coaching Intervention. Liu, T., Martinez-Torres, K., Mazzone, J., et al.[2023]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

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

2. United States pubmed.ncbi.nlm.nih.gov

Teaching the imitation and spontaneous use of descriptive gestures in young children with autism using a naturalistic behavioral intervention. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

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

4. England pubmed.ncbi.nlm.nih.gov

Effects of coaching on the fidelity of parent implementation of reciprocal imitation training. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

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

6. United States pubmed.ncbi.nlm.nih.gov

The implementation of reciprocal imitation training in a Part C early intervention setting: A stepped-wedge pragmatic trial. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Brief Report: Telehealth Music-Enhanced Reciprocal Imitation Training in Autism: A Single-Subject Feasibility Study of a Virtual Parent Coaching Intervention. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

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