Reciprocal Imitation Training 6/5/06 1
Brooke Ingersoll, Ph.D.
Lewis & Clark College
Reciprocal Imitation Training 6/5/06 2
Reciprocal Imitation Training
Reciprocal imitation training (RIT) is a naturalistic intervention designed to teach
young children with autism to imitate spontaneously during on-going play
interactions with a play partner. The goal of this technique is to teach your child
to imitate as a means of social interaction and therefore, it is more important that
your child attempt to copy your actions than to perform any specific action
correctly. RIT 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. As part of the parent training program,
it is suggested that you practice this intervention at home with your child for 20
minutes a day.
References:
Ingersoll, B. (in press). The social role of imitation in autism: Implications for the
treatment of imitation deficits. Infants & Young Children.
Ingersoll, B. & Gergans, S. (2006). The effect of a parent-implemented
naturalistic imitation intervention on spontaneous imitation skills in young
children with autism [Electronic version]. Research in Developmental
Disabilities.
Ingersoll, B., Lewis, E., & Kroman, E. (2006). Teaching the imitation and
spontaneous use of descriptive gestures to young children with autism
using a naturalistic behavioral intervention. Paper under review.
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, 487-505.
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Step 1: Select Materials
Although RIT can be implemented during a variety of activities that don?t use
toys, such as the bath, or outside, toys are an important part of teaching imitation
skills. It is important to choose toys that your child enjoys playing with. Toys that
can be used in many different ways (such as balls, slinkies, cups and containers,
figurines, etc.) are better than toys that have only one or two functions (such as
mechanical toys). Also, toys that are interesting but not overly absorbing are
better than very absorbing toys because your child will be better able to pay
attention to you if he or she is not overly absorbed by the toys. Have several
different toys available so that your child can select the toys he or she is more
interested in. Have two of the same toy, so that your child can have one and you
can have one. This helps promote imitation and allows you to imitate your child
without having to take your child?s toy away.
Recommended Toys
Stacking cups
Stacking rings
Blocks
Koosh Balls
Squishy Tubes
Balls
Slinkys
Sensory toys (beans, beads, feather boas, water)
Cars
Trains
Tub Toys
Weebles
Little People Figures
Animal Figures
Pretend Food
Musical toys (drums, tambourines, maracas)
Playdoh
Coloring/painting materials
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Step 2: Imitate Your Child
The basis of RIT relies on imitating all of your child?s gestures, vocalizations, and
actions with toys. Imitating your child promotes shared attention and social
responsiveness in children with autism. It also lays the groundwork for teaching
reciprocal imitation because your child learns that imitation is a back and forth
interaction. In addition, imitating your child?s speech or preverbal vocalizations
promotes the use of spontaneous language and vocalizations. The following
strategies will make imitating your child most effective.
Be visible: Make sure that you are always in your child?s line of sight. Sit so
that you are face to face with your child, so that he or she can make eye contact
easily. If your child has a hard time sitting, you will need to move around to stay
face to face with your child.
Imitate play with toys: Imitate what your child is doing with the toys he or she
chooses to play with. Children become much more aware that you are imitating
their behavior if you have two sets of the same toy. This way you can imitate
your child?s play at the same time he or she is playing.
Imitate gestures/body movements: Imitate your child?s gestures and body
movements. This will also help your child realize that you are imitating him or her
and that his or her behavior is meaningful and can influence how you act.
Imitating gestures/body movements is especially helpful when your child is not
engaged with a toy. For example, if your child is wandering around the room,
follow the same path purposefully, while trying to remain face to face. Children
typically find this behavior quite funny and really enjoy interacting this way.
Imitate vocalizations: For children who are preverbal or just starting to talk, it is
important to imitate all your child?s vocalizations and words. With a verbal child, it
is recommended that you only imitate language that is appropriate to the context
of the play. Again, when using this technique it is important to be visible and
animated.
Be animated: Exaggerate your imitations of your child?s gestures, facial
expressions, and vocal quality to draw attention to the fact that you are imitating
your child. While imitating your child, you can vary your imitations slightly to
keep them interesting. For example, if your child drops a toy on the ground
without paying attention to it, you can bounce your toy on the ground in an
exaggerated way. Also, you can pause with an expectant look in the middle of
imitating your child to encourage your child to initiate for you to continue the
game. Use words like ?Uh Oh?, ?Oh No?, ?Ready, set, go?, sound effects and
gasping to let your child know you have something to share.
Imitate appropriate behavior: Imitating your child will typically increase the
behavior that is being imitated. Therefore, when imitating your child, it is
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important to decide which behaviors to imitate. For children who exhibit little to
no appropriate play, try to imitate every appropriate action or vocalization. This
could include, throwing a ball, looking in the mirror, babbling etc. Do not imitate
behaviors that are dangerous or aggressive such as hitting or breaking toys. If
your child is producing behaviors you do not want to see increase you can
?imitate? that behavior while shaping it into something more appropriate. For
example, if your child is mouthing an object, you can pretend to eat a similar
object, or if your child is flapping his or her hands to show excitement you could
?imitate? the excitement but express it by clapping your hands. For children that
have a majority of appropriate play, try to imitate only the appropriate behaviors.
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Step 3: Describe Your Play
Describe what you and your child are doing to highlight the fact that you are
doing the same thing. This should look somewhat like a running commentary or
a sports announcer. While describing your play, be aware that the type of
language you use can have a large impact on your child?s understanding and use
of language. The following strategies will help make describing your play most
effective.
Simplify your language: Use simple language that is slightly more complex
than your child?s language. For example, if your child is not yet speaking, use
single words; if he or she uses single words, use 2-3 word phrases. You can
also simplify your language by leaving out higher level parts of language (e.g.,
?Feed baby? instead of ?You are feeding the baby?).
Speak slowly: Slow down your rate of speech. The slower you speak, the more
your child will be able to pick out the important words and meaning. Although
you want to provide a running commentary, make sure to you?re your child a
chance to respond. Pause between comments to give your child time to process
the auditory information.
Stress important words: Children often have a hard time recognizing important
words in sentences. You can help your child pick up ?meaning? words by
pausing before important words and stressing them (?We have a?BUNNY?).
Be repetitive: Use the same language over and over. You can use the same
phrase repetitively (?Down it goes. Down it goes?) or you can repeat specific
important words (?Car is rolling. Roll, roll. Rolling fast?).
Expand your child?s language: Expand your child?s language by imitating your
child?s speech and then adding more information. By adding more words, you
revise and complete your child?s speech - without direct correction. For example,
if your child says ?buh?, you could say ?ball?. If your child says ?train? you could
say ?yellow train?. If your child says ?I push car?, you could say ?I am pushing the
car?.
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Step 4: Teach Object Imitation
To teach imitation, you will begin going back and forth between imitating your
child, and providing opportunities for your child to imitate you. The goal is to get
into a back and forth ?social game? where you and your child take turns imitating
each other. Of course, you will be doing most of the imitation; your child will only
be expected to imitate you once every one to two minutes. In order to help your
child learn to imitate, you will use physical guidance and praise. The following
strategies will make teaching imitation most effective.
Model actions with the same toy: In order to increase your child?s ability to pay
attention to your actions and motivation to imitate, you should model an action
with the same toy your child is already playing with. Every minute (on average),
model an action with the duplicate of the toy your child is engaged with. Make
sure that your child is attending to you (making eye contact or watching your
actions) when you model actions. Imitating your child should help increase
attention, but you may also call your child?s name, or block his or her play to get
his or her attention if necessary. Also, it is important that your child knows this is
something he or she should imitate, so make sure the action is ?big? so that your
child notices it. If your child is not engaged with a toy, try to get him or her
interested in a toy or model an action with the last toy your child was playing with.
Use a verbal label with the action: When you model the action, you want your
child to pay attention and imitate. However, you want your child to learn to
imitate you spontaneously, rather than on command. Therefore, rather than
telling your child to imitate (e.g., ?Do this.?) or telling your child what to do (e.g.,
?Give the baby a drink?), you should use a ?verbal label? to describe what you are
doing. This way your child will learn to imitate when you model an action and talk
about it, rather than only when you tell him or her to do so. Verbal labels should
be short, at or slightly above your child?s language level, be said clearly and
stressed, and describe the action without giving a command. For example, when
modeling rolling a ball, make sure your child is watching you, roll the ball with an
exaggerated gesture, and say ?Roll?. To help your child imitate in many context,
vary what you say (i.e., say ?bounce? one time and ?boing? another when
modeling the same action at different times). If your child has a very difficult time
paying attention to what you are doing, you can say his or her name to get his
attention first; but try to avoid doing this every time or your child will learn to
imitation only when you say his or her name.
Model actions your child is likely to imitate: You will want to begin by
modeling actions that your child is naturally inclined to want to imitate. This
includes actions that your child already performs on his or her own (familiar
actions) as well as actions that are at or slightly above your child?s developmental
level. If you model actions that are too advanced, your child is less likely to
understand the action and imitate. To decide good actions to model, watch what
your child does with toys on his or her own and model similar actions. If your
child likes to explore toys by banging, throwing, and dropping them, model these
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types of actions as well as nesting one object in another, putting objects in
containers, lining, stacking, or ordering toys in certain ways. If your child uses
most common toys appropriately, such as pushing cars, putting people in cars,
and throwing and catching balls, model these types of actions as well as some
basic pretend actions. The actions you model do not have to be functional or
?appropriate?; the goal is to increase your child?s motivation to imitate your
behavior.
Model the action up to three times and then prompt: Give your child several
opportunities to imitate the action spontaneously. Model the action with a verbal
label and wait 10 seconds for your child to imitate. If he or she does not imitate
spontaneously after 10 seconds, model the same action again with the same
verbal label. Do this up to three times. If your child does not imitate after the
third model, you may tell your child ?You do it? if he or she responds to verbal
instructions; otherwise physically guide your child to imitate you.
Praise your child for imitating: As soon as your child imitates you, praise him
or her with verbal praise and physical affection if your child enjoys this. Praise
should be more intense if your child imitates you spontaneously than if you need
to physically guide your child to imitate. It is more important for your child to
match your actions in general, than to perform a specific action exactly, so be
sure to praise any attempt at imitation even if it is not perfect. After your child
has imitated your action or gesture, let your child play with the toys as he or she
likes for the next minute and go back to imitating your child.
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Step 5: Increase the Complexity and Flexibility of Imitation
Once your child is able to imitate familiar actions consistently with the toy he or
she is playing with, you can begin to focus on increasing the complexity of your
child?s play by modeling novel actions. In addition, you can increase your child?s
flexibility by modeling actions with toys that your child is not currently playing
with.
Model novel actions: The goal of modeling novel actions is to increase the
complexity of your child?s play. It is important to continue to model interesting
actions at or slightly above your child?s developmental play level. However, you
may begin to increase the complexity of the actions you model. In particular, you
should consider adding basic pretend elements to your child?s play. Be sure to
continue to model familiar actions so that your child remains motivated to imitate
you.
Model actions with different toys: Once your child is consistently imitating a
range of actions, both familiar and novel, you want to increase his or her ability to
imitate with toys that your child is not currently attending to. When doing this, it is
a good idea to start by modeling highly motivating or familiar actions with a
different toy from the one your child is playing with. By using motivating or
familiar actions, you increase the likelihood that your child will disengage from his
or her current toy and shift focus to the toy you are playing with. Before modeling
an action with a different toy, make sure that the duplicate toy is in front of your
child so that he or she can easily find it. No more than half of the actions you
model should be with a different toy. Once your child is able to shift to a new toy,
you may begin to model less motivating and/or novel actions.
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Step 6: Teach Gesture Imitation
Once your child is consistently imitating actions with objects (roughly 50% of the
actions modeled), you can begin to teach gesture imitation. Gesture imitation is
taught using the same strategies as object imitation; however, instead of
modeling an action with a toy, model a gesture that is directly related the toy your
child is playing with. For example, if your child is playing with toy food, you can
model patting your tummy to indicate that the food tastes good. Like object
imitation, you should pair the modeled gesture with a related verbal label (
?Yummy?). You should make sure to model gestures that can be physically
prompted (i.e., involve the child?s hands) so that you can physically guide your
child to complete the gesture if he or she does not imitate spontaneously. The
gestures that you model can include conventional gestures (waving bye-bye,
blowing a kiss, nodding yes or no), joint attention gestures which involve an
object (pointing to express interest, giving, showing), descriptive gestures
(holding arms out for ?big?, fingers close together for ?small?), and pantomime
gestures (pantomiming ?drinking?). If your child is not playing with a toy, you can
model an action with an object and then a related gesture. When doing this, only
prompt your child to imitate the gesture.
Gesture Suggestions
Easier gestures are those that are more commonly used and require less fine
motor skills. These gesture suggestions are listed roughly in order from easier to
more difficult.
GESTURE MEANING
Clap hands Good job
Point to object Look/ Put it here
Point up/arm up Up
Point down/arm down Down
Wave hand Bye bye
Hand or finger in circle Spin / Dizzy
Blow kiss Kiss
Peekaboo Surprise
Both palms on side of face, mouth open Surprise / Oh no
Pat stomach Full/ Yummy
Wave hand toward you Come here
Shake head No
Hand up, palm out Stop
Hands over ears Loud
Arm down Go
Hand cupped around ear Listen/ What?s that sound
Pat object Sit here/ Come here/ Put it here
Index finger over lips Be quiet/ Shh
Shake extended index finger up & down Naughty
Pat open hand over open mouth Tired
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Still hand over open mouth Surprise
Both palms upturned Where / Don?t know
Press palms together by side of head Tired / Going to sleep
Nod head Yes
Shake body part (that got ?hurt) Ouch
Pat body part (that got ?hurt?) Ouch
Arms stretched out to both sides Big
Hands close together Small
Index finger and thumb in a ?U? Small
Index finger up-turn in circle around ear Crazy / Silly
Hands over eyes Not looking
Flap arms Flying
Hand over eye, palm down Look
Shrug shoulders I don?t know
Slap thigh Funny
Hands open-fingers curved facing outward Scary / Lion
Hands together-move one forward quickly Fast
Fingers walk slowly Slow / Walking