Imitation by James W. Partington, PhD, BCBA-D, et al

7/29/2019 Imitation by James W. Partington, PhD, BCBA-D, et al.

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inTroducTion

Parents and educators recognize that children can learn a wide varietyo skills by observing the actions o others. Specifc skills are oten taught

to children by demonstrating an action that the child is to perorm (e.g.,how to dry himsel with a towel, throw a ball, use a vending machine).More generalized skills such as social interactions, ollowing classroomroutines, or playing games are also oten learned by watching whatothers do in certain situations. When children are unsure o how torespond, one o the most eective courses o action is to watch whatothers are doing and respond in a similar ashion.

Proessionals and theoreticians in the feld o child developmentare in agreement about the importance o children learning skills byobserving the actions o others (Bandura, 1962; Bijou, 1993; Bijou& Bear, 1965; Piaget, 1962). However, researchers also note thatmerely observing the actions o others is not sufcient to result in skill

acquisition. To acquire skills, an individual must be able to imitate theobserved actions (that is, duplicate the behavior modeled by others)(Catania, 1972) and discriminate the appropriate conditions or use othe skills (Brown, Brown, & Poulson, 2008).

Parents understand the importance o their children being ableto observe children who are exhibiting appropriate behavior and

communicating and socially interacting well with their peers ateachers. Thus, parents o children with an autism spectrum disord(ASD) oten wish to include their children in educational settin

with typically developing children to enable exposure to modelsappropriate language and social behavior. The hope is that the chwith autism will learn how to participate in educational activiticommunicate, and socially interact with other children. For a childlearn rom appropriate models, however, the child must be able to battend to the actions o others and imitate them. Without the abilitywatch and replicate others actions, a child will not be able to learn many critical skills that are being modeled by others.

Unortunately, many children with autism oten dont pay cloattention to the critical aspects o the actions carried out by individuwho are perorming a task. A child may have numerous models actions that could be useul in learning a wide variety o skills, but i t

child doesnt pay attention to those actions, the learning opportunwill be missed. Moreover, even i children are observing appropriamodels, they still will not learn the skills i they havent learned to imitasequences o actions. Thus, it is important to ensure that children aable to both pay attention to the actions o others and replicate thoactions in a very precise manner.

imiTaTion:a CriTiCal ComPonenT oF

eduCaTional inTervenTions

For Children wiTh auTism

sPeCTrum disorders

By JAM ES W. PARiNGON, PHD, BCBA-D;1

MARiAN WOODSiDE, MED;2

AND S CO W. PARiNGON, BA3

aflt: 1 Behavior Analysts, Inc.; 2 Oakland Unifed School District; and 3 University o Caliornia, Los Angeles.

it s mportant to ensure that chldren are able to both pa attenton to the

actons o others and replcate those actons n a ver precse manner.


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JaMeS W. PartingtOn, PhD, BcBa-D,is the director o Behavior Analysts, Inc.and provides services to children and theiramilies. He is a licensed psychologist with40 years experience working with childrenwith developmental disabilities and isinternationally recognized as a leader in thefeld o behavior analysis with expertisein language-based interventions. Dr.Partington is known or his work

teaching parents and proessionalsabout practical, evidence-basedprocedures necessary or eectiveeducational interventions. Hehas been a aculty member oseveral universities, includingWest Virginia University, theUniversity o San Francisco,and St. Marys College. Dr.Partington is a ormer presidento the Northern CaliorniaAssociation or Behavior

Analysis and has served asa member o the BehaviorAnalyst Certifcation Board. Heis the author o The Assessmentof Language and Learning Skills-Revised (ABLLS-R) and Capturingthe Motivation of Children withAutism or Other DevelopmentalDelays and has also producedseveral instructional videos relatedto eective treatment or childrenwith autism.

ScOtt PartingtOn, Ba,graduated rom the University o

Caliornia, Los Angeles (UCLA) in2010 with a bachelors degree inpsychology. He is currently pursuinga masters degree in experimentalpsychology at the University oColorado at Colorado Springsand will begin pursuing a doctoral

degree in behavioral psychology at the University o Kansas inthe all o 2012. His research interests include problem-solvingperormance across the liespan and behavioral economics.Scott has previously worked with children with autism at theSTARS School and the Lovaas Institute in Southern Caliornia.

Marian WOODSiDe, MeD, hasbeen working with children with

autism spectrum disorders in publicand non-public school settings inCaliornia or the last eight years andhas had a STARS model classroomover the same time period. She iscurrently an early elementary specialday classroom teacher in the Oakland

Unifed School District. Marian completed her bachelorsdegree in psychology at the University o Caliornia-Berkeleyand her masters degree in education at St. Marys College.She is currently enrolled in an education program at SanFrancisco State University.

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imiTaTive skills: whaT The research shows

Researchers have documented that the ability to imitate the actionso others emerges at an early age or typically developing children(Gopnik, Meltzo, & Kuhl, 1999; Meltzo & Moore, 1989; Poulson& Kymissis, 1988; Poulson, Kyparissos, Andreatos, Kymissis, &Parnes, 2002), and develops in complexity over the frst two yearso lie (Hanna & Meltzo, 1993; Kuczynski, Zahn-Waxler, Radke-Yarrow, 1987; Masur & Ritz, 1984). The development o the imitativerepertoire has a major inuence on the development o language skills(Charman, 2006; Masur, 2006; Meltzo & Gropnik, 1993; Nadel,Gurini, Pez, & Rivet, 1999), social interactions with peers (Nadel& Peze, 1993; Wolberg, 2003), the development o joint attention(Slaughter & McConnell, 2003; Tomasello, 2001), and the sharing o

experiences and emotions (Stern, 1985).Many studies have demonstrated that there is an imitation defcitin children with autism (see Rogers & Williams, 2006 and Williams,Whiten, & Singh, 2004 or reviews; Perra et al., 2008; Stieglitz Ham,Corley, Rajendran, Carletta, & Swanson, 2008; Thurm, Lord, Lee, &Newschaer, 2007; Vanvuchelen, Roeyers, & De Weerdt, 2007;Vivanti, Nadig, Ozono, & Rogers, 2008). Studies have ound thatchildren with autism do not perorm imitation tasks as well as eithertypically developing peers or children with other developmentaldelays (Abrahamsen & Mitchell, 1990; Charman et al., 1997; Curcio,1978; Dawson & Adams, 1984; Dawson, Meltzo, Osterling, &Rinaldi, 1998; DeMyer et al., 1972; Jones & Prior, 1985; Heimann& Ullstadius, 1999; Rogers, Hepburn, Stackhouse, & Wehner, 2003;

Stone, Ousley, & Littleord, 1997). These fndings suggest that there isan imitation defcit specifc to autism. Some researchers believe thatthis particular defcit is, in act, one o the core eatures o an ASD(Schreibman, 2005).

Impaired language development also is a hallmark o ASDs. Asalready noted, imitation skills are essential or the development olanguage. McDufe and colleagues (2005) ound that imitativeabilities were prelinguistic predictors o vocabulary in young childrenwith autism. Greater imitation skills have been associated with higherlanguage skills in both typical and nontypical populations in multiplestudies (Charman et al., 2003; Stone et al., 1997; Stone & Yoder,2001; Thurm et al., 2007).

It is interesting to note that the imitation skills o a child diagnosedwith ASD prior to commencement o early intervention programs havebeen shown to predict responsiveness to the intervention. In somestudies, children with ASD were more likely to attain higher levels odevelopment i they had already developed some imitat ive skills prior tothe implementation o early intervention services (Sallows & Graupner,2005; Weiss, 1999). Similarly, Ben-Itzchak and Zachor (2007) oundthat ater controlling or students IQ, imitation and receptive languageskills were the only variables dierentiating between high-perormingand low-perorming children with autism ater one year o appliedbehavior analysis (ABA) early intervention. Thus, it would appearthat children with autism are likely to beneft rom a well-establishedgeneralized imitative repertoire. The development o a wide range o

imitative skills, thereore, should be included in childrens interventi

programs (Rogers & Vismara, 2008).Numerous studies have demonstrated that children with autism w

possess some preexisting imitative skills can go on to develop a wirange o skills using imitative models. Examples include:

Teaching peer imitation skills to preschool children withautism using an established imitation repertoire and adult-led teaching sessions (Carr & Darcy, 1990)

Teaching children with autism to imitate their peers playactions with toys (Tryon & Keane, 1986)

Using imitative prompts to teach a child with autism totact (i.e., expressively label) common objects using sign

language (Partington, Sundberg, Newhouse, & Spengler,1994) Using an imitation-based intervention to develop and

use spontaneous gestures in young children with autism(Ingersoll, Lewis, & Kroman, 2007)

Teaching children with autism to engage in play usingimitative models (Ingersoll & Schreibman, 2006)

Almost all o these intervent ions have used proessionals to develthe imitative skills ; in only a ew studies have parents also been taughow to urther their childs imitative skills (Ingersoll & Gergans, 200Risley, 1968).

Several other topics are relevant to a discussion o children w

autism and development o imitative skills:

1 Development o initial imitative skills: Although the developmo initial imitative skills is requently included as a component early intervention programs or young children with ASD, theis still a lack o research ocusing on how to teach imitation skto children who lack any baseline skills. The limited researrelevant to the development o initial imitative skills is based small sample sizes, and it reports on the development o oa small number o imitative responses (specifc actions threplicate the actions o others). Furthermore, although theare some reports o response generalization (the child bei

able to imitate untrained actions as a result o the imitatitraining), there is a defciency o research pertaining to the moeective methods to develop a well-generalized repertoire imitation skills in students with ASD (Accardo, 2004; IngersolSchreibman, 2006; Lovaas, Freitas, Nelson, & Whalen, 196Metz, 1965; Ryan, 2007).

2 Groups o imitative skills: Applied and experimental analysisimitative responding indicates that imitation is not a single o skills (Baer & Deguchi, 1985; Baer, Peterson, & Sherma1967; Baer & Sherman, 1964; Poulson et al., 2002; YounKrantz, McClannahan, & Poulson, 1994). A childs ability imitate simple gross motor actions does not ensure that he or s

Chldren wth autsm are lkel to beneft rom a wellestablshed generalzedmtatve repertore. Te development o a wde range o mtatve sklls,

thereore, should be ncluded n chldrens nterventon programs.



will be able to imitate fne motor actions, actions with objects,

sequences o actions, or vocalizations (Beadle-Brown, 2004;Garcia, Baer, & Firestone, 1971; Stone et al., 1997).

3 Range o imitative skills targeted or intervention: Program guidesintended to help practitioners design instructional programs orchildren with autism or other developmental delays typicallyinclude recommendations or the development o imitation skills(Kent-Udol, 1974; Lea & McEachin, 1999; Lovaas, 1981;Maurice, Green, & Luce, 1996; Rogers & Dawson, 2009;Partington, 2006). Many o these guides provide specifcteaching recommendations about the types o skills to includein such interventions, and some provide details on how to teach

the skills (Strieel, 1974). For children to have a well-generalizedimitative repertoire, they must be able to imitate a wide varietyo types o actions. When we reviewed the types and exampleso imitative skills included in 38 research articles and programguides (Partington & Partington, 2008), we ound that many othese sources included ewer than 10 imitative responses (orexample, Charman et al., 1997; Slaughter & McConnell, 2003) ,and only fve sources included at least 80 specifc responses(Baer et al., 1967; Beadle-Brown, 2004; Lea & McEachin,1999; Metz, 1965; Partington, 2006). To accurately comparethe variety and types o imitation skills that can be imitated byboth typically developing children and children with autism,a larger number and broader range o imitative skills must be

investigated.

gaps in research and pracTice

Although research clearly demonstrates that children with autism havedefcits in imitating others, there continues to be a signifcant lack oinormation about how parents and educators can develop an eectiveset o imitation skills in both the home and school environments.Moreover, most available studies have been conducted in researchrather than natural settings using a limited number o participants andstudying a very small range o imitative behaviors. Given that imitativeskills are essential to a childs development, parents and educators needto know what constitutes an adequate set o imitative skills and need

to have the teaching skills to help children acquire a well-developedimitative repertoire. Although we would expect the development othese skills to be a signifcant ocus o childrens individualized educationprograms (IEPs) , a review o most IEPs indicates that learning objectivesto develop imitative skillsskills that are critical to the development omany other important skillsare oten absent.

We present the ollowing two small case studies as init ial investigativeeorts to address practical issues related to developing an eectiveimitative repertoire or children with ASD. The frst case study sought toidentiy the imitative skills o typically developing preschool children. Thesecond case study investigated the eects o having special educationclassroom sta provide specifc instruction to develop imitative skills inchildren with a diagnosis o ASD in a public school classroom.

case sTudy 1: measuremenT oF The imiTaTive

skills oF Typically developing children

mEthoDS

Participants: Typically developing children (N = 4) ranging in age rom37 to 56 months participated in the study. The girls we call Karen(age 3 years and 1 month) and Iris (age 3 years and 4 months)attended the same preschool. Lance (not his real name), a 4-year-old boy, and Jasmine (not her real name), a 4-year-and-8-month-oldgirl, were not enrolled in any preschool at the time o this study. Allour participants were reported to be in good health, and neither theparents nor preschool sta nor their physicians had concerns related tothe childrens development.

Instrument: The study used the Partington Imitation Skills Assessment(PISA), a tool we developed to address the need or a comprehensiveassessment that measures the diverse types o imitative skills reportedin the literature (Partington & Partington, 2008). The assessmentcontains a total o 108 tasks that are grouped into one o the 12dierent domains shown in Table 1. In this study, some PISA tasks werepresented such that children could see the model while they wereperorming the task (such as raising and holding arms over head),while other tasks required children to provide an imitative responseater the model had presented the activity (or example, watching themodel tap a tambourine three times and then imitating the tapping).

Gven that mtatve sklls are essental to a chlds development, parents and educatorsneed to know what consttutes an adequate set o mtatve sklls and need to have the

teachng sklls to help chldren acqure a welldeveloped mtatve repertore.

1. Simple imitation with objects2. Arm and hand gross motor movements3. Static versus kinetic movements4. Gross motor actions with legs5. Hand fne motor movements6. Head and mouth movements7. Sequences o actions8. Facial expressions9. Actions with vocalizations

10. Imitations with body movement11. Imitation o models presented in a mirror12. Imitative models presented at a distance

Setting and materials: The study was conducted at either the childspreschool or house. In both situations, the child and researcher saton a couch behind a child-size table. Only toys that pertained to thestudy were in the room. These toys included two tambourines, twodrumsticks, a book, two wooden cubes, a small plastic container, a toydump truck, and a cardboard box that was cut to resemble a garage.The researcher recorded the accuracy o the childs responses on thePISA task list.

Tb 1.Po imo Sklls assssm doms



Procedures: The child was required to make eye contact with theresearcher beore the latter demonstrated the task or the child toimitate. Once the child was visually attending to the researcher, thechild was given an instruction to imitate an action (e.g., Can you dothis? Do this, or Do what I do.) ollowed by modeling the action(s)to be imitated. The child was allowed fve seconds to provide aresponse. We then scored the response as being correct, incorrect, anapproximation, or a non-response i the child ailed to respond to theinstruction within the fve seconds ollowing the modeled action. I thechild accurately imitated the model, the researcher presented the next

task. I the child did not respond, imitated incorrectly, or only made anapproximation on the frst presentation, the instruction was repeatedand the second attempt scored. Ater the researcher scored the secondattempt, he then proceeded to the next imitative task regardless owhether or not the child correctly imitated the model. Children receivedeedback in the orm o praise throughout the assessment (such as,Awesome job [name o child] , Nice, Wow, great job! andWow, youre a superstar!).

Measures and analysis: We recorded the total number o frst-trialcorrect imitative responses, approximations, errors, and non-responseson the PISA or each child. Additionally, we calculated the total correct

responses, approximations, and non-responses ollowing the secondpresentation o the task ater a non-correct frst-trial response. Thepercent o correct responses that occurred on the frst presentation othe task and ollowing the second presentation were then calculated.

rESUltS

The studys results indicate that typically developing children rangingrom 37 to 56 months o age display a high level o imitative ability.The percent o correct responses on the frst presentation o themodel ranged rom 77% to 96% (see Table 2). Furthermore, all o thechildrens scores increased when the responses were scored as correcton the second attempt or those items missed on the initial presentation.When allowed to attempt the tasks a second time, the range o correct

imitative responses increased to 87% to 97%. The time required tocomplete the entire imitation protocol ranged rom 23 to 28 minutes,with an average o 26.5 minutes per participant.

There were relatively ew actions that the children were unable toimitate. The most requent types o errors occurred on tasks that requiredthe children to imitate an action ater it was modeled (such as touchingour items in sequence or imitating a series o motor movements aterthe model had demonstrated them), moving a oot to point the toesup and down, moving a oot rom side to side, imitating specifc acialexpressions, and carrying out actions with a concurrent vocalization.

DISCUSSIoN

The results rom this study demonstrate that by around age thretypically developing children can imitate a substantial range actions; by our years o age, children are able to accurately imitaa substantially larger range o actions. Our study also indicates thtypically developing children rom three to our years o age cimitate actions and provide accurate responses even ater the modeno longer present. The our children in the study were able to complean average o approximately our to fve imitative responses per minuor the duration o the assessment.

Typically developing children demonstrated the ability to imitatewide variety o imitative skills without any previous structured teachinTheir perormance on the broadly scoped PISA demonstrates thtypically developing children can uently imitate a large number actions within a 20- to 30-minute time period and can do so whprovided with only social reinorcement. Furthermore, even whchildren were unable to imitate an action or series o actions on tfrst attempt, they were oten able to imitate those same actions whprovided with one additional demonstration. The studys fndings mbe useul in determining the level o imitative skills important or childrwith ASD to be able to ully participate in a wide range o activitwith typically developing peers.

case sTudy 2: sysTemaTic insTrucTion oF

imiTaTion skills To young sTudenTs wiTh auTism

mEthoDS

Participants: Children who had previously been diagnosed with ASand attended a special education classroom in a public school (N3) participated in this study. The children were rom our to fve yeao age, with mixed socioeconomic status and dierent ethnicities (i.Asian, Caucasian, and Arican-American). The participants did nhave any ormal imitation training prior to the study. At baseline, Lu(not his real name) was 4 years 4 months old, could talk, had abo100 words in his verbal repertoire, requently used two-word phrase

had been receiving autism intervention services or two years, ahad been receiving discrete trial training (DTT) or fve months. (Dis a teaching methodology that breaks skills into small componeareas that can be quickly presented; the responses can be promptecorrected, or reinorced immediately.) Lisa (not her real name) w5 years and 5 months old, did not speak, used a mixture o siglanguage and some vocalizations to communicate, and had bereceiving services or ASD or one and a hal years and DTT or omonths. Steve (not his real name) was 4 years and 11 months ocould talk, had about 150 words in his verbal repertoire, requen

Tb 2.numb d p of o ms sod o Po imo Sklls assssm

fo yplly dvlop ld

cld a Mus ims v # co l % co l # co 2d % co 2d

Karen 3-1 25 107 92 86 103 96

Iris 3-4 28 104 80 77 90 87

Lance 4-0 23 108 104 96 104 96

Jasmine 4-8 27 108 104 96 105 97



used three-word phrases, and had been receiving autism interventionservices or over two years and DTT or 4 months.Prior to being selected to participate in this study, the childrens

imitative skills were measured on the PISA. Each participant scoredwell below the scores o the typically developing three-to-our-year-old children who participated in the frst study (see Figure 1). Whereasthe number o correct responses demonstrated by the typicallydeveloping children on the frst presentation o the task ranged rom80 to 104 correct imitative responses, the pre-intervention scores orthe children with ASD ranged rom 36 to 72 correct responses on the

same measure. Thus, the imitation skills o the three subjects selectedto participate in this study were below the lowest score o any o theyounger typically developing children rom the frst study.

Instruments: The study used the PISA as well as a short version o thePISA called the Brie Imitation Skills Assessment (20 imitation skillsderived rom the larger PISA see Table 3).

Setting and materials: A amiliar adult conducted all teaching sessionsand assessments in the childrens public school special education

classroom. The materials used on the PISA and Brie Imitation SkillsAssessment were a drum, two drumsticks, two wooden cubes, a book,a small plastic container, a mirror, a toy dump truck, and a toy cargarage.

Procedures: A amiliar adult (teacher) administered the PISAindividually to all participants. Due to the lengthy nature o theassessment, it was administered in several smaller sessions determinedby the needs o each child, or a combined total o over 60 minutesor each participant. Participants were not corrected i they respondedincorrectly but received moderate verbal praise and encouragement(e.g., You are doing such a great job) throughout the test.

A amiliar adult also individually administered the Brie ImitationSkills Assessment, which was completed by each participant inabout fve minutes. As with the PISA, the adult made no attempt to fxincorrect responses and used no reinorcement other than moderateverbal praise or continuing testing.

Thirdly, an imitation training intervention was conducted over a two-month period. We selected six initial responses to be included in eachstudents intervention program based on an analysis o the individualstudents baseline imitation skills. The students classroom teacherdetermined the imitative domains in which students had numerouserrors and created an imitation curriculum or each student ocusing onthese defcit areas. A classroom sta member conducted the teachingsessions in a 2-to-1 student-to- teacher ratio. Since not all students in

the classroom were experiment participants, the researcher ensuredthat participants would not be paired together during imitationteaching sessions. Participants were seated or stood (depending onthe task) across rom the instructor at a distance o approximately one-and-a-hal eet. All o the sta had received training in DTT teachingmethodology.

The intervention presented 18 trials per day (three trials or eacho the six specifc imitation responses selected). When the childwas attending to the instructor, the instructor provided an instructionto imitate and modeled an action. Instructors provided participantswith gestural or physical prompts necessary to perorm the action.The prompt level (i.e., ull physical to partial physical to gestural) was

aded across trials, and instructors delivered greater reinorcementor more accurate and independent imitative responses. Instructorsimmediately ollowed up correct imitative responses (i.e., responsesthat matched the model) with verbal praise and a participant-specifcreinorcing item or activity. For a skill to be considered acquired,the student was required to correctly and independently imitatethe instructor-perormed action on the frst trial o three consecutivedays o learning trials. Whenever a child met the mastery criterionor a response, it was replaced by another imitative response in theteaching sequence.

Incorrect responses were corrected using a systematic correctionprocedure. The correction procedure consisted o repeating theinstruction to imitate, again modeling the action, and using the level o

Tb 3.t Bf imo Sklls assssm ms

Task Response

1. Four actions ater model2. Block in cup and pencil under book (model present)3. Touch nose at 10 eet away4. Clap 1 vs. 3 times5. Static vs. kinetic: palms together vs. clapping6. Arms out in ront and fngers spread7. Wink8. Sour ace

9. Fingers interlaced10. Two actions ater model11. Array 3: stack blocks (original model absent)12. Cup over; pencil in cup; book open; block on book13. Three actions ater model14. One arm out to side15. Touch nose 1 vs. 2 times16. Touch knee with one hand17. Point with index fnger on desk18. Shake head yes19. Shake head no20. Open mouth rom 10 eet away

F 1.

Comparative scores on the Partington Imitation Skills Assessment atspecifc ages or typically developing children and children with autismprior to intervention.



prompting (physical or gestural) necessary to have the child perormthe action. Prompted imitative responses were ollowed by praise. Theinstructor continued the correction procedure until the child was able toperorm the target imitative response without a prompt. Ater achievingan unprompted response, the instructor asked the child to perorm adierent known response (a distracter trial), and then repeated theprevious imitative response that had not been correctly imitated onthe frst presentation to obtain a required independent (unprompted)response. The corrected imitative response was then ollowed bypraise and a child-specifc reinorcing item or activity.

Measures and analysis: The study used three measures. The frst measurewas the number o correct imitative responses to the 108 items in thePISA. The second was the number o correct imitative responses onthe Brie Imitation Skills Assessment. Finally, trial-by-trial data regardingthe number o correct, incorrect, prompted, and ailed responses weremeasured or each skill taught during each o the instructional sessions.For all three measures, we considered a response correct only i ittopographically matched the action perormed by the model withinfve seconds o the presentation.

The PISA assessment was administered prior to and immediatelyollowing the imitation training intervention as well as 10 months post-

intervention to determine whether the results o the intervention weremaintained. Additionally, we employed a multiple baseline acrosssubjects design that allows participants to be their own control groupby staggering the start time o each participants treatment phase(Creswell, 2008; Gliner, Morgan, & Harmon, 2000). Biweekly dataon the 20-item Brie Imitation Skills Assessment were collected on allsubjects throughout the study. Ater the frst subject, Luke, demonstrateda stable baseline on this measure, the treatment phase began or Luke

only. During his treatment phase, we continued to collect biweedata using the 20-item assessment tool or all three participants. ALuke demonstrated an upward trend o increased imitation skills on tmeasure, the treatment phase or subject two, Lisa, began. The saprocedure was ollowed or subject three, Steve.

rESUltS

Participants demonstrated improved imitation skills as measured by three types o data: the 108-item pre- and post-intervention PISA, t20-item biweekly Brie Imitation Skills Assessment, and the daily tr

by-trial DTT data. On the PISA, participants demonstrated an increain their percent o correct items on the pre- and post-interventiadministration (Figure 2). Lukes scores increased rom 67% to 83(scores o 72 to 90), Lisas scores increased rom 33% to 68% (3673), and Steves scores increased rom 37% to 59% (40 to 64).

l

Correct 72 90 98Approximation 12 9 0Incorrect 23 9 10Non-response 1 0 0

l


st


ParticipantNumber of responses

Tb 4.Pre-, post-, nd 10-month follow-up scores of

chldren wth utsm on the Prtngtonimtton Sklls assessment

Pre-intervention

Post-intervention

10-monthfollow-up

F 2.

Number o actions accurately imitated and approximated on thePartington Imitation Skills Assessment in children with autism prior to andollowing intervention.

From the frst to the second administration o the PISA, all thrparticipants also changed in their overall pattern o respondinwith an increase in both correct responses and approximations (sTable 4). In addition, participants PISA scores increased or we

maintained at 10-month ollow-up. Two o the subjects (Luke and Lisdemonstrated urther increases in their correct scores at 10 montwhile the third (Steve) scored close to his immediate post-interventiscore. Lisa demonstrated the largest increase, going rom 73 correresponses immediately a ter the end o training to 93 correct responsat 10-month ollow-up.

The mean scores on the 20-item Brie Imitation Skills Assessmincreased or all participants rom the baseline to intervention phas(Figure 3). At baseline, Luke had an average score o 11.3 correresponses out o 20, rising to a mean score o 16.6 during his treatmphase. Lisas average correct scores increased rom 6.6 (baseline)14.5 (intervention), and Steves scores increased rom an average 5.9 to 10.8 correct responses or the baseline and inter vention phas

Numberofimitativeresponses

Luke Steve Lisa

Pre-intervention

Approximation

Correct

Approximation

Correct

Post-intervention



The intervention phase was in eect or eight and a hal weeks orLuke (43 treatment days), fve and a hal weeks or Lisa (27 treatmentdays), and two and a hal weeks or Steve (13 treatment days). Overhis 43 days o treatment, Luke learned 24 new imitation skills (anaverage o 3.5 days per skill). Over her 27 days, Lisa acquired 14new imitation behaviors (an average acquisition rate o 5 days perskill). Over only 13 treatment days, Steve acquired 3 new skills (anaverage o 7 days per skill) (see Table 5).

DISCUSSIoN

All three subjects demonstrated improved imitation skills through theirparticipation in the child-specifc imitation curriculum conducted viadiscrete trial training in their classroom. Moreover, participants pre-and post-test PISA results indicate that their overall improvement scorewas much greater than the quantity o specifc skills they were taughtthrough their in-class imitation curriculum. For example, Steve acquiredonly three new imitation skills as measured by his classroom curriculumtraining. However, ollowing the intervention, he improved on 24responses on the PISA. We observed similar patterns in the othertwo subjects, demonstrating that participants were generalizing theskills they learned during their individualized intervention curriculum toother similar imitative behaviors. This result supports earlier fndings o

generalized imitation (Baer & Deguchi, 1985).

general discussion

The important role o imitation in the development o a childs languageskills (Partington et al., 1994; Ryan, 2007), social interaction skills(Garfnkle & Schwartz, 2002; Nadel & Peze, 1993), and play skills(Ingersoll & Schreibman, 2006) has been widely acknowledged.However, there is a signifcant lack o data about what types oimitative skills need to be taught and how to develop these skills inchildren who have specifc defcits in this repertoire. It is particularlynoteworthy that only one prior study has developed simple imitativeskills in a school classroom setting (Ryan, 2007). With the signifcantincrease in rates o ASD diagnosis and the corresponding increase in

the number o ASD children who attend special education classroomsin public schools, it is crucial that methods to develop imitative skills inthese environments be investigated and validated.

In our frst small-scale study, typically developing childrendemonstrated the ability to perorm a wide variety o imitative skillswithout any previous structured teaching. Their perormance on thebroadly scoped PISA demonstrated their ability to uently imitate alarge number o actions within a 20-to-30-minute time period whenprovided only with social reinorcement. Furthermore, when unable toimitate an action or series o actions on the frst attempt, the childrenoten were able to successully imitate the actions when providedwith an additional demonstration.

In our second study, the initial evaluation o children with ASDusing the PISA urnished results consistent with previous researchpointing to defcits in imitative skills in ASD children (Perra et al.,

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2008; Stieglitz Ham et al., 2008). All o the children with ASD inthe second study perormed below the levels o all o the t ypicallydeveloping children in the frst study. Additionally, the children withASD required more time to complete the PISA.

The second study demonstrated that ASD children who receiveminimal imitation training in a special education classroomenvironment can improve in their ability to imitate those responsestaught during instruction. The children with ASD made signifcantimprovements in both the overall number and types o imitativeresponses acquired in a relatively short period o instructional time.

With only 18 imitation trials per instructional day, all three o thechildren made substantial gains in their ability to imitate the responsesincluded in the instructional sessions as well as other responsesnot included in the training. Moreover, the children maintainedthese outcomes or ten months ollowing the study. These resultsdemonstrate that minimal instructional time can result in acquisitiono skills that are apparently maintained by continued participation intheir educational program and by naturally occurring environmentalinteractions.

Our preliminary research indicates that comparing the skills ochildren with ASD to children without developmental delays can helpidentiy a wide range o actions to target or intervention programs

and that relatively small amounts o instruction can quickly producesubstantial improvements in imitative skills. However, there are stillmany issues that warrant urther investigation. First, it would bedesirable to study a larger sample o typically developing children,especially those younger than 3 years o age. Because the childrenwho were already 3 years o age were able to imitate the majorityo the actions, assessing younger children might help to identiythe developmental sequence in which the various types o imitativeresponses are acquired. This additional inormation could provevaluable in helping parents and educators identiy the actions to targetor intervention with children with ASD. Second, increasing the samplesize or studies involving children with ASD would confrm the efcacyo current teaching strategies with individuals displaying a wider range

o general skill defciencies and would also ensure that establishprocedures can be replicated in other classrooms, treatment centeand home environments. Third, although our relatively brie interventi(18 trials per day or several weeks) produced a substantial increaseimitative skills, it would be desirable to investigate whether increasthe number o teaching trials per day and extending the length o tintervention would produce even greater eects.

Further research is also needed to determine the most efciemethods or developing a generalized imitative reper toire that includa broad range o imitative skills. Our research utilized a DTT orm

to teach imitative skills to children with ASD in a special educaticlassroom. However, some research fndings suggest that these skcan also be developed in less structured teaching interactions thoccur in the childs natural environment (Ingersoll & Schreibma2006; Sundberg & Partington, 1999). A direct comparison o teectiveness o each o these approaches and combinations o ttwo approaches would help practitioners identiy the most eectstrategies or parents and educators to use with children with varyilevels o defciencies in their imitative repertoire.

conclusion

The development o a repertoire that includes a broad range o imitat

skills is likely to assist children o all ages in being better preparedlearn rom interactions with amily members, neighbors, peers, aothers who have not been trained to systematically teach such skFurthermore, children who have developed an imitative repertoire mbe better prepared to beneft rom an inclusive educational settbecause they are more likely to learn new skills merely by watchiand then using their imitative skills to perorm the actions demonstratby others. Thereore, parents and educators should place a maemphasis on ensuring that instruction is provided such that all childrhave a well-developed set o imitation skills. These necessary skcan help them achieve the greatest amount o overall independunctioning, including sel-help skills, social interaction skills, and othskills that acilitate participation in amily and community events.

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Imitation by James W. Partington, PhD, BCBA-D, et al