reviewed the following article:
Part 1: Review and discussion of Ingersoll’s Reciprocal Imitation Training article and resource Pamphlet 
After reviewing the materials, please respond to the following:
1. Research supports the association between imitation and what three skill areas?
2. What ‘traditional’ behavior approach is often used to teach imitation skills? What are 2 limitations of this approach as cited in the article?
3. What general approach has been designed to address the limitations of the traditional behavioral approach and what are the cited benefits of this approach?
4. In looking at the outcomes of the study, how did the study improve imitative behavior? What other skills areas demonstrated improvement as well?
Part 2: Critical Thinking/Application 
Next the team will have an opportunity to brainstorm ideas for supporting skill training in the natural environment. 
1. What are some skills that can be taught in the natural environment using reciprocal imitation training? 
2. Thinking back to student Zuri and their VB-MAPP milestones assessmentLinks to an external site., what skill areas may be useful to teach using natural environment training?
3. Select 3 specific skills that could be taught using natural environment training and more specifically, reciprocal imitation training. Use the following grid to indicate the activity, when you would teach the skill, time you would need to teach the skill, brief description of the skill and how you would teach the skill. You may select one of the strategies provided in the RIT handout (e.g. object imitation, gestural imitation, vocal imitation etc. or you may select another method based on the materials presented in the course on natural environment training).
Journal of Autism and Developmental Disorders, Vol. 36, No. 4, May 2006 ( 2006)
DOI 10.1007/s10803-006-0089-y
Published Online: March 28, 2006
Teaching Reciprocal Imitation Skills to Young Children
with Autism Using a Naturalistic Behavioral Approach: E?ects
on Language, Pretend Play, and Joint Attention
Brooke Ingersoll,1,2 and Laura Schreibman1
Children with autism exhibit signi?cant de?cits in imitation skills which impede the acquisition
of more complex behaviors and socialization, and are thus an important focus of early
intervention programs for children with autism. This study used a multiple-baseline design
across ?ve young children with autism to assess the bene?t of a naturalistic behavioral
technique for teaching object imitation. Participants increased their imitation skills and
generalized these skills to novel environments. In addition, participants exhibited increases in
other social-communicative behaviors, including language, pretend play, and joint attention.
These results provide support for the e?ectiveness of a naturalistic behavioral intervention for
teaching imitation and o?er a new and potentially important treatment option for young
children who exhibit de?cits in social-communicative behaviors.
KEY WORDS: Autism; imitation; intervention; behavioral; social communication.
researchers have suggested that imitation may be a
primary de?cit in autism that underlies the abnormal
development of social-communicative behaviors
(Meltzo? & Gopnik, 1994; Rogers, 1999; Rogers &
Pennington, 1991; Smith & Bryson, 1994).
Research supports the association between imitation and social-communicative behaviors in autism.
A longitudinal study of imitation and language in
young children with autism found an association
between imitation of body movements and the
development of expressive language 6 months later
(Stone, Ousley, & Littleford, 1997). In another study,
Stone and Yoder (2001) examined the ability of a
variety of child variables (play level, motor imitation,
and joint attention) to predict language outcomes.
They assessed 35 children with an autism spectrum
diagnosis at age two and again at age four. After
controlling for language skills at age two, they found
only motor imitation ability and number of hours of
speech/language therapy signi?cantly predicted language outcome at age four, suggesting a strong
Autism is a development disorder characterized
by pervasive de?cits in social-communicative behaviors, including language, pretend play, and joint
attention (APA, 2000). There is also a growing body
of literature that demonstrates children with autism
have de?cits in imitation (see Rogers, 1999; Smith &
Bryson, 1994 for reviews). In typical infants, imitation emerges early in development (Melzo? & Moore,
1977) and plays a critical role in the development of
cognitive and social skills. Research suggests that
imitation is associated with the development of
language (e.g., Bates et al., 1988), play (Fiese, 1990;
Uzgiris, 1990), and joint attention skills (Carpenter,
Nagell, & Tomasello, 1998). Given this association
and the evidence for imitation de?cits in autism, some
1
2
University of California, San Diego, La Jolla, CA, USA.
Correspondence should be addressed to: Brooke Ingersoll,
Department of Psychology, Lewis and Clark College, 0615 SW
Palatine Hill Rd, Portland, Oregon 97219, USA; E-mail: bri@
lclark.edu
487
0162-3257/06/0500-0487/0 2006 Springer ScienceþBusiness Media, Inc.
488
correlation between imitation and language development in children with autism. There is also a
relationship between imitation and play skills in
children with autism. For example, Stone et al. (1997)
found that object imitation at age two was highly
correlated with the development of play skills 1 year
later, suggesting the importance of imitation in play
development. Indeed, interventions targeting play in
children with autism typically use imitation to teach
novel play behaviors (e.g., Leaf & McEachin, 1999;
Lovaas, Freitas, Nelson, & Whalen, 1967).
Research also suggests an association between
imitation and joint attention in autism, although not
as strong. Curcio (1978) found that gesture imitation
was associated with the number of communicative
gestures used by non-verbal children with autism. In
another study, Carpenter, Pennington, and Rogers
(2002) found that object imitation and coordinated
joint attention were correlated with each other in
preschool-aged children with autism. In this sample,
object imitation preceded the development of joint
attention, a pattern that was reversed for typically
developing children (Carpenter et al., 1998). The
authors suggested that, unlike typical children, children with autism learn to use language through
imitation rather than joint attention. Given these
associations, researchers have suggested targeting
imitation in young children with autism may promote
the development of later social-communicative
behaviors (Carpenter et al., 2002; Klinger & Dawson,
1992; Rogers, 1999; Rogers & Bennetto, 2000; Tryon
& Keane, 1986), highlighting the importance of
interventions addressing imitation de?cits early in
autistic development.
Early intervention programs typically use a
traditional behavioral approach, also referred to as
discrete trial training, to target imitation skills (e.g.,
Leaf & McEachin, 1999; Maurice, Green, & Luce,
1996). In this approach, the learning environment is
highly structured and controlled by the therapist,
usually with the child and therapist facing each other
in child-sized chairs. Imitative behavior is broken into
a series of discrete sub-skills and presented in multiple, successive trials. Speci?c behaviors (e.g., clapping,
placing a block in a box) are selected by the therapist
from actions that the child is not yet performing
spontaneously. Acquisition is facilitated by the use of
explicit prompting, prompt fading, and contingent
reinforcement (food or access to a preferred toy).
Each action is taught individually in a block of 10
trials; however, several di?erent actions may be
targeted across blocks within a session. After mastery
Ingersoll and Schreibman
of an imitative action (e.g., 80% correct over three sets
of 10 trials), random rotation of several mastered
actions is presented within a single set of trials.
The traditional behavioral technique has documented success in teaching children to imitate a
variety of non-verbal actions and words. Metz (1965)
used physical prompting and food reinforcers paired
with verbal praise to teach body and object imitation
in two children with autism who had previously
exhibited little to no imitative behavior. He found that
after intensive training several imitative responses
were maintained in the absence of reinforcement.
Baer, Patterson, and Sherman (1967) replicated this
experiment using a more controlled reversal design
with children with mental retardation. They found
that as training progressed, new imitations were
increasingly easy to teach. In addition, the children
imitated probe trials of imitations that had never been
reinforced during training. The imitative behavior
extinguished during the reversal, demonstrating the
control of reinforcement over the behavior.
Lovaas and colleagues used a similar approach
to teach verbal (Lovaas, Berberich, Perloff, & Schaeffer, 1966) and non-verbal (Lovaas et al., 1967)
imitation in response to a verbal discriminative
stimulus (SD) to children with autism. In both
studies, imitation became increasingly easy to teach
as it came under the control of the SD. When
reinforcement was delivered non-contingently, the
behavior deteriorated. Laying the groundwork for
current, comprehensive early intervention programs
using a traditional behavioral approach, Lovaas et al.
(1967) used the newly acquired imitative behavior to
teach self-help and leisure skills.
Despite documented success at teaching imitation skills, several limitations of the traditional
behavioral approach have been noted. First, training
occurred in highly structured environments and used
arti?cial reinforcers. Although generalization across
actions was found, no studies examined generalization
of these skills to non-treatment settings or therapists
or the spontaneous use of imitation during play.
Subsequent studies have shown that highly structured
teaching environments and arti?cial reinforcers can
impede generalization to the natural environment
(Koegel, O’Dell, & Koegel, 1987; Lovaas, 1977;
Spradlin & Siegel, 1982). Second, with the exception
of one study (Metz, 1965), the imitative behavior was
brought under the control of a speci?c verbal SD (‘‘Do
this’’ or ‘‘Say’’). Research has shown that when
behavior is brought under tight stimulus control, its
spontaneous use is compromised (Carr, 1981). Third,
Reciprocal Imitation in Autism
489
maintenance of imitative behavior was dependent on
continued reinforcement of some responses, suggesting that it did not acquire its own reinforcing
properties. And fourth, imitative behavior was targeted as an isolated skill rather than in the context of
other co-occurring social-communication behaviors
and thus not representative of natural adult–child
interactions (Schreibman, Kaneko, & Koegel, 1991).
Thus this approach may actually hinder the spontaneous, social-communicative use of imitation in the
natural environment (Koegel & Koegel, 1995).
Naturalistic behavioral treatments, such as incidental teaching, milieu teaching, and pivotal response
training (PRT), have been designed to address the
limitations of the traditional behavioral approach by
incorporating behavioral techniques known to facilitate learning (i.e., multiple trials, explicit prompting
and shaping, contingent reinforcement) with techniques known to facilitate early social-communicative
behavior in typical children (i.e., contingent imitation, following the child’s lead, linguistic mapping)
(Warren, Yoder, Gazdag, & Kim, 1993). There is
extensive literature to support the e?ectiveness of this
approach for teaching language (see Kaiser, Yoder, &
Keetz, 1992, for review), and more recently, prelinguistic communication (Warren et al., 1993), play
skills (Stahmer, 1995; Thorp, Stahmer, & Schreibman, 1995), peer interaction (Pierce & Schreibman,
1995), and joint attention (Pierce & Schreibman,
1995; Whalen & Schreibman, 2003).
The naturalistic behavioral approach provides
increased generalization (Charlop-Christy & Carpenter, 2000; Spradlin & Siegel, 1982) through naturally
occurring teaching episodes and direct response–
reinforcer relationships (Kaiser et al., 1992),
increased spontaneity (Schwartz, Anderson, & Halle,
1989) by following the child’s lead (Kaiser et al.,
1992), and more natural adult–child interactions
(Schreibman et al., 1991) because teaching is embedded in ongoing play interactions (Kaiser et al., 1992).
Despite success addressing a variety of social-communicative behaviors, this type of intervention has
not yet been used to teach imitation skills.
This study assesses whether immediate object
imitation can be successfully taught using reciprocal
imitation training (RIT), a naturalistic behavioral
intervention, and whether increases in imitation lead
to collateral changes in the children’s language,
pretend play, and joint attention behaviors.
METHOD
Participants
Five children with autism participated in this
study. Children were diagnosed using DSM-IV criteria (APA, 2000) from an outside professional with
expertise in autism and the ?rst author using the
Autism Diagnostic Observation Schedule-Generic
(ADOS-G; Lord et al., 2000). The children ranged
in age from 29 to 45 months at intake with mental
ages ranging from 15 to 29 months on the Bayley
Scales of Infant Development, 2nd edition (Bayley,
1993). The children’s primary caregivers completed
the MacArthur Communication Development Index
(Fenson et al., 1993) to determine language age and
the Childhood Autism Rating Scale (CARS; Schopler,
Reichler, DeVellis, & Daly, 1980) to determine
severity of autism. Language ages ranged from less
than 8 months (non-verbal) to 25 months and level of
autism severity ranged from mild-moderate to severe
(see Table I).
All children exhibited de?cits in spontaneous
object imitation during play with others according to
parent report and imitation of fewer than 10% of
actions presented during an informal baseline session
Table I. Participant Characteristics at Intake
Autism severity
Child
Chronological
age (mos.)
Mental age
(Bayley) (mos.)
Language age
(MacArthur CDI) (mos.)
(CARS)a
(ADOS)b
Connor
Lena
Heather
Nathan
Jason
41
45
29
34
34
29
23
15
16
16
25
22