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

• Published in: Journal of autism and developmental disorders Vol. 55; no. 8; pp. 2950 - 2962
• Main Authors: Liu, Talia, Martinez-Torres, Keysha, Mazzone, Julie, Camarata, Stephen, Lense, Miriam
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2025; Springer Nature B.V
• Subjects: Access; Adult; Attention; Autism; Autistic children; Autistic Disorder - psychology; Autistic Disorder - therapy; Behavior; Behavior Rating Scales; Behavior Therapy - methods; Behavioral Science and Psychology; Brief Report; Caregiver Training; Caregivers; Child and School Psychology; Child Development; Child Rearing; Child, Preschool; Childhood; Children; Coaching; Communication; Communication Skills; Direct Instruction; Evidence Based Practice; Families & family life; Feasibility; Feasibility Studies; Female; Fidelity; Humans; Imitation; Imitative Behavior; Individual Differences; Intervention; Male; Mentoring - methods; Mothers; Music; Music Activities; Music Therapy; Music Therapy - methods; Neurosciences; Parent Caregiver Relationship; Parent Child Relationship; Parent Participation; Parent-Child Relations; Parenthood education; Parents & parenting; Parents - education; Pediatrics; Phonemes; Probes; Psychology; Public Health; Receptive Language; Singing; Skill Development; Skills; Social Behavior; Social education; Social skills; Song; Speech; Telemedicine; Training; Vowels; Reciprocal Imitation Training; Autism; Naturalistic developmental behavioral intervention; Parent coaching; Telehealth; Music
• ISSN: 0162-3257; 1573-3432; 1573-3432
• DOI: 10.1007/s10803-023-06053-z

Purpose Telehealth delivery increases accessibility of parent-mediated interventions that teach parents skills and support autistic children’s social communication. Reciprocal Imitation Training (RIT), an evidence-based Naturalistic Developmental Behavioral Intervention (NDBI) focused on imitation skills, a common difficulty in autism, holds promise for telehealth-based parent training. Imitation is also a core component of musical play during childhood and the affordances of musical play/song naturally shape parent–child interactions. We evaluate the feasibility of a music-based, telehealth adaptation of RIT—music-enhanced RIT (tele-meRIT)—as a novel format for coaching parents in NDBI strategies. Methods This single-subject, multiple baseline design study included 4 autistic children (32–53 months old) and their mothers. Parent–child dyads were recorded during 10-min free play probes at baseline, weekly tele-meRIT sessions, and one-week and one-month follow-up. Probes were coded for parents’ RIT implementation fidelity, parent vocal musicality, and children’s rate of spontaneous imitation. Results No parent demonstrated implementation fidelity during baseline. All parents increased their use of RIT strategies, met fidelity by the end of treatment, and maintained fidelity at follow-up. Parent vocal musicality also increased from baseline. Intervention did not consistently increase children’s imitation skills. A post-intervention evaluation survey indicated high parent satisfaction with tele-meRIT and perceived benefits to their children’s social and play skills more broadly. Conclusion Implementing tele-meRIT is feasible. Although tele-meRIT additionally involved coaching in incorporating rhythmicity and song into play interactions, parents achieved fidelity in the RIT principles, suggesting one avenue by which music can be integrated within evidence-based parent-mediated NDBIs.