Teaching Imitation to Children with Autism: A Focus on Social Reciprocity

Introduction Children with autism exhibit significant impairment in imitation skills (for a review, see Rogers & Williams, 2006; Smith & Bryson, 1994; Williams, Whiten, & Singh, 2004). However, the scope of this deficit is highly debated. Imitation skills do not appear to be uniformly disrupted, but rather limited to specific types of actions and contexts (e.g., Williams et al., 2004). One possible explanation for these discrepancies is that children with autism may have difficulty using imitation for certain purposes. Research on typical development suggests that imitation serves two distinct functions in infancy and early childhood. One is a learning function, through which infants acquire new skills and knowledge, and the other is a social function, through which infants engage in social and emotional exchanges with others (Uzgiris, 1981, 1990). Recently, it has been hypothesized that children with autism may be particularly impaired in their social use of imitation, while the learning function is less impaired (Ingersoll, in press-a; Rogers, Cook, & Meryl, 2005). The possibility that the social use of imitation may be especially disrupted in individuals with autism has significant implications for the treatment of imitation deficits in young children with autism. This paper will address three issues with respect to the imitation skills of children with autism. First, it will review evidence for a specific deficit in the social use of imitation. Second, it will discuss limitations of current methods for teaching imitation which target only the learning function in highly structured contexts, and third, it will describe a naturalistic imitation intervention designed to teach the social use of imitation in young children with autism. Evidence of a Specific Deficit In the Social Use of Imitation There have been two general approaches to investigating the distinction between the two functions of imitation in children with autism. The first approach has been to present actions which represent the different functions in structured or elicitation contexts. The second approach has been to vary the contexts in which the imitation tasks are presented. Studies utilizing each of these approaches are summarized below. Studies Comparing Both Types of Imitation within Structured Elicitation Tasks Specifically, a child is seated across from the examiner in a distraction-free environment. The examiner gains the child's attention, models an action and instructs the child to imitate (e.g., "Do this", "You do it"). Actions that represent the learning function of imitation are typically meaningful actions on objects, whereas actions that represent the social function of imitation have involved body movements and non-functional acts on objects (Rogers, Cook, Young, & Giolzetti, 2005). For example, Hobson and Lee (1999) compared children with autism and developmental delay on an object imitation task in which the experimenter modeled the action in either a "harsh" or "gentle" style (i.e., body movements). The children with autism imitated a similar number of goal-directed actions as the developmentally-delayed children. However, they did not imitate the experimenter's style. The authors suggested that children with autism, while capable of imitation as demonstrated in their ability to replicate the goal of the actions (learning function), do not use imitation as a means to identify with others (social function). In other study, children with autism were found to be more likely to imitate actions with objects that produced a sensory effect (flashing lights and sounds) than those that did not (Ingersoll, Schreibman, and Tran, 2003). Typically developing children matched for mental age did not show this discrepancy and imitated all actions equally well. The typically developing children also used more social behaviors during imitation than the children with autism. This suggested that typical children are motivated to imitate by the social feedback (i. …