Department of Psychology, University of Washington, Seattle, Washington, USA.
Autism Res. 2021 Aug;14(8):1777-1788. doi: 10.1002/aur.2522. Epub 2021 May 6.
Despite the development of several evidence-based Naturalistic Developmental Behavioral Interventions (NDBIs), very few have been adapted for use in community-based settings. This study examines the implementation of Reciprocal Imitation Training (RIT)-an NDBI-by community Early Intervention (EI; IDEA Part C) providers serving toddlers from birth to 3 years. Of the 87 EI providers enrolled from 9 agencies in 4 counties across Washington State, 66 were included in the current sample. A stepped-wedge design was used to randomly assign counties to the timing of RIT training workshops. Self-report measures of practice and self-efficacy regarding ASD care were collected at baseline (T1, T2) and 6-months and 12-months post-training (T3, T4). At T3 and T4, providers reported on RIT adoption and rated items about RIT feasibility and perceived RIT effectiveness; at T4, they also reported on child characteristics that led to RIT use and modifications. From pre-training to post-training, there were significant increases in providers' self-efficacy in providing services to children with ASD or suspected ASD. At T3 and T4, provider ratings indicated high levels of RIT adoption, feasibility, and perceived RIT effectiveness. At T4, providers indicated that they most commonly: (a) initiated RIT when there were social-communication or motor imitation delays, or an ASD diagnosis; and (b) made modifications to RIT by repeating elements, blending it with other therapies, and loosening its structure. While additional research is needed, RIT may help families get an early start on accessing specialized treatment within an established infrastructure available across the United States. LAY SUMMARY: Reciprocal imitation training (RIT) is an evidence-based treatment for ASD that might be a good fit for use by intervention providers in widely accessible community-based settings. After attending an educational workshop on RIT, providers reported feeling more comfortable providing services to families with ASD concerns, used RIT with over 400 families, and believed that RIT improved important social communication behaviors.
尽管已经开发了几种基于证据的自然发展行为干预措施（NDBIs），但很少有被改编用于社区环境。本研究考察了互惠模仿训练（RIT）的实施情况——一种 NDBI——由为 0 至 3 岁幼儿提供服务的社区早期干预（IDEA 第 C 部分）提供者实施。在华盛顿州 4 个县的 9 个机构中招募的 87 名 EI 提供者中，有 66 名被纳入当前样本。采用阶梯式楔形设计随机分配县参加 RIT 培训研讨会的时间。在基线（T1、T2）和培训后 6 个月和 12 个月（T3、T4）收集关于 ASD 护理的实践和自我效能的自我报告措施。在 T3 和 T4，提供者报告了 RIT 的采用情况，并对 RIT 的可行性和感知 RIT 的有效性进行了评价；在 T4，他们还报告了导致 RIT 使用和修改的儿童特征。从培训前到培训后，提供者提供 ASD 或疑似 ASD 儿童服务的自我效能感显著提高。在 T3 和 T4，提供者的评分表明 RIT 的采用、可行性和感知的 RIT 有效性水平很高。在 T4，提供者表示，他们最常见的做法是：（a）当存在社交沟通或运动模仿延迟、或 ASD 诊断时，启动 RIT；（b）通过重复元素、将其与其他疗法融合以及放松其结构，对 RIT 进行修改。虽然还需要进一步的研究，但 RIT 可能有助于家庭在美国广泛可用的既定基础设施内尽早开始接受专门治疗。简要概述：互惠模仿训练（RIT）是一种针对 ASD 的循证治疗方法，可能非常适合在广泛可及的社区环境中使用的干预提供者使用。在参加了关于 RIT 的教育研讨会后，提供者报告说，他们为有 ASD 问题的家庭提供服务感到更加舒适，他们为 400 多个家庭提供了 RIT，并认为 RIT 改善了重要的社交沟通行为。
