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

Researchers tested whether parents could learn autism intervention skills through video calls using music and play. Four mothers learned to use special play techniques with their autistic children (ages 2-4) during online sessions. All mothers successfully learned the skills and kept using them weeks later. Parents became more musical in their interactions, but children's copying skills didn't clearly improve.

Parents were very satisfied and felt their children's social and play skills improved overall. This shows online parent training with music can work well.

This feasibility study evaluated telehealth delivery of music-enhanced Reciprocal Imitation Training (tele-meRIT) for parent coaching in autism intervention. Four mother-child dyads participated in a single-subject, multiple baseline design study. All mothers successfully learned and maintained RIT implementation strategies through virtual coaching, achieving treatment fidelity by intervention end and maintaining it at follow-up. Parent vocal musicality increased during the intervention.

However, children's spontaneous imitation skills did not show consistent improvement. Parents reported high satisfaction and perceived broader benefits to their children's social and play skills. The study demonstrates that telehealth delivery of music-enhanced parent-mediated interventions is feasible and can effectively teach parents evidence-based naturalistic developmental behavioral intervention strategies.

Telehealth delivery of parent-mediated NDBIs appears feasible and acceptable to families. Music integration may enhance parent engagement in intervention techniques. However, inconsistent child outcomes suggest need for larger efficacy studies before clinical implementation. The approach shows promise for increasing accessibility of parent training programs.

Very small sample size (4 dyads) limits generalizability. Single-subject design provides limited statistical power. Study focused only on feasibility rather than efficacy. Short follow-up period (one month). No control group for comparison. Children's imitation outcomes were inconsistent, questioning intervention effectiveness for child skills.

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.

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. 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.

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.