Associations Between Types of Imitation and Receptive and Expressive Language Skills in Preschoolers With Autism

Purpose: Imitation and language are associated in autistic children. However, imitation involves various types. This cross-sectional study examined the associations between different imitation abilities and receptive and expressive language skills in autistic preschoolers while controlling for nonverbal IQ (NVIQ). Additionally, these associations were explored separately in two subgroups based on language level. Method: A sample of 176 autistic preschoolers, aged 2–6 years, was assessed using (semi)structured behavioral tasks measuring imitation (elicited object, gestural, and verbal imitation; spontaneous object imitation; and deferred object imitation), nonverbal cognitive, and language abilities. Results: The model with elicited object, verbal, and spontaneous object imitation explained the largest proportion of variance in receptive language after controlling for NVIQ, although a model with elicited gestural, deferred, and spontaneous object imitation showed nearly equivalent explanatory power. Elicited verbal, deferred, and spontaneous object imitation contributed most to explaining expressive language. The interaction effects indicated that differences across subgroups only emerged for spontaneous object imitation. Within-group analyses revealed different imitation abilities contributing to the most predictive model of concurrent language skills, in the minimally speaking/some words group and the speech in sentences/fluent speech group. Conclusions: Various imitation abilities contribute to receptive and expressive language beyond NVIQ. For autistic children with varying language skills, immediate verbal and object imitation abilities were key contributors to language performance, suggesting that these may be important targets for intervention. In the minimally speaking/some words group, immediate and deferred object imitation contributed to language skills, whereas these abilities were less predictive for verbally more fluent autistic children. Supplemental Material: https://doi.org/10.23641/asha.33311877