Adapting measures of motor imitation for use by caregivers in virtual contexts: Reliability, validity, and sensitivity to change

Early imitation challenges for children with autism are thought to contribute to broader delays in their social communication development. As such, imitation is an important intervention target for young children with and showing early signs of autism, and efforts are underway to disseminate evidence-based imitation interventions into community settings. To our knowledge, there are currently no established imitation assessments that have been validated for use in virtual contexts. This study was designed to examine the reliability and validity of two caregiver-implemented imitation measures delivered with support from a remote virtual assessor. Study participants (177 caregiver-child dyads) were enrolled in a large, multisite study that is examining the effectiveness of a caregiver-implemented intervention delivered through the Part C early intervention (EI) system across four states. Results indicate that the assessments can be administered remotely with strong fidelity, internal reliability, predictive validity, discriminant validity, convergent validity, and sensitivity to change. Stability over time was adequate. These findings suggest that imitation skills can be measured effectively using a remote caregiver-implemented assessment, which provides greater opportunity for virtual clinical trials targeting social communication in young children. CLINICAL TRIAL REGISTRATION: The trial protocol was registered at ClinicalTrials.gov (NCT05114538).