An association of imitation skills with language development in typically developing children versus children with autism spectrum disorder and developmental delay: An observational cross-sectional study

Abstract

Background: Recent studies have shown a significant improvement in receptive and expressive language skills of children with autism spectrum disorder (ASD) using imitation skills. Thus, this study was designed to evaluate and compare imitation skills of children with ASD, children with developmental delay (DD), and developmentally age-matched typically developing (TD) children and to associate imitation skills and receptive-expressive language development in children with ASD and in children with DD. Objectives:(1) To evaluate imitation skills in children with ASD and children with DD, (2) to compare imitation skills of children with ASD and children with DD with imitation skills of TD children, and (3) to correlate imitation skills with receptive-expressive language development of children with ASD and children with DD. Study Design: This was an observational cross-sectional study. Methods: The study included 12 children with ASD of 4-6 years, 12 children with DD of 4-6 years, and 12 TD children of age that matched the developmental age of children with ASD and children with DD. Denver II Prescreening Developmental Questionnaire was used to assess the developmental age, Motor Imitation Scale to assess the imitation skills, and MacArthur-Bates Communicative Development Inventory to assess the receptive-expressive language skills in 2 sessions of 40 min each. Results: No significant difference was found between the mean developmental age of ASD and TD (P = 1; 95% confidence interval [CI]: 1.37, 17.29), ASD and DD (P = 1; 95% CI: −8.12, 7.79), and DD and TD (P = 1; 95% CI: 1.21, 17.12). This proves that the three groups were matched as per the developmental age. A significant difference was found on comparing the imitation skills of children with ASD and TD children (P = 0.005; 95% CI: −8, 0) and children with DD and TD children (P = 0.00; 95% CI: −7, −3). On correlating imitation skills with receptive-expressive language development of children with ASD, no significant correlation was found (P = 0.948; 95% CI: −0.559, 0.587 and P = 0.455; 95% CI: −0.388, 0.714, respectively), whereas a significant correlation was found between imitation skills and receptive-expressive language development of children with DD (P = 0.014; 95% CI: 0.182, 0.903 and P = 0.034; 95% CI: 0.059, 0.877, respectively). Conclusion: Imitation skills of children with ASD and children with DD are significantly affected compared to TD children. Imitation skills might not be the only contributing factor in development of language skills.