Enhancing the application and evaluation of a discrete trial intervention package for eliciting first words in preverbal preschoolers with ASD.

Five preschoolers with autism who had no words got a new twist on discrete trial training. The team mixed Rapid Motor Imitation Antecedent Training (RMIA) into standard DTT and taught parents to use the same moves at home.

Sessions ran three times a week for about six weeks. Each trial started with the adult doing a simple motor action like clapping. The child had to copy it. After the imitation, the therapist immediately gave a small toy and said its name, turning the imitation moment into a chance to speak.

Three of the five kids said their first real words during the study. They also hit early language milestones such as calling people by name and asking for items.

The two children who did not start talking still improved. They made more sounds and eye contact, setting the stage for future speech.

Lancioni et al. (2009) and Meier et al. (2012) showed that teaching mand or tact alone can make the other pop out. Ioanna’s team used that same idea but started with motor imitation instead of pure verbal drills.

Hu et al. (2023) later echoed the plan. They used echoic-to-mand training and saw untaught tacts appear, much like the RMIA-first approach here.

Dass et al. (2018) used the same DTT package—echoic prompts, prompt delay, error correction—but aimed at naming smells, not first words. Both studies prove the parts work; Ioanna just aimed them at the very first spoken words.

If you run DTT with minimally verbal preschoolers, slide in five rapid motor imitation trials before you ask for speech. The quick imitation primes the mouth and brain, and parent coaching keeps the momentum going at home. You might hear the first word weeks sooner.