This study evaluates the effectiveness of an intervention package including a discrete trial program (Rapid Motor Imitation Antecedent Training (Tsiouri and Greer, J Behav Educat 12:185–206, 2003) combined with parent education for eliciting first words in children with ASD who had little or no spoken language. Evaluation of the approach includes specific intervention targets and functional spoken language outcomes (Tager-Flusberg et al., J Speech Lang Hear Res 52:643–652, 2009). Results suggest that RMIA, with parent training, catalyzes development of verbal imitation and production for some children. Three of five participants acquired word production within the DTT framework and achieved milestones of early functional spoken language use (Tager-Flusberg et al., J Speech Lang Hear Res 52:643–652, 2009). The implications of these findings for understanding the role of discrete trial approaches to language intervention are discussed.