But it is easy to be inadvertantly prompting certain reactions with your behavior and ABA has helped me to carefully analyze what I’m doing to illicit a response so that I’m not creating prompt dependence before gaining that eye contact. ABA pushes me to fade my prompts, to be mindful that I am varying my interactions, and to be diagnostic about what is actually working.

I might use RDI guidance to gasp loudly with excitement to gain a child’s attention, share natural eye contact with the child as we gaze at the butterfly I’ve pointed to and then extend the moment with a “Why” question like “Why is the butterfly sitting there?” to help target a goal from his ABA program. As the moment fades and his interest moves on I’ll use pacing ideas from floortime to follow his lead and keep the interaction going until another opportunity arises, or until I see the need or chance to create one.

I think each program has it’s weaknesses to be sure. But I think families are but under undue stress to CHOOSE, and I think many opportunities for collaboration are lost through the disdain and fighting amongst the various therapies. We’ll need to work together, learn about the valid criticisms from outside our field and chosen programs, and share validated ideas if we are going to make a deep impact on the lives of the children for whom we all care.

I first learned about RDI from a friend who is a long-time ABA-er and seemed to find it worked to combine them.

We never did “look at me” in our original Lovaas program; lots of emphasis on fun and keeping everyone motivated.

From Discussion
Gutstein, S.E. Preliminary Evaluation of the Relationship Development Intervention. Manuscript accepted for publication by the Journal of Autism and Developmental Disorders.
http://www.wesd.org/journals/Files/Research/Preliminary%20Evaluation%20of%20the%20Relationship%20Development%20Network.pdf

“…Several limitations of the present study forestall definitive conclusions. Results
are based on examination of a small sample of relatively “high functioning” children.
Few children in either group had significant cognitive deficits. The variety of measures
used to evaluate cognitive functioning make a valid comparison impossible. Future
studies should make sure that RDI and non-RDI groups are comparable and that standard cognitive measures are employed. Similarly, the assortment of measures of language functioning made it difficult to evaluate its potential influence.

Additionally, older children and Teenagers were not studied. Thus, the effects of age, cognitive and language functioning on treatment effectiveness are as yet untested. The current results were obtained using consultants from a single setting – the clinic where RDI was initially developed. The efficacy of training other clinicians to provide effective RDI consultation has not been determined. Finally, the retrospective nature of the study, precluding random assignment or matching procedures, opens up the possibility of a self-selection bias where important variables led to parents choosing RDI vs. another intervention method.
The findings presented in this paper call for replication with larger sample sizes, more
rigorous evaluation of language and cognitive functioning, other measures of social and emotional functioning and randomization and matching designs. Future research should investigate the impact of parent variables in treatment selection, language and cognitive functioning as well as other important variables on subsequent outcome…”

There is another paper (maybe it’s actually this one) published in Autism last summer, but I haven’t looked at it recently. Sorry, otherwise I’d post the citation.

I don’t have a particular concern, because if it is positive for the child, it is and certainly the results of this study look good. What does concern me is extrapolating to adult outcomes without data, followup study on the participants in this case study or without that larger sample study that the author himself states.

We define our quality of life by our feelings of competence, relationships, and independence. People with autism desire that same quality of life. In order to achieve this we need to remediate the core deficits of autism instead of compensating for them. Give your child the ability not only to survive in a dynamic world but thrive in it!

RDI™ (Relationship Development Intervention) is geared to remediate these deficits. It is a home-based program that works with both parents. The
main goal is to re-establish the relationship between parents and child. This relationship is knows as guided participation. In this interaction the parent acts as a guide and the child is the apprentice. It’s not about compliance, but about having a guide who will set limits, allow collaboration, and break down a task into small steps so that the child can feel competent. It is
when the child feels competent that small challenges can be introduced in a safe environment and relationship.

Behavioral approaches have been successful at teaching skills and rules and increasing good behaviors, but have not been successful at increasing a child’s quality of life. Quality of life meaning they will have friends, get married, have jobs and live independently. RDI has not only shown to improve quality of life, but has been successful at changing childrens ADOS catagories. Behavioral treatments are great for learning skills, but don’t provide meaning in a dynamic world.

For example, some behavioral approaches might teach a child to “look at you” using discrete trials in order to teach the child eye contact. The RDI™ approach would be to show the child the importance of eye contact. A foundational skill would be that my gaze has meaning. In order to teach the child this we would break the objective down into smaller pieces. One could take three cups and hide a toy or chip under one of them. The guide would them look directly at a cup (first with her face right next to the cup) then later with just glancing with her eyes. Another way of showing the importance of eye contact would be to cut out all verbal communication. In place of this you would communicate using gestures, facial expressions, head nods, and exaggerated movements. You are then requiring your child to look and decode your language by observing instead of verbal direction. By doing this you are giving your child the tools to become an active learner and participant in life.

Recently, Dr Marianne Barton PhD. spoke at the Connecticut Autism Society about changes that will be made to DSM V based on a study looking at long term diagnostic markers of Autism. Two of the current categories required for an ASD diagnosis, delayed speech and the presence of repetitive and stereotypical behaviors, would no longer be required. The only criterion that will be used is social “experience sharing” deficits, which detect ASD earlier and more accurately.

These DSM changes corroborate with the core deficit theory of RDI founders, Dr. Steven Gutstein and Dr Rachelle Sheely.

Right now I have to get thru a busy week as a Stepford Wife haha and then I will revisit your kind offer!

(I also had a quick look at VAB’s blog which really resonated with me so it was comforting)

But all this is way off track from Kristina’s post I just wanted to respond with thanks.

In terms of the question, whatever method is used, the therapists must always assume that the individual is competent.

I’m a sped teacher, and if you feel comfortable contacting me privately, I’d be willing to make some private suggestions. I have to rush to work this morning or I would say more.

For myself (again, remember, I am not working with students in a self-contained classroom but in the mainstream), I appreciate candid, polite and calm conversations about your concerns. Depending upon your state’s particular IEP form, there are appropriate places for your concerns to be recorded in the IEP.

It is entirely appropriate for you to be your child’s advocate, and as both a parent and professional, I’ve walked that thin line between being effective and not being effective, and have observed the differences between the two.

For more general information, I’m part of a community on Daily Kos that is posting weekly diaries on special ed, and I’ll be doing two general diaries at the end of September on both eligibility issues and IEP writing issues. The series is called “A Little Bit Special” and my username is the same as here. Some of that discussion may be helpful to anyone reading here.

-teachers need to develop a relationship with child showing empathy and respect for child

- teachers need to be flexible and speak positively to child always in a natural age appropriate manner

- foster a caring, relaxed and loving atmosphere for learning to happen

Everyone tells me certain things should be written into my child’s IEP but I do not know how to ask for the above without offending the teachers who think they know best.