Tuesday, November 29, 2011

RDI strategies ( with tools of the mind)

I am excited to write this blog ( starting a series to help with strategies for the home and schoolroom) for so many reasons! By the end of this series I may have covered them all, but we will start off with the foundations for why I think this topic is incredibly important for the ASD community.
Tools of the mind is a book that takes a developmental approach for children…typical children, It is written for teachers, to give them tools in the classroom to help their students construct knowledge from their experience and memories. To help equip children with Mental tools as quoted in the Preface “ Mental tools are ideas we learn from others, modify and then pass on.” This is the link from Amazon about the book, http://www.amazon.com/Tools-Mind-Vygotskian-Childhood-Education/dp/0130278041/ref=sr_1_1?ie=UTF8&qid=1321685132&sr=8-1
and this is a link on a write up about the approach. http://www.nytimes.com/2009/09/27/magazine/27tools-t.html?pagewanted=4
This book does not reference children with ASD. So why, as a mom who has heard “your child has autism” twice… am I writing about the Vygotskian approach covered in this book? The reason is…I want to take you on my journey, with my own two children, on why I find it crucial to look at typical development for the answers in how to help children with Autism. I mean we all know this…our kids are not developing typically, and the gap widens with each year. We are told Autism is a developmental delay. We even know ASD children and adults struggle with executive function , social referencing, , relationships ,Experience seeking, perspective taking, etc . Only recently ( alittle over a decade) have we started to piece together, looking at typical development to help children with ASD. Before this, the philosophies of behaviorism were used for our children, even though behaviors were just the by product of what was lacking developmentally. Even with our children’s health, looking at typical development helps us to understand what health conditions may co exist with a child’s neurological delay. This is why supplements like Fish oils, Enzymes, and probiotics can be very helpful to children on the spectrum. They help to restore typically developing body chemistry in the health system of our children( Co occurring condition), so that the developmental gaps can be effectively addressed ( ASD).
Let’s back up 8 years ago…my older son was 7 ( Diagnosed at 3) and my younger son was 2 ( just diagnosed a few months before). As a parent, I felt like I was living this totally different life then my friends with their NT kids. At this point I had an older son who was not affected and then 2 sons diagnosed. I had to approach parenting very differently, contrary to how I always thought about my own parenting style in my head. I felt this huge disconnect…like I was running on this huge hamster wheel, reacting to everything but not going anywhere. I t would take the birth of my daughter..for me to be reacquainted with what a typical baby can actually do…and how much we really take for granted in terms of mental cognition. Of course any parent with a child with ASD no longer takes any mental state for granted!
As I watched my little girl, and then watched my two sons, it was like I was dealing with two different *species* of children. I kept saying to myself, why the disconnect..I mean, after all, they are all children. How do I give my boys, what my daughter has *naturally*? I realize this is the million dollar question! And I definitely realize that each child is unique. As I really delved into this question, attended seminars, conferences, etc, it became apparent to me some of the questions I chased after… And yes, vygotsky’s theory of development does have a role in my journey, along with other theorists.
So it makes sense now, my oldest son who was diagnosed on the spectrum is now almost 15 and my youngest son is 10…why I want to blog about Tools of the mind. They are both school age, with my one son a freshman in high schoo( Both no longer struggle with the core deficits of Autism). Schools today are struggling with helping children be good creative thinkers and problem solvers…but schools today for ASD? Yikes. I weep when I read stories about abuse in the school, on the bus, etc. it is far to commonplace. There is a lot I could comment on about this topic, and perhaps that will be for another day, but for now, I have to just state that I believe teachers want to teach, but our education system is so rigid on accumulating information that we have lost the art of helping children to think…I mean think, reflect, and make decisions. This will definitely be covered in more detail in some of the upcoming chapters. So if we, as a society, struggle to educate *typical* children, then how are we doing when it comes to children with ASD? THAT…is one of the goals of this series!
That first quote at the beginning of my post, “Mental tools are ideas we learn from others, modify and then pass on.” That is exactly what my own journey has been like. My mental tools in the world of Autism, and how I have come to modify what I have learned, and pass on.
Tools of the mind is not a book on Autism…but is a book on ALL children. I will also get into this more as we dive into the book, but the intervention I chose for my two sons ultimately was based on the very same premise…the information on how to HELP children with Autism is found in the world of Typical development. Taking the same plan, and *redoing* it because our kids missed out on those milestones the first time because of Autism. RDI ( Relationship development intervention) is based on many of the same principles of the work of different cognitive developmentalists, including Vygotsky. RDI applies this knowledge concerning typical development, to ASD…bridging that great divide and making, well at least for this mom, like all her children were following the same plan!
Next up…Chapter one of “tools of the mind”… I hope you will join me with this book, going over strategies for supporting our ASD children in their classrooms…working off of principles from the model of typical development!

Tuesday, November 15, 2011

Countdown to the Holidays.......with RDI

This time of the year gets even busier for us so here are a few ideas to put some RDI into your day to maximize opportunities.Try some of these fun activities with your child...Remember to keep it simple, with lots of pauses and non verbals to help foster experience sharing and lots of waiting and declarative communication to see if your child can *THINK* of his/her next step!!!! Some modifications may be needed depending on your child. Have fun and always keep in mind ...it is the experience we are spotlighting, not the activity! Check back in January for 60 days through Winter...with RDI

Paint together , each of you with a brush and poster boardCut two pieces of fruit up and taste test the differencesTake a walk to spotlight breathing in the cool air
Play Freeze DanceCoordinate drinking a favorite drink together (cocoa anyone???)Blow up a balloon and see how long you can keep it in the air
Start a placemat
http://kids.nationalgeographic.com/kids/activities/crafts/thanksgiving-dinner-placemats/
Finish the placemat!
taking your time for the experience and not just *getting* it done
Decorate a pie
http://kids.nationalgeographic.com/kids/activities/
Enjoy Thanksgiving dinner..take a moment to practice raising your fork together to eat at the same timeSing together...take this opportunity to sing your favorite holidays songs or any song that you both enjoyLook through a few pictures from last year at thanksgiving, and talk about memories made(Even if you are doing the reminiscing, your child is listening)
Make the bed, then coordinate falling on the bedPut three surprise items in a bag and anticipate what is in the bag togetherPlay Catch
Any Christmas or Holiday cards yet?? Check the mail!
Keep checking!!
Make a homemade Christmas Card together
http://familyfun.go.com/christmas/christmas-cards/
Take a walk together and spotlight any lights that are on houses, etc
Take a drive to look at lights in the neighborhoodMake a plan together for which 2 holiday shows to watch in the upcoming week.Who do we need to buy for?? Involve your child in thinking who to buy for this season
Go to a different store that you have never been tooShare a moment with putting together or picking out a Christmas treeWater the tree together/ or fix branches together ( for an artificial tree)
Make a gingerbread house- SImple is grahams and frosting or a kit, or from scratch! Use lots of candy! :)Involve your child in some activities for decorating the tree ( simultaneously put two decorations on at the same time)Put aside 10 ornaments, one for each day and then decide each day which ornament to put on the tree together ( lots of non verbal or *thinking*
Cookies!!! Need I say more! Making a batch may be overwhelming, so have your child pour in the vanilla or some other small role.Need to taste the cookies!! Comment on the flavors you taste and your favoritesTake a walk together and spotlight any lights that are on houses that weren’t there the last time?
Bring out some wrapping paper and scaffold your child’s ability...practice folding and taping all the way up to wrapping an actual present togetherMore Cookies! Stirring together! Coordinate the cookie dough
Lots of pausing and waiting
Bring out two bins, so each of you can coordinate putting the cookies away together
Review with your child a few minutes of video from cookies or tree decoratingHoliday craft … match an idea to your childs level
http://familyfun.go.com/christmas/christmas-ornaments/homemade-paper-stars-954207/
Unwrap a box together for a surprise Model as necessary
Take a walk together ...wow look, more lights then even before!Sing a favorite song together, pausing to help your child step inSet the table together, giving your child a simple role they feel competent in
Merry Christmas/Happy Holidays. Spotlight for your child in some of the traditions of your family as you celebrate your holidayMake clean up fun...pretend the wrapping paper is a swamp to escape from or have a *snowball* fight with paperAlll that trash!! Coordinate taking the trash out together!
Take a walk to just relax and *be* together recovering from the hustle and bustleSleep in!! Stay in your Pj’s alittle longer today and play a board gameHappy New Year!! Coordinate making noise with pots and pans ( can be done during the day too:))

Tuesday, September 27, 2011

Parenthood episode- I looked them in the eyes

Last week’s parenthood was so telling when it comes to the raw emotions of watching our children struggle with understanding other people’s perspective.  My eyes instantly started to burn as I fought back the tears as I watched *mom* watch Max sitting on the playground reading a book as the other children interacted.  If you missed the episode, you can find it here http://www.nbc.com/parenthood/

I also enjoyed watching the writers roundtable  here www.nbc.com/.../1354851 and here is where Jason Katims talks about the asperger’s storyline taken from * real life*

Of course as I watched parenthood, and watched the classroom scene ( raise your hand if you felt like reaching through the TV into that classroom??), along with the lunchroom and playground, I could not help but know that a parent of a child with Autism had to be involved in the writing.  We, as a community, can relate to the emotions that we all go through, no matter what side of the spectrum our children fall.

Nothing rang more true to me that our children just want to understand.  They want to get what other people around them seem to get without having to work at it!  For children with Aspergers, and HFA, the *only* thing that *seems* to stand in the way of this ability to understand friendships and relationships, is that they are hung up on rules, black and white thinking, and instrumental language to try and connect with others.  I say only and seems because *understanding friendships* is really not a skill we learn,  at least at its core.  It starts as early as 2 months old when a typical child will learn how to tune into another person.  This progression thoughout the first year of life is CRUCIAL to development of the social *ability* to understand friendships.  This video is just one example of how early these milestones are in place.

Without fundalmental developmental milestones in place, its no wonder that Max is baffled on why his introduction and * looking* did not get him the result he expected.

Imagine if a child could not understand that the other person has a perspective…and that a relationship is the merging of what is happening between two people ( I have thoughts, you have thoughts)!  Think about how this affects each area of interaction with your own child.  Do they ever ask what you are thinking?  Do you feel as though you are doing all the *work* in the conversation?( A sure sign of this is questions questions and more questions)

Last week I had the pleasure of giving a 2.5 hour lecture at Camden County College. IN that talk, I covered the way we all process information regarding relationships and perspective.  I went through typical development and with each stage, showed what *that* looks like and then showed videos with strategies to help fill in those missed milestones for our kids on the spectrum.  I used video clips from families I work with and also showed my own children…before and after,  helping them to *get back* on their developmental track.

I continue to love that shows like Parenthood open the dialogue for how to help our kids and families after those initial words are heard “ your child has Autism”

Friday, July 22, 2011

RDI Cheat sheet to start.....



Relationship Development Intervention ®

 "Cheat" Sheet by

Kathy Darrow-  RDI Certified Consultant



There are two different ways our brains process information, Statically and Dynamically.

Static thinking is what you know. For example, formulas, procedures (like following a recipe), memorized information (like multiplication tables), habits and routine.  We know that one rule is we need to stop when the traffic light is red.

Dynamic thinking is what you can do with what you know in a continually changing world. In other words, how you solve real world problems.  Dynamic thinking involves major processes like flexible thinking, experience sharing communication, appraisal and self-awareness.  When we use dynamic thinking our brains are operating more mindfully.  We deliberate, reflect, worry, hypothesize, and daydream.  AN example is what happens if the traffic light is not functioning.  We can deliberate the fact that the light must be broken and plan our next action accordingly.

Our children on the spectrum are weak in dynamic intelligence!  Keep in mind the following strategies when beginning to remediate your child's obstacles to Dynamic Intelligence.



                  REACH our children



Reaching your child- One minute of mindful competency propels thinking in comparison to one hour of prompted action which promotes dependence.  One minute of competency builds a mind to make discoveries in relationships.  One hour of prompting( commands, questions) builds skills without meaningful long term motivation. Remember the better use of your time and your child's time!

To help your child discover their competency and to build dynamic thinking fostered in resilience, slow your interactions down to allow your child to process what is taking place- in other words-     

Experience the Experience.  When you are guiding your child to understand how to connect with you, it Is crucial that you remember the goal is not anything to do with *WHAT* you are doing. This means thinking that you have to finish the activity.  Having a mindset that you have to finish leads to being task focused. Parents, when focused on doing something, can easily turn into concentrating on the mechanics of the end result.  Children on the spectrum naturally look at any activity as a task to complete since they excel in static intelligence.  In order to help guide our kids to enjoy the *us* instead of the activity (me), you have to purpose in your framing to NOT be about any end result of an interaction.  THis is a lot harder than it sounds and takes a lot of practice.   Pay close attention to your interaction, at the start and your goal, and then reflect on the ending.  Did you child take all the control, was the activity all about him and you were a bystander In his world? Did he decide it was over and you are left standing there thinking, so I guess we are done?  Did you find yourself struggling with what you can do to connect with your child?  Instead you should feel that there was a connection, a moment where there was nothing In the way, just pure connection.  This moments are quick at first, but start to build as your child's trust and competency builds.

Cheat recap- remember to focus on the process ( A connected relationship), not the end product (what did we get done)

Journal to me your reflections on experiencing your latests Interactions with your child!

Anticipate you’re actions/reactions to guide your child

At first your child may want to be in control, or the opposite and be passive,  or maybe engage in self stimulatory behavior which is an Indication of both and a defense mechanism to escape the overwhelming feeling of incompetence.   IF you make your child do anything you are simply thinking for your child and removing all self discovery. For mindfulness, guide your child in the understanding that you will be with them, waiting for them to accept their responsibility in the back and forth interaction.  Reactions from the child will have already been anticipated and framed so the child focusing on the relationship is *US*.   We will continue to review this on your framing sheets.

Cheat recap- Frame out your interactions for success and promote discovery for your child's competence.  SLow down your response time to allow your child the opportunity to process ( wait ( counting helps) 45 seconds whenever possible for a response)

Journal to me your successes and/or struggles In monitoring your reactions and actions in the journaling section of the RDI online system

Collaborate interactions in your day.  Our children tend to want to be entertained.  Entertaining is very different then each person in the activity having an active role and being co- collaborators. While there is nothing wrong with SOME entertainment in our life, we want our children to not view us as an instrument for their entertainment.  PLus that gets exhausting after a while. :)  We want to teach them joint attention, how to appraise important changes In the environment, and to determine how it makes sense of what is going on around them.  We can do this in the simplest of activities.  One of the secrets to turn an activity from entertaining to engaging the mind Is to create moments of productive uncertainty. This simply means we are allowing room for discovery by creating opportunity for our child to be competent in a role and slowing our pace down so that our child has a chance to process, then respond.  To do this they need to be out of entertainment mode and into being a co creator of the interaction. ( We always learn more effectively when we are involved and not just a passive bystander being entertained)  When we create this opportunity, we help our child learn by discovery and integrate this process to assist in their resilience!  Here is an example.  It is very common in Autism to entertain the child when they attend to us as a reward.  Instead of doing this, we can turn that action into an opportunity for true mindful engagement by celebrating with the child his role in competence.  Creating a moment of pleasant competence that is shared by a mutual gaze with no overwhelming *background* noise encodes as mindful success in our children.  They want to continue this success because they have felt the competence in their own action, not because they are being entertained by another person.  This is crucial for LONG term motivation and success.  This is giving a child the Why bother thinking in their relationships.

Cheat recap-  Escape the trap of entertainer and move to mindful guide!  Just as much fun with the added bonus of not feeling like you are doing all the work!!

Journal the changes you see when you go from Entertainer to mindful guide!

Helping your child to communicate without words

Babies are excellent communicators before they even talk. Some of our children talk without understanding true communication.  This is also a result of a strong static intelligence and a weaker dynamic intelligence. Children who are highly verbal need to learn how not to depend on language and start to comprehend the other channels of communication.  This can be challenging. To remediate this issue, start using more Non verbal communication  to promote your child in understanding that your face and expressions hold the clues to communication, not just words.  In our own life, we are able to process many different channels of communication at the same time.  We are able to access our dynamic intelligence to do this.  An example of this Is sarcasm, saying one thing but our body language says another.

For children who are Non verbal, they still *hear* you.  Talk less at them, yes talk less and use more non verbal communication to fill in their developmental gaps. They will begin to use language when this sequence is remediated…and their language will be functional.  Another strategy used for Non verbal children along with verbal children, is Implementing self talk in the day.  This means you as the guide, will comment on your thought process at different periods of the day.  This is not talking at your child. This helps your child hear that you are thinking and helps them to understand that you have a perspective.  Consider this example. You are eating an apple.  Without expecting a reply, you self talk that it is delicious, juicy, etc.  Your child gets to *hear* your thinking without the pressure of a response ( our children struggle with processing time) A second example is self talk through a difficult situation expressing things like, wow this is hard, I wont give up though, I can do it!  Here is my final example regarding behavior- A child is jumping on the couch.  You think to yourself, I really don’t like that and what comes out of your mouth is , get off the couch or something to that effect.  Instead of speaking your final thought, self talk your initial thought of , "I really don’t like that".  Give your child time to process your perspective so they can make their own discovery.  There is more thinking on your child's part then when you just tell them to get off the couch, along with helping them be in tune that you have a perspective.

Cheat Recap- Use small amounts of slow, simple and deliberate speech along with Increasing Non Verbal communication.  When you do talk, use experience sharing communication whenever possible.  Examples are "I have my shoes on", or "Wow" or "I love this color" or "ooohhhh".  Instrumental communication consists of questions or commands ( get your shoes)  There is limited thinking needed with instrumental communication ( means to an end)

Journal to me your own discoveries with communication and what you are seeing with your child on the RDI online system either in journaling or when you submit your video!



For my RDI families- Family Reflections-

As you journal to me and submit video, we will pinpoint specific developmental missteps within the objective. Addressing unique missed sequences with the process of remediation is a reflective work for both you and your child. Keep this sheet handy as a help with  your objectives.

To my Blog readers-  Thank you for visiting my blog.  I hope you find this beginning cheat sheet Informative. If you do not have an RDI consultant please feel free to start to implement these starter strategies at home. Once I experienced the difference from these strategies for my own children I knew I needed to take remediation to the next level! 

If you would like to take your child's remediation to the next step  (Dynamic Intelligence intervention/curriculum)  please visit www.autismremediationforourchildren.com  for more information or email me at RDI4Autism@gmail.com

Sunday, June 5, 2011

Eye Contact- Fostering your Child with Autism to WANT to look at you

“Look at me”….I don’t know about you, but each time I hear that I am transported back to my childhood, when I’m in trouble with my Mom.  I would come home and first thing I knew to do is NOT look at my mom….because well, gaze holds all sorts of emotion!!  Maybe if I did not look at her, she would think I did not see her and I could escape upstairs…yeah, you know how that ends!!

To my surprise fast forward to when I became a mom and then for my second and third child,  a mom to two children with Autism…I found myself hearing some people tell me to instruct my child to look at me for any sort of eye contact.  I of course did just that for awhile…because like any mom, I wanted desperately to have my beautiful boys look in my eyes.  I felt as though there were two things standing in the way of me and my boys.  One was that they did not look at me and the other is they did not talk.( I will write on that next weekJ) If they would just look at me….and talk to me….ahhh,  my heart would be in such a better place!!!  Ok and it was for a short time because I was thrilled with any eye contact I was getting  even if I did have to prompt it.   Whenever my boys did look at me or when they used words for that instrumental request for juice or crackers… I melted!!  But……. to me it still felt *different* then my typical kids.  I wasn’t sure if that was all it was going to be or if I should dig deeper.   Would it just improve as they got older? It was one of those things that kept me up at night,  and I know you know what I mean!!

For me,  it was nagging so I went searching ….seaching for answers that I was not sure there was an actual question too.  Most of the websites I went on talked about holding a piece of candy up and when a child looked then they were rewarded by that candy.  I read sites that talked about rewarding a child with social reinforcers,, playing with a favorite toy, etc.  One site said have the child put makeup on you…so they are close to you and the chances of them making eye contact are greater.   I have to say I went through many sites that talked about trying to set up a reward for my child whenever they looked at me.  So I thought, hmmm I don’t have to do that with my typical children.  I mean I get that my other two were dealing with Autism but still,  I felt like there was a gap….and I was right!  What I learned to *search* for was not Autism and Eye contact but instead just Eye contact.  Then it all made sense….even why I avoided eye contact with mom!!  I needed to understand WHY we look!  It is second nature for those of us who are not on the spectrum so I needed to take something that I never had to learn, but just *did* and understand *how* to teach this intuitive process to my own two children with Autism.

Eye contact is about communicating emotional information.  We can do a lot with eye contact…check out this video

How many different conversations can you see going on with eye contact/Gaze?  Our eyes are merely the showman for our thoughts.  When someone tells me to look at them, it is instantly nothing to do with a positive emotion or actual thinking…Im irritated.

So if eye contact is something we do to communicate emotional information, I wanted to make sure that my boys WANTED to communicate with me when they looked at me.

A Look can be intimidating, submissive, playful, and many other things.  For a child,  a LOOK is to share information or perspective from a trusted person in their life.  This is the foundation step that a child uses to understand why the other persons Eyes hold information for them to process!  This is an example of the importance of this developmental milestone    http://www.youtube.com/watch?v=eyxMq11xWzM

This foundational milestone is crucial to the further perspective taking ability in all children….including our children with Autism.  Teaching Eye contact as a behavior misses the incredibly important thinking aspect on why people look at each other to begin with!  And ….. our kids can develop this Dynamic thinking for perspective.  It starts with them learning that our face holds the key to the experience sharing in any interaction.  BUT,  and this is huge,  THEY need to make this discovery with our guidance.  And this discovery has nothing to do with telling them the discovery we want them to make, which is what the words “look at me” do.  Any command to a child, any child, turns off their need to think!  It is the difference between * get your shoes on* and the child obeys or *we are leaving* and the child has to go through a thought process of what is needed before they can leave.  These milestones in thinking create and develop good problem solvers!!

Here are 3 strategies to help your child * want to look at you* From the RDI Program- Relationship Development Intervention

1.     Limit talking-  Use less words and pause between thoughts ….not in a strange way but just more deliberate ( limit the chatter and amount of words used)  If we are chit chatting away all the directions and instructions there is no reason for our kids to actually look at us for any sort of information,  we are providing them all their thinking through our instruction.  Once it registers that we stopped talking, they will look to find out why and this continued practice is instrumental in  learning to reference others for information

2.    Use more non verbal communication- Be more expressive with communication.  Oh OH….or a surprised look on your face will cause your child to reference you.  Something like clearing your throat helps your child to process that he needs to see what is going on.  Again,  this is all practice for your child to see that *WE* hold information, not just in our words, but in body language and facial expression.  If I were to say to you…”Nice shirt” with  a smirk, we would be able to access that I really did not mean the words I spoke!  To get to this foundation,  we must start at the beginning.

3.    Use more self talk -  We all have a thinking process going on before we speak the words. When appropriate, speak your thought process out loud so your child can understand that you have thoughts just like he does.  Something like, Wow, delicious when you take a bite of food.  DO NOT ask them if they like theirs…self talk is placing no demands on your child but simply giving them another vehicle to understand and become interested in your perspective. Demands can be very stressful for your child….what we want is for them to see your emotion, see your thoughts and as long as there are no demands placed on them to turn on the fight or flight mode,  begin to internalize that others can think differently then they do.  This foundational skill emerges at 18 months old in a typical child.



For more information on getting the tools to remediate your child’s Autism,  visit Kathy at -  www.autismremediation.com

Saturday, June 4, 2011

Dynamic compared to Static Intelligence

Our guest author this week, Sue Simmons, delineates the difference between dynamic and static intelligence in an everyday meaningful kind of way. Learn how you can apply some simple RDI principles to help foster more dynamic thinking in your family.   www.rdiconnect.com

It takes only a glimpse of today's world to realize that we are living in unprecedented times. We flip from answering our cell phones, to sending email to friends, to writing to-do lists at lightning speed. Our minds can barely keep up with the demands of our fast-paced world - this requires us to be able to think in a truly "dynamic" fashion.

Consider how incredible our brains are - imagine sitting on a beach, gazing at breathtaking scenery (ahhh). As you gaze at the sparkling water and sink back into your chair, you notice the soft breeze against your arms. Where does your mind go? If you're like most of us, your thoughts wander. As you look around at the people in your midst, you wonder where they live or wonder about the conversations they're having. You study their body language and facial expressions. You may begin to ponder dinner options for that evening. Perhaps someone you see reminds you of a friend and you realize that you owe her a call. Suddenly, your mind goes to your work and you realize that on Monday you have a meeting and begin mentally preparing for it - you realize that you've left your planning to the last minute and do some fast thinking about what you can juggle to free up some extra time. You root through your bag for a notebook to jot down some notes but as you search for your notebook, you see the sunscreen and remember it's time to slather more on the kids. You remember the last time you forgot the sunscreen and how awful you felt. Incredibly, all of these mental processes occur in a remarkably short period of time!

Dynamic intelligence represents the ability to mentally "stick handle" when obstacles show up - to think in shades of grey; to use our past experiences (the sunburn for example) to avoid future mishaps. Being on a beach may allow our minds to wander but this isn't always possible! Consider driving your car. Sure, you can mull things over if you're on a straight stretch of road without other cars around, but in a busy intersection it's much different! As you make a left hand turn at a busy intersection, you're able to shelve all other thoughts that may compete for your attention as your priority is avoiding a collision, pedestrians and cyclists! I think you get the picture. However, dynamic intelligence isn't just thought - but being able to use these thought processes to interact thoughtfully, collaborate and meet our own needs at the end of the day. No small feat.

So what is static intelligence? By definition, static means unchanging. Two times two will always equal four; the capital of Canada will always be Ottawa and apples and oranges will always remain in the fruit category - but don't ask me how tomatoes made it in there. Think back to your driving experience... we know that green means "go" and red means "stop." We tie our shoelaces the same way and use the phone book to look up numbers the same way. Typically, children with autism and other developmental disabilities can excel in the realm of static intelligence, yet they lack dynamic intelligence, which creates the lion's share of their frustration.

The Beginnings of "Dynamic Intelligence"

Picture a parent with a young infant. At this age, the child listens intently when mom or dad speaks - what are they saying to the child? How are they speaking? Likely, they're not reading War and Peace or telling jokes. No, they're up close, using big facial expressions, cooing and using simple sentences. They speak softly and use "sing-song-like" intonation. The child responds by cooing back, giving mom and dad the feedback that they need to stay in sync with the child. When I began to realize how magical the "dance" between parents and their children is, it hit me like a ton of bricks: We are nothing short of hard-wired to communicate to our young in exactly the fashion that they need in order to learn how to understand our nonverbal communication - long before they learn to communicate using words! When the words develop, they enhance the "emotional feedback loop" that's already there!

It's through the miraculous, ever-changing relationship between parent and child that dynamic intelligence begins - through understanding nonverbal communication then through developing resilience and eventually through learning to borrow the parent's perspective. So - our children learn the foundation of "dynamic intelligence" through parents and caregivers. Eventually, once they are able to relate to others, we teach them static skills, like brushing their teeth and using a knife and fork. It's assumed that by the time a child is school-age, they are able to function in a dynamic environment - and we all know how dynamic a kindergarten classroom is!

Can Dynamic Intelligence be "Taught?"

Unfortunately, common belief these days is that children with ASD and other developmental disabilities can only be taught "static" skills. This is NOT the case! Their brains may be wired differently, but they are more than capable of learning "thinking skills" if guided in the right manner.

RDI® Consultants are trained to coach parents to "guide" their child's cognitive, emotional and social development - to teach parents, grandparents, teachers and other significant adults to re-construct the "guided participation relationship" through which dynamic intelligence is learned. Parents break down learning to think and perceive a world full of change and complexity into small, simple components. Adults learn to slow down and amplify information feedback, so that both adults and children are more readily able to understand and adjust to one another.

Parents learn to use the activities of daily life to introduce safe, but challenging experiences for the child. Children learn to respond in more flexible, thoughtful ways to novel, increasingly unpredictable settings and problems. Trust emerges as children learn to recognize regularity and patterns, even in a continually more complex world. Eventually authentic competence emerges as they take ever-greater responsibility for tackling tasks and problems with many partners in varying settings.

Through their parents, the "cognitive apprentice" learns authentic, give and take communication, and develops the ability and desire to connect with others on many different levels.

What can you do to help your child think in a more dynamic fashion? You can start right now by slowing your rate of speech, and being aware of when you "pepper" your child with questions! Children with developmental disabilities often need extra time to process information; their mental "stick handling" isn't as well honed as others. Take a few moments each day to think about how you speak to your child, and imagine how you would feel listening to your own communication... a little extra breathing space is often good for everyone - parents included!

Thank you Sue for this excellent blog! 
Kathy Darrow
visit me on facebook at Mastering Milestones in Autism

Wednesday, June 1, 2011

The RDI program and its effectiveness for our children

A brief introduction to Relationship Development Intervention®


Relationship Development Intervention (RDI®) is based upon research in developmental psychology and the developmental psychopathology of autism spectrum disorders. The specific focus of RDI is to create a ‘guided participation’ relationship with caregivers, through which children develop competence in handling gradually more complex environments. The programme involves supporting families and caregivers/school staff in their roles as participant guides, creating daily opportunities for adaptive and thoughtful responding in the face of novel and increasingly unpredictable settings and unexpected change. Through participation in caregiver-guided continually more complex cycles of regulation, challenge and new regulation, the aim is for individuals on the autism spectrum to learn not only to tolerate, but also to enjoy changes and transitions.

The RDI Program focuses on developing:
·                    an appropriate mix of verbal and non-verbal communication
·                    abilities to engage with others
·                    declarative, self-regulatory and self-narrative language
·                    episodic memory
·                    reciprocal, genuinely fulfilling relationships;
·                    pleasure in living in dynamic environments where change is enriching

Relationship Development Intervention® involves rigorous and extensive training procedures and monitoring of competence, ensuring quality of care as well as treatment adherence. RDI is implemented through intensive parent education, customised and balanced planning, modelling and role-playing, and involving parents in a support network, regular videotape review of parent-child performance, and school staff training and consultation.

There are four sources of evidence that together provide grounds for believing that RDI is effective in ameliorating autism-specific behavior, especially in relation to the children’s limitations in social engagement and flexibility in thinking and action:

1.                 Gutstein, Burgess, & Montfort (2007) report on the 3-year follow-up of 16 children who met 'gold standard' criteria (ADOS/ADIR) for autism, Asperger’s syndrome or autism spectrum disorder prior to treatment with RDI.  Marked clinical improvements after RDI were reported; for example, whereas prior to treatment 10 had ADOS scores corresponding with the diagnosis of autism, none did so at follow-up, at which point five were classified as ‘autism spectrum’ and five as ‘non-autism’. There were especially marked improvements in the children’s capacity to share experiences with others.  Semi-structured interviews with parents revealed that the children’s flexibility had significantly improved. Moreover, there had been positive changes in the children’s educational placements.  In this study there was not a treatment-as-usual control group (a previous pilot study had included such a control group who did not show the gains of the RDI-treated group). Having said this, the magnitude and breadth of this response to RDI renders it very unlikely that the effects were non-specific.

2.       Aldred, Green, & Adams (2004) report a randomized control trial of an intervention for autism that has close affinity with RDI in its attempt to foster developmentally effective parental input through a focus upon the children’s social deficits. The approach ‘educated parents and trained them in adapted communication tailored to their child’s individual competencies’.

The study reported significantly greater improvements in the treated vs. untreated group of children with autism, on a range of outcome measures:  total scores on the Autism Diagnostic Observation Schedule, expressive language, parent-child interaction, and the children’s initiation of communication.  The authors concluded:

'this study suggests that a specific intervention that addresses bi-directional adult/child communication breakdown, joint attention, and is tailored to the specific needs of the cases can improve autistic symptoms across severity and age groups in terms of quality reciprocal communication and expressive language'.

Like RDI, this treatment approach provided specialized structured interventions that scaffold social interaction.  The uniqueness of RDI lies in its sharper focus on links between social relatedness and the capacity to engage in flexible thinking and coping through the guided-participation relationship.

3.                 RDI is founded upon developmental principles that have been subject to programmatic research studies at the Developmental Psychopathology Research Unit at the Tavistock Clinic and ICH/UCL (e.g., Hobson, 2002).

In particular, RDI  focuses on aspects of autism that are pivotal for the development and maintenance of almost all the distressing features of the syndrome, and in particular, the children’s limited interpersonal engagement with other people and their accompanying propensity to becoming ‘stuck’ in particular, one-track modes of thinking.

The focus of RDI is what happens between the affected child and his or her caregivers, with special attention to emotional contact and behavioural regulation.  Thus RDI studies how a given child with autism has difficulties in engaging with another person emotionally; then it provides coaching for the carer to foster the child’s potential for such engagement, reducing the likelihood that moments of engagement (which are often fleeting) are lost.  Perhaps most important, RDI allows the child to enjoy and build upon the engagement that is achieved.  Such interpersonal engagement is hugely important not only for the child’s wellbeing and the parent’s ability to relate sensitively, but also for improving the child’s self-regulation, communication, and more flexible and appropriate thinking.

The intervention is concerned with fostering parenting, rather than attempting to modify children’s functioning over a protracted series of brief sessions.  It is widely accepted that when appropriately designed, parent interventions have special promise for fostering development among children with autism.

In a series of recent (and ongoing) studies, J. A. Hobson and colleagues (Hobson et al., 2008; Hobson & Hobson, 2008; Hobson, 2009; Hobson et al., 2009; Hobson & Gutstein, 2010), have followed children/adolescents with autism and their families (participating in RDI programs) over time. On the basis of prospective study and retrospective chart review, preliminary results of the above studies (note: research is ongoing) suggest that this approach may yield significant changes in global clinical/psycho-social functioning as well as in improving qualities of parent-child interaction and social communication.

Finally, there arises the question of cost-effectiveness.  This has not been subject to formal study.  However, one of the great advantages of RDI is that it can be time-limited, yet its effects on parental functioning and through this, on affected children’s social relations and cognitive functioning, are sustained over much longer periods.  Personally, we are strongly of the view that the substantial lifetime benefits of RDI more than justify its cost – but as yet, there is not quantitative evidence on the matter.



Dr Jessica Hobson, PhD
Senior Research Fellow
Institute of Child Health, UCL and
Tavistock Clinic, London

References

Aldred, C., Green, J., & Adams, C. (2004).  A new social communication intervention for children with autism: pilot randomized controlled treatment study suggesting effectiveness.  Journal of Child Psychology and Psychiatry, 45, 1420-1430.

Gutstein, S.E., Burgess, A.F., & Montfort, K. (2007).  Evaluation of the Relationship Development Intervention Program.  Autism, 11, 397-411.

Hobson, J. A., Hobson, R. P., Gutstein, S., Ballarani, A., & Bargiota, K.  (2008). Caregiver-child relatedness in autism: What changes with intervention? Presentation at 2nd International Conference: Communication – the Key to Success. Pontville School and Edge Hill University, May.

Hobson, J. A., Hobson, R. P., Gutstein, S., Ballarani, A., & Bargiota, K.  (2008). Caregiver-child relatedness in autism: What changes with intervention? Poster presented at the International Meeting for Autism Research, London, UK, May.

Hobson, R.P., & Hobson, J.A. (2008).  Interpersonal engagement: A focus for understanding and intervention in autism.  In symposium on The understanding and treatment of autism: A revolution in the making? Organized by R.P. Hobson, Annual Meeting of the Royal College of Psychiatrists, July.

Hobson, J. A. (2009). The guided participation relationship as a focus for change in children with autism and their parents. Presentation at the biennial meeting of the Society for Research in Child Development, Denver, CO USA, April.

Hobson, R.P., Hobson, J.A., Gutstein, S., (2009).  Parent-child interaction and global assessment of functioning:  measuring change and outcome in adolescents with autism. Presentation at International Meeting for Autism Research (IMFAR), Chicago, USA, May.

Hobson, J. A., & Gutstein, S. E. (2010) The Guided Participation Relationship as a vehicle for change in autism. Manuscript under review.

Hobson, R.P. (2002).  The Cradle of Thought. London: Macmillan.


Studies  are underway with the Institute of Child Health at UCL and the Tavistock Clinic in London following cases in treatment prospectively. Reports on cases seen through the Connections Center but coded and analyzed independently by a separate research team blinded to treatment details have been presented in numerous conferences, and we have a collaborative paper with Dr Gutstein under review. The more sophisticated study, with a sample from an independent site  is nearly complete and data analyses will be conducted over the summer.