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 FOR MORE INFORMATION SPECIFICALLY ABOUT RDI VISIT:
www.rdiconnect.com
ABOUT RDI
The Relationship Development Program is a program for educating and coaching parents of children with Autism Spectrum Disorder. This program is based on the latest information from developmental psychology, communication research and autism research as well as the most effective components of other intervention programs. A selected bibliography is attached There is evidence in the communication literature that teaching the parents how to change their interaction style facilitates change in the CHILD as well. After all if the parent is able to facilitate the interaction Then the therapy will be on going and not waiting for outside personnel. In addition new research from THE UCSF Autism clinic shows once again the importance of the role of the parent in intervention. In a retrospective review of clients who had passed through the autism clinic the only significant factor for success seemed to be in the level of parent participation in the program (Schuler in preparation).
The primary focus of this program is on helping parents and their children restore the critical inter-subjective relationship which is inherently damaged by the impact of autism during infancy. The inter-subjective relationship is how children learn to function in dynamic relationships. Its ABSENCE is one of the most persistent and resistant deficits in autism. In addition RDI addresses the core deficits of autism. These core deficits are:
Dynamic Appraisal
Ability to understand environments present many potential opportunities to organize, relate and prioritize information in different ways, and those environments are always changing. Ability to distinguish minor changes from major changes in the environment. Ability to determine which information is most important at any point in time.
Episodic Memory
Allows us to anticipate future possibilities, and learn from past mistakes. Memories of success are stored and used to develop perseverance and resilience. Builds motivation to endure challenges. Allows us to prepare for potential future scenarios and expect future uncertainty.
Innovation
Ability to formulate new strategies when prior strategies do not work. Ability to improvise when exact resources are not available. Ability to engage in hypothetical and speculative thinking.
Inter-subjectivity
Ability to understand that people perceive the world through a unique subjective point of view. Allows the ability to grasp other people’s intentions and the diverse and sometimes conflicting motives that define our actions. Required to integrate ideas with others. Necessary to carry on productive collaborations.
Relative Thinking
Ability to formulate "good enough" and "best fit" solutions that are based on highly specific needs and competing demands of real-life problems. Ability to shift, when external factors require that a project be modified, delayed or given lower priority.
Self-Awareness
Involves a coherent sense of personal identity. Ability to engage in effective self-evaluation and analysis. Ability to examine personal impact of potential actions. Understand the need to constantly monitor own subjective state. Use productive self-regulation strategies to achieve greater emotional awareness and control.
Unlike other methodologies, RDI does not teach scripted behaviors, but rather develops those dynamic abilities that will allow the child to make friends, live independently, and obtain satisfying employment.
RDI parent training is implemented through the following methods
1. parent education and readiness
2. individualized balanced planning
3. ongoing consultation from a certified consultant
4. periodic reassessment (every 6 months)
5. advanced parent education
6. peer dyads and small groups
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The program is implemented through training the parent in how to be the guide for their child in mastering complex problems and situations despite increasing levels of uncertainty and unexpected change. The guides (i.e. the parents) help the child capture and store critical memories of success in gradually more complex environments. Parents are taught to review their daily lifestyle so that they can structure activities throughout the day to provide safe but challenging opportunities for discovery.
The principles of the RDI program are:
1. Remediation of the critical deficit areas
2. Build on a foundation of developmental psychology and autism research
3. Systematic objectives and progress tracking based upon typical development. These objectives are in a developmentally staged hierarchy.
4. Children learning increasing competence through being apprentices to their parents
5. Parents learning to be competent guides
6. Consultants act as facilitators and coaches
7. Methods used are optimal for developing intelligence
8. Continued program evaluation and upgrading.
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RDI has both parent and child objectives. The parent objectives include understanding the core deficits and how they impact their children is various areas, understanding dynamic vs. static systems, understanding issues related to quality of life,understanding the concept of remediation, understanding the goals and principles of RDI, developing a mission statement, and preparing for the master-apprentice relationship. Parent objectives can be met in a variety of ways. Families that attend the four day parent training will have knowledge of these, whereas families that have only been to a two day or watched the video may need more direct instruction. Depending on the families needs some of this may be done prior to the RDA, but will continue to be focused on throughout the intervention period.
Ongoing support can be provided in several different ways. Since this is a parent driven model, all must involve the parents' active participation. Parents will be asked to videotape sessions with the child, review these, indicate which sections the consultant should focus on completing paper work to indicate the objective being focused on and the specific framework being used, the challenges that were provided to help the child increase their regulation and stretch their "zone of proximal development." (Vygotsky), what the parent thought went well and what they felt could be improved, as well as possible expansions, and what questions they have for the consultant. These will be reviewed by the provider, with online feedback in a timely fashion ( or within 48 hours), to be followed up by phone or at the next in- office session for ongoing planning.
In addition parents will be asked to submit daily reporting forms at least 5 times per week, to share activities that they were not able to videotape as well as opportunities to work on regulation and address other core deficits. These forms are reviewed by the consultant with feedback provided on line, by phone and in person. This allows the family to think about and demonstrate ways that they are incorporating RDI into their daily life.
Sessions with families may take several forms. In most cases, the parents will meet in the office with the therapist. If the parent feels that they would like to demonstrate their work with the child to the consultant, the child can be brought to the office or a home or community visit can be arranged.
Group meetings for RDI families will be held once a month. Fathers will meet one month and mothers the alternate month. This alleviates the problem of babysitting, but also has been found to provide the best support. Families are asked to bring 10 minutes of tape to share. There is also an element of direct practice at each meeting. In addition all clients enrolled in the RDI program are entitled to participate in the live chats offered by the Connections Center. Those families who are unable to attend will be asked to participate in an online chat.
When children reach the stage that they understand how their actions affect others and can modify their own actions to achieve co-regulation and collaboration, they will be included in a dyad with another child at the same level. This will require an extra 5 hours per month of funding, to allow for the sessions and review with parents. Families need to continue to work with their child at home to continue progressing through objectives at higher levels.
Reports detailing participation and a short summary of the family's progress will be provided every 12 weeks. Every 6 months the RDA 1 will be repeated. Regular session hours will be used for this and the review with parents. Since treatment is ongoing, RDA 2 and 3 can also be accomplished in this way and reflected in a comprehensive report (representing RDA 1. 2. and 3) at the end of the 6 month funding cycle.
Some insurances will bill you directly. Speak to your regional center representative regarding possible funding.
Please contact Linda Andron-Ostrow at landron@factfamily.org regarding our fees, availability and appropriateness of therapy for your child.
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