Customer Reviews

Autism Aspergers: Solving the Relationship Puzzle--A New Developmental Program that Opens the Door to Lifelong Social and Emotional Growth

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I have worked with Steve Gutstein for over 10 years now as a patient and sufferer of Asperger's Disorder, and I have never had as much hope for my own success and well-being as I have now, after reading this book. It's truly remarkable that someone who does not himself suffer from the disorder could have so much insight into the delicate intricacies of human social dances and the troubles that people like me have in deciphering and processing their nuances. If you do read this book (as you definetly should), you will come to know me as Roger, and you will read my confusing and troubling story of struggle, frustration, and success, as well as those of many other patients Steve has dedicated his time to. These stories are not just for psychologists and Asperger's sufferers. They are for anyone who needs a reminder about what makes social interaction so wonderful and why sometimes, the most simple forms of communication can lead to the most wonderful encounters. Along with the remarkable stories, of course, is the clinical side of Steve's work. Although I am not a psychologist, and do not have an extensive knowledge of the literature on autism and AS, I find the outline of Steve's methods for treatment logical, concise, easy to understand, and above all, correct. I only hope that in time, people take in Steve's message and work to seriously incorporate autism and AS sufferers into their lives by helping them find THEIR OWN path, not choosing one for them. This book will hopefully mark a crtical turning point in the history of the treatment of AS and autism, and I am honored to be a part of it.

I am mom to a quite adorable 4 year-old with Asperger/Autism/HFA....every year a different label..but by any other name, he's still as sweet. I wanted to pour out all the help I could give him. I devoured hosts of books on all the labels. Every book was an eye-opening, informative, helpful tool along our journey, but Dr. Gutsteins book was the journey itself! The journey my son must embark on to be a participant in the human relational experience and not just an observer. To loose himself in the shared giggles of a pal. To be stirred inside by a knowing smile or glance. To embrace the wonderment, spontaneity and magic of play. To see himself through the eyes of others. To walk in step with a friend. This is what my son was missing. It is elusive, hard to grasp or put into words. I knew my son needed something yet to be addressed by any of the books I had read or professionals I had consulted. It was as if Dr. Gutsteins book quenched an aching thirst. The book is a practical treatment approach called RDI. Do not be misled by the simplicity of the treatment methods. The "games" are simple, but powerful! Do not skim the book or skip through the chapters, read it, read it again. ...After reading the book, my son became a patient at the Connections Center. The RDI treatment has already unlocked a door to a lifetime of relational joy for my son. He has come so far in an amazingly short time. We will continue our journey and I hope many others will discover their journey as well.

Dr. Gutstein's book describes a six-phase intervention program for teaching people with Autism/Asperger Syndrome to desire, enjoy, and participate in meaningful relationships, which in turn will enhance their lives. His program is entitled Relational Development Intervention (RDI), and is a new approach for a social skills program. It is well known that early intervention is the key for proven effective results with children who have an Autistic disorder, and he advocates this strongly.

The book is more than a theory, as Dr. Gutstein shares some of his actual patient examples as proof that the program can make a major change in our children's lives. He takes the theory out of the classroom and puts it into practice in the real world. His past experiences of being a medical school professor and his private practice experiences have been instrumental in the development of his program. He helps parents understand the social deficits in their children who have Autism, and provides a guideline for them to follow in describing his treatment plan.

As a parent of a child who has Asperger Syndrome, I was encouraged to learn that some of my suspicions are founded in fact. I found myself nodding in concurrence as I read about how some of our children are motivated to relate to objects, while people are being their captive audiences; and was encouraged to learn how his program worked with developing Experience Sharing in our children.

For me the book was like having a world atlas at my fingertips. I could easily see where we have been, and can get an overview of the terrain ahead. I know that working with our son will be a life long project, and finding a program that helps him have a more productive life later by teaching him relationship skills now is a gift that I can give him.

Some day my child will dance. Right now I hear the orchestra tuning up for that dance; therefore, I will continue with the dance lessons for now to prepare him (and me) for that swan song event.

This book is an added asset to a parent's resource collection of books on working with our Autistic family members.

I'm actually revising this review having reread the book and learned more about RDI, as I feel I have a better idea of what the approach is really all about now. My new in-a-nutshell assessment: there are some things I really love about RDI, and some things that I don't care for. To be fair, I would say the same about most treatment approaches.

To start with the positive: I think the thing that makes RDI special are what they now call the "Child Goals". There was a time when we thought teaching children with autism to be 'social' meant drilling them on how to say "Hi, my name is ____ what's your name how are you do you want to play", and other such catch phrases that would be fairly useless on a real life, chaotic playground full of it's own hidden codes and rules. The same for abstract thought, imagination, perspective taking. Some things don't translate well to the old "10 trials" format. So a big bravo to RDI for researching this topic and developing goals based around how these skills emerge in typical development.

Now for what I see as the core problems in RDI. First, it is all set up around the philosophy that if children feel competent, they will participate (as opposed to ABA, which says if children feel MOTIVATED they will participate.) So if you are trying to do a social activity with an autistic child, and they keep running away trying to go play with light switches or Thomas Tank Engine, RDI says it's because they don't feel competent. Make the situation easier, help them more, slow down, and they will happily engage with you.

Nothing wrong with this philosophy, but I'm here to say, I haven't found it to be true. There is actually emerging research to suggest that children with autism may be wired to be 'systemizers' and to pay attention to more mechanical/mathematical type information while lacking typical levels of motivation to attend to social information. If this is the case for a child, you can simplify all you want and the issue isn't that they don't understand, it's that they don't care and you're not creating a reason for them to care. You can be the best teacher in the world but it won't do much for a student who is tuning you out.

Second, RDI says that most of the methods used in ABA teaching are Bad with a capital B, and encourage families to really avoid these methods. Again, the problem? A lot of those methods are extremely effective with autistic children, and taking them off the table really limits your teaching tools. This includes methods such as giving the child a direct instruction or asking them a direct question, prompting them to answer or respond, or teaching new material in a very repetitive, predictable way.

I think the interesting argument that you get down to here is: when teaching an autistic child, how much should you accommodate a child's autism vs. how much you should try to change it? In my mind, using ABA type methods lean more toward accommodation - teaching in a way that is easier for an autistic child and more in line with their style of learning. RDI methods stress change - you teach more in the way you would expect a neurotypical child to learn and hope they will in turn adapt to this.

What I have seen to happen, in my admittedly very limited observation, is that children who are closer to that neurotypical way of thinking do well with RDI, whereas children who are more classically autistic don't seem to get much out of RDI unless it's adapted for them. For the children who have some of those base skills already, RDI can be the push they need into becoming a dynamic thinker. For a child who doesn't attend well to social information, needs to have their interest/motivations incorporated to a large degree, and doesn't learn well outside of highly structured teaching situations, I almost wonder if it's akin to teaching a deaf child with nothing but verbal direction.

So my advice? I like the ideas, I do. I would recommend this therapy for high-functioning children with fairly good language and some pre-existing social motivation. For more involved children, I would recommend it as an add-on to other types of therapy such as Floortime or Verbal Behavior, that are more focused on adapting to the child's way of thinking instead of waiting for them to adapt to yours.

If I'm reviewing this book, and just this book, then I give fairly high marks. The book gives some nice insight into the development of social interaction and how typical therapies aren't well equipped to address this. It's a bit vague as to how you would in fact remediate these deficits, but still a worthwhile read.

I can't really review the book without reviewing the RDI program, however, and here I have some reservations. If you do buy this book with the intent of starting an RDI program, you may well be told the following:

- ABA programs make children "more autistic", even though they appear to be getting better this is only a short term illusion, underneath it all they are being taught to think in a more black-and-white 'autistic' way. You may be told that you must stop your ABA program in order to work with a consultant. (Floortime is also considered bad news.)

- Language fundamentals (i.e., basic vocabulary, understanding language, speaking in sentences) are not a core defecit of autism despite the fact that they are listed as part of the diagnostic criteria, and so they are not targeted. The child will 'get' this language by doing RDI, however, even though it's not specifically addressed.

- Quality not quantity of treatment is important (I disagree - research seems to show that time IS important in therapy, and leading parents to believe that reducing time can be better for the child seems worrisome.)

- Children don't need reinforcement to participate, or for you to use their natural interests. So long as they feel competent, they will participate in the activities you've set up. If this is not the case, it's typically blamed on a 'co-occurring disorder', (for example, bipolar disorder, ADD, or oppositional defiant disorder,) rather than giving consideration to the fact that the child isn't motivated or interested in social stimuli.

I have concerns that parents are actually being told that they should go out and fire their ABA therapists when so much research exists to support these programs and there is virtually none behind RDI. Not to mention that RDI now includes mandatory parent training goals in the beginning, and these can take months to complete before you ever see a goal for your actual child. That's precious early intervention time lost, at a time when every second matters.

My thought is that this program would be good for a high-functioning or Aspergers child who is beyond the more basic skills taught in ABA and early intervention programs. For that population I think it makes sense. For a child who needs to develop basic language and skills, however, be wary of some of the holes in this program.

Even having lived with the first reviewer from the day of his birth, I did not fully understand this disorder until I met Steve and then read this book. It is almost impossible for the non-AS person to grasp what these people cannot do. That is because the rest of the world does effortlesly as an integral part of their being what AS people cannot even grasp. But they can! This book shows that it can be done. AS never goes away, but life can become more than just tolerable for AS people, they can experience the joy of fully being alive. All it takes is a great psychologist, with great insight. Here are his many stories and how he gets it done! A must for those with AS and their loved ones. A good idea for the rest of us so that we might understand what it means to be human.

Gutstein's premise -- that people on the spectrum need to learn emotional sharing -- is quite a different approach from the standard therapies. Most therapies work on functional skills, whereas Gutstein works on functional motivation. The two go hand-in-hand, and that's where his book has value. However, it's not a very readable book, and it needs extensive editing to be accessible to its preferred audience of parents and therapists. Look instead for one of his two follow-up books, which give an overview of RDI and also provide specific exercises.

I was given this book by another parent whose son has autism, and my son has a preliminary diagnosis of PDD-NOS. While I do agree that an important part of the missing piece for specturm children has to do with their inability to read and respond to the emotional and social cues of their peers, I have my doubts as to whether or not that certain "piece" is the most critical and primary component of autism that needs to be adressed first and primarily in order to begin the process of recovery. Frankly, I am dubious of any therapy that requires parents to spend $3,000 on a four day seminar before they can purchase more therapy, which will likely have to be paid for out of pocket. I find that the RDI's official websites use of guilt and fear in goading parents out of their precious resources is not only irresponsible, but generally reprehensable as well. When I hear something like recovery, or hope for you child's fullest potential, initially comes with a three-thousand dollar cash outlay plus the cost of travel and hotel accomodations, so that someone can tell me over the course of four days, that my son has a deficit when it comes to socialization, I immediately become suspicious. Buyer's beware I say: when therapists have our children's best interest at heart, they never use guilt or fear to get parents into their offices so that treatment and help can begin to lighten the already heavy load of caring for a child with autisim spectrum disorders.

I have recommended this book for use with several children I work with, as well as the companion books with the actual excercises. I found them comprehensive and a good read, and was quite interested to find out what my "social skills" levels were (frequently under the age of one year, according to the tests provided in the back of the practical book on Adolescents and Adults).

I am Aspergers or HFA, depending upon whom you ask (significant language delay, but not diagnosed until an adult). But having worked with a couple of RDI consultants, and having read the books... I am NOT comfortable with the therapy for myself.

Quite frankly, I don't want to socialize that much, and not being good at it works as well as any other reason to not do so. And if neurotypicals are as terribly good and flexible at adjusting to the levels of the person they are socializing with as they like to claim, then they can bloody well do so for a change. I feel no need to change who I am, or how I act, simply to fit the prejudices of others.

Yes, I know it would make life that much easier. But as I recently told a DAN/CAN type at a local ASA conference, I would like a "cure" for my autism about as much as he would like a "cure" for his personality.

Gutstein's book has far reaching social value beyond that of Autism. I think of his work RDI as soul building, something our society desperately needs. Gutstein takes apart the developmental elements of social/personal connection without losing the sense of mystery that there is in relationships. ie. He analyses the kiss without reducing it to a technicality. Although steps are given once you have grasped the content of the book there is room for the individuals creativity and intuition to take the material and run with it.
I feel strongly that this book should be required reading for all psych, forensic and Social work students as it goes to the core of our ability to relate to other individuals and society.