19 of 19 people found the following review helpful:
3.0 out of 5 stars
It's the elephant's trunk!, July 3, 2011
This review is from: The RDI Book: Forging New Pathways for Autism, Asperger's and PDD with the Relationship Development Intervention Program (Perfect Paperback)
This is my modern day, autism-equivalent to the old parable about the blind men and the elephant.
Five autism experts go on an outing to the mall with a parent. First they head to the food court for lunch, then to various stores. Everything seems to be going well, when suddenly the boy throws himself to the ground in an all-out meltdown, wailing and pounding the floor with his fists, maybe even hitting his own head.
RDI expert: He's experiencing too much uncertainty. Did you notice this started when we came into a store he'd never been inside before? Clearly, we need to work on his ability to handle frustration and uncertainty through RDI exercises.
Sensory-motor expert: He's experiencing auditory overload. Did you notice this started when we walked by that high pitched security alarm? Clearly, we need to work on sensory integration exercises to help him handle this overload.
ABA expert: This is an escape behavior. Did you notice this started when we came into a clothing store - the other spots in the mall were reinforcing. The food, the escalators, the toy store. Clearly, we need to work out a behavior plan to extinguish this behavior.
Floortime expert: Great! He's moving into a developmental level where he's able to express his will. Think terrible two's. Clearly, we should take him home and do more Floortime until he moves to the NEXT level.
Nutritional expert: His behavior is the result of something in that lunch. Did you notice the timing - it would be hitting his bloodstream right about now. Clearly, we need to do some testing to eliminate...
In unison: Uh oh.
Cut to mom, who is now banging HER head into the floor...
My very elongated point is that I will say what I've said about every other good therapy book I've reviewed - a nice piece of the puzzle. Now. for those who want the boring specifics as I think they pertain to various children, see below:
Pros:
- One of the few programs that addresses very important skills (relating to others, empathy, reading people, imagination, problem solving, etc.)... well, honestly, I guess I should finish this sentence with "at all". Sadly, a lot of programs for developmental disorders don't go too far beyond the basics - ABCs, 123s, life skills, early language skills, that sort of thing.
- I believe that, for the most part, the brain is very task specific. We learn mostly by "doing", especially early in life. Yet, we often try to teach social and cognitive skills using things like worksheets alone - what should the boy in the picture say to his friend, etc., and expect it to carry over to "real life". These exercises may serve a purpose, but to really learn social and cognitive skills, I think you need to use them in context.
- RDI is sort of the anti-ABA. This is good and bad (see below): ABA tends to focus on the tangible and concrete, so the skills I mentioned above are often neglected. Also, ABA tends to treat all behaviors as falling into a few narrowly defined categories (escape, avoidance, etc.) and deals with all behaviors in pretty similar ways (ignore it, reinforce something else, etc.) These techniques may be ok early on - you don't work on verbally problem solving a temper tantrum with your toddler, after all - but past a point they seem to inhibit the development of important skills like self talk, problem solving, self regulating, etc.
Cons:
- Maybe this is just me, because other people don't seem to echo the sentiment, but I find RDI frustratingly vague at times. I see a lot of terms thrown around - guided participation, frameworks, emotion sharing, variations, co-regulation, coordination, etc. - but not a lot of specific definitions and criteria. Yes, I'm sure many people would laugh, roll their eyes at me, and say "Oh, you're one of those people, huh?" I'm sorry, though, I just can't get past that. What, specifically, in measurable terms, constitutes Good Guided Participation, or an instance of "rapid co-regulation"? I feel like RDI is a lot of "You'll know it when you see it", which is fine for some people, but it leaves me feeling directionless. Give me a concrete goal and concrete criteria for measuring that goal, because my idea of co-regulation might not be your idea of co-regulation.
- I feel like there are parts of RDI that have to just "happen", with little or no way to prompt them if they don't. For example, face to face emotion sharing - what happens if the child doesn't "emotion share" with you? Say you set up a great environment, great activity, build anticipation, and - ta da! - at the proper moment you stay in the child's line of vision and emotion share your heart out... and the child just stares at you, or stares past you at a spot on the wall. My guess is that RDI would say go back and work on more basic skills, but when you get back to emotion sharing, the same point still holds. It's entirely possible that the child is not going to emotion share back, and there's really no way to prompt this skill and then fade your cues - if the child doesn't do it they don't do it, and then what? My sense is that RDI doesn't like prompting, which is fine - but what do you do when something just "doesn't happen?"
- RDI is sort of the anti-ABA. This is good and bad (see above): RDI doesn't, in my opinion, really allow for the idea that children with autism Just Aren't Interested in certain things to the degree that typical children are. Maybe RDI will acknowledge this, with the assumption that there is something "blocking" the child's natural interest, that if we can remove this block the interest will return. I say, to a degree, social interest is innate. Babies are born with the desire to lock on to people's faces and watch mommy's every expression with rapt interest. There's no "reason" for them to do this, they're just born with the desire, the way a duck is born with the desire to head for water. If a child with autism does not have this desire, or has it to a lesser degree, you can't "make" them have it simply by creating opportunities. I think there is an assumption in RDI that the desire is there and you need to find it, vs. ABA, that seems more geared toward the idea of CREATING that desire through various techniques.
Also, while I've said in other reviews that ABA can be TOO functional, I'll say the opposite here, that you do in fact need SOME functional communication. I feel strange doing RDI with children who are minimally verbal, who can't put on their own clothes, go to the bathroom, or tell me they're hungry or hurt. I have to ask myself - what if I'm only able to teach this child five new skills this year? Would it be cool if they learned to follow my eye gaze to the plane above us? Yeah, sure... but I can't justify spending an hour a week on that when they can't tell me they're delirious with thirst. For early learners, the functional is important, and you have a limited amount of time and resources to teach skills, so at some point you have to prioritize. A lot of the early skills in RDI are not "stand alone" skills, in my opinion. They're great if you're going on the idea that they will lead to something else down the road - but in and of themselves, they may not be all that functional.
So, to summarize, my feelings on this program haven't changed a whole lot since I first heard about it. I think it's best for high functioning kids, and for kids who don't need a lot of support in other areas like language development. For children working on more basic skills, I think it's fine as an add-on, but you're going to have some big holes in your program if you rely on this entirely.
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4 of 4 people found the following review helpful:
5.0 out of 5 stars
Great Book, about Autism and RDI, November 18, 2010
This review is from: The RDI Book: Forging New Pathways for Autism, Asperger's and PDD with the Relationship Development Intervention Program (Perfect Paperback)
I would highly recommend this book for any person who has a loved-one affected by Autism.
Part I of the book is the best explanation of Autism, and the ASD brain, that I have ever read. Dr. Gutstein's information about the brain, dynamic thinking (versus static thinking), and the dynamic brain (versus the rigid, non-integrated brain) is clear and thorough. He goes on to explain, in readable details, where these natural developmental brain functions break down in the ASD brain. And most important, as the parent of two children with ASD, I loved Dr Gutstein's description of the parent-child relationship and it's effect on child development. Dr Gutstein goes on to speak of the importance of re-establishing that natural, guiding relationship with ASD children. Dr. Gutstein's passion for individuals with ASD and their families is unmistakable in this book.
Part II of the book explains the RDI Protocol. Dr Gutstein speaks of the parent and child curricula, the importance of targeted remediation of the core deficits of ASD, and most importantly, he supports each stage with a chapter. The individual chapters offer a detailed description of what families can expect with their RDI Program. The details about each program stage in this book give families the information that they need to decide if RDI is the right ASD intervention protocol for their family and their child.
As this book so clearly explains, RDI is about changing relationships - changing the parent-child relationship, and changing the relationship that the ASD child has with the real world. As a parent, there is nothing more important than that. This book is able to give a clear and precise explanation of how RDI works and what RDI can offer a family affected by ASD. This is a great book, about Autism and RDI.
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