Saturday, May 1, 2010

OK, Now I Get RDI

I posted this article quite some time ago.  It was a pretty active post, with over 64 comments.  The gist of my post was that RDI was difficult to understand clearly without paying big bucks to have someone explain it to you.

Well, someone recently provided me a copy of one of Gutstein's earlier books, Relationship Development Intervention with Young Children.  Inside I was surprised to find not pages and pages of theory and anecdotes, but activities and exercises explaining how to move through the RDI stages.  Finally, something practical for me to look at without words like "dance" or "redo".  The activities are clearly laid out with goals that make sense.

What I've found so far is that RDI appears (at the early stages at least) to be a lot like speech therapy.  Some of the early activities focus on changing how you communicate with your child, getting the child to pay attention, and sharing enjoyment with activities.  A good speech program is Hanen's More Than Words, which has a lot of similarities with these RDI activities.  I like what I have read so far - these activities are practical and will help develop the skills I think they claim to develop.

One interesting thing to note is that my suspicion about needing some ABA to get started is probably true.  I often wondered what RDI proponents would suggest for a child who completely ignores the world around them.  Here's an interesting excerpt from the book I am borrowing:
A small group of children with autism appear oblivious to these methods.  They may monitor their communication environment so poorly that they do not even notice your highly emphasized, indirect prompts.  These children require an initial behaviour modification approach where they initially learn to respond to direct prompts (emphasis mine).
In other words, some children need some ABA to get started before one can even start these RDI activities.  Now that makes sense to me.  As Alanna has gained skills in communication and attention our ability to do these kinds of activities is increasing.

Lastly (and I expect to be flamed for this), Gutstein has claimed the reason he stopped publishing these activities was because the ABA crowd was de-constructing them and making them into behavioural programs.  I think he has a valid point, but I also think the primary motivating factor was to make his method proprietary and "license" it to franchisees, namely the RDI Consultants.  I am sure Dr. Gutstein has done well financially after making this decision.  I suppose I can't really fault him for this, but I wish he was more interested in helping parents of children with autism rather than making money.


  1. We are the family with that kid who falls in the small group of children oblivious to these methods hahahaha.

    You should watch us do RDI. Its funny.

    BUt we keep doing it. Because it works in the smallest tiniest little gains...

    And when those things happen, I am blown away.

    Eg. Yesterday Khaled finished dinner. I prompted him to put his plate away by pointing at the plate. He did it. He went to his toys and was playing. Then I turned around and started griping at my husband that just because I was left at the table getting khaled to finish his meal, why could he not just clear the stuff from the table and so on (nagging ensued).

    I walked off in a huff. Only to turn arond and see Khaled walking to the kitchen towards me holding the last pot that was left on the table. With this huge smile that sort of means look I am trying to please you.

    No one gets him to clear anything but his plate. No one talked to him or asked him to do anything. Its in these moments you see a RELATIONSHIP. Its priceless. I dont know how it happens, but once your kid starts to see you more as a guide and someone to look up to and please. It is like you feel like a real parent.

  2. Be careful with the activities in that book. We used them in ABA - my daughter could follow our eyes to a prize in a discreet trial, but was not interacting non-verbally outside that trial. We checked off activities, taught her activities, without getting two-way non-verbal interaction.

    The books don't capture a re-do of the parent/child relationship if you use them in a behavioral fashion, and that's why I think Dr Gutstein wants to unpublish them.

    You can accomplish the activities in that book and COMPLETELY miss the relationship aspects the book was written to illustrate.

    Please be careful.

  3. yah,I havent tried anything from that book yet because they are above and beyond my sons current abilities to regulate, reference, and sustain the two way communication stuff.

  4. I have been an RDI consultant for 6 years and have never used the activities in that book. I tell you that to help you understand that the activities really have nothing to do with RDI. They were designed to help people implement some of the principles years ago when RDI was first beginning as an approach. However, as the model has grown over the years it has moved away from an activities-based approach. The specific activities you do with your child don't matter at all as long as you are applying the principles of interaction and engagement that RDI is based upon. If you use the activities book as the basis for understanding RDI you won't have an accurate understanding of the model. By the way, the system we use as consultants is not franchised to us and has no activities within it. It is a system that provides consultants and families with a developmental sequence to know where to target our efforts. It is not a collection of activities.
    Nicole Beurkens

  5. I wrote a five-post series on RDI recently (Part I, Part II, Part III, Part IV, and Part V). Hopefully it will give you a clearer idea. Flaming is not my style, but clarifying and elaborating is. It is never easy to figure out how to help our children because we have an information cornucopia thanks to the Internet. When we started on this journey in 1991, there was hardly any information available. It is both a gift and a curse! LOL

    Here are a couple of brief bullets addressing what you wrote:

    * RDI is more than speech therapy. It addresses how to guide a child through the social and emotional milestones they missed (or lost) because of autism. That is what is meant by redo.

    * Rather than "getting things out of a child", the idea is to present opportunities and see what happens. Sometimes, what I have in mind turns out completely differently because the idea is to respond to what my daughter does which is never predictable. We have a single stimuli with many possible multiple responses. From that point on, my response depends on how she responds and vice versa. That is what is meant by dance.

    * Some children might need a small amount of behavior mod just to get started. However, going through ABA to graduate will not address what RDI addresses. ABA puts a child in the position of being a responder rather than an initiator. The longer a child plays that role, the longer it takes to think dynamically.

    * The one branch of behaviorism that is most compatible with RDI is Positive Behavior Support.

    * RDI is about how you work with your child. It could be any activity. There are thousands of objectives available once a person gets a consultant. How I provide opportunities for my daughter to learn it may look very different from how another parent guides their child.

    * In any area of autism treatment, there is a wide disparity from one professional to another, whether it's teachers, therapists, doctors, etc. Gutstein is trying to make sure that people claiming to do RDI are not simply doing a bunch of activities in a rote, predictable fashion.

    * Clearly, there is profit involved. However, the computer system you have access to via a consultant has a whole host of information: video library, e-learning, archived webinars, scheduled webinars, access to the objectives from all 12 stages, an entire record of everything the consultant and family has sent. It takes money to set that up. What is neat about the e-learning is being able to share it with people in your family, teachers, other therapists, etc. to help them understand how they can better understand how we guide our children.

    I'll try to restrain myself this time! :-)

  6. Just as an FYI everyone, (and it's my husband who wrote this entry, not me) we don't always use discreet trial training. We also use natural environment teaching and things flow very naturally. Yes it is hard work for her but it's not simply rote. Often when she learns a new behaviour she's not sure what it is for but it becomes more meaningful after she has learned it and can apply it. Then she becomes an initiator and doesn't need any reinforcement because the activity is just intrinsically enjoyable for her. This is how all children learn, obviously children on the spectrum just need more time and different methods and reinforcers. But we all learn that way because we all need motivations...they just may change over time.

    Alanna often acts as initiator, but as well she does act as responder. I believe that children with autism need to be in both roles, just as any other child would.

    And we weren't saying RDI was speech therapy. We were just comparing methods used in the book to the Hanen speech program that we took. They are much the same.

  7. To Penny: I realize that the activities in the book are just examples that have underlying objectives. However, I think it's nice to have examples. To date, I've not seen any - just explanations on how it would vary so much between children examples are meaningless (when clearly they are not). I totally get what you mean - the whole point of RDI from what I can tell is that there is no magic solution - no step 1-2-3 to get to the goal. However the activities can demonstrate the goal, and if you pursue the goal while modifying the activities or using it as an example to come up with other ways to apply RDI, then I think it is useful.

    To Nicole: I realize the activities are just examples, but as I said to Penny, this is the most concrete information I've had on RDI since I started researching the topic. The franchising of RDI is not in the computer system, but in the education. It is not possible to attend the RDI training in Houston without having a consultant if you are a parent. The total cost of this training is approximately $5720 USD and takes about 12 days. It would cost me $12000 to pay an RDI Consultant for a year's worth of service.

    To Tammy and Nicole: The cost of maintaining the on-line system is a separate expense and is not even close to what RDI Consultants charge. I know because I am in the software business and I know how much it costs to run servers. The bottom line is that many people look at RDI as a business, and I think Gutstein targets people who want a business because of the restriction on parent training. RDIConnect has this testimonial: "Prior to becoming an RDI Consultant I had a private speech and language practice. I was STRUGGLING TO KEEP ENOUGH CLIENTS TO WORK, and struggling to feel competent with the autism population. The RDI Training and on going learning involved in being in the field has provided me with an invaluable set of tools to work with and help families with. It has also provided me with an amazing group of other therapists to think and learn through. As a result, MY PRACTICE IS VERY BUSY." This is why I am skeptical of the secrecy of RDI information when compared to something like Floortime where information is much more freely available :)

  8. BTW Tammy, thanks for your blog posts, that was some of the most helpful explanations I've seen yet and makes it much clearer.

  9. I know they do sound a bit cultish don't they?
    I have noticed I have started sounding cultish about it too! :D

    But there is nothing more cultish than 30-40 hours of ABA. And the phrase "evidence-based". Evidence of what?? Marriage? Happiness? Employment? Quality of friends? Cleverness(has anyone ever come up with a good way to measure that?)

    In the end there is no formula. Just a bit of lets try this and see how long it takes before it fails. And you are right, who has that kind of money to try everything?

    You are on the right track you cute little family. Research everything and see what may be the best fit for Alanna!

  10. ditto Penny. i had the book. did the exercises...and it was not anything about RDI.

    RDI is a is is FT.. We have spent $$ on useful and not useful things over the years. The number one thing we spent $$$ on for our son was a cochlear implant. the number 2 is RDI. I 'played' around with it for 3 years- using that book you mention, reading blogs, trying it myself. and i am a TOTAL do-it-yourselfer. Tammy and Penny can confirm that. But when I finally got a good consultant, Andrew just started flying..not in skills..but in our relationship and our quality of life. I ENJOY our life!!!! and it is no longer just a daily 'task' of trying to get to a certain goal..even though there are goals/objectives in is not even close to the same as what you would 'think' of as a goal.

    Anyway- i know where you are comign from. you sound similar to myself..just don't miss out because of your perception of RDI. All that might be true. Let's say it IS a money making thing- that doesn't make RDI a wrong path. Don't use your perception of RDI as a reason for doing something else. And be very careful at what you think you are doing with that book. I actually might dig it out again that you mention it because i have a specific objective we are working on..i can USE the book now to frame my chld's specific obj.

    RDI is not as expensive as ABA least around these parts.

  11. Here is a comparison: the State of South Carolina will fund up to $50,000 a year for ABA therapy for autistic children until they turn 16 years old (or they graduate). I pay my consultant (who is considered one of the best in the field of RDI) less than $5,000 a year. Since she is also an SLP and Pamela's second greatest need is language, we get great insight on what to do about Pamela's language issues as well as her dynamic thinking and social and emotional development. Some of the things she has helped me with that I do not think I could have done on my own: dealing with Pamela's mild anxieties (she no longer stalks her dad before he goes to work because his schedule is unpredictable), using more gestures to supplement her language, interaction patterns (which enabled Pamela to participate in her cousin's wedding in a meaningful way--check out this video--she handed out 100 programs to strangers in 30 minutes and was so poised--all based on an assembly line pattern we learned four months earlier), and the latest thing yet to be blogged is slowing down to think before she talks. There are others but I don't want to bore you! LOL

  12. P.S. I vouch for Queen Mum. She did lone ranger RDI for much longer than I did. We have been cyber friends forever and her consultant helped her turn around some very challenging issues with Andrew. She's had very positive experiences, especially out in public, since she started with her consultant.

    P.S.S. I really am trying to reign in my enthusiasm . . . :-)

  13. again. i was just uploading a video to youtube..and i was freaked out that one of my older videos was viewed by close to 800 people. I just marked it private LOL. but i had a series of 3 videos where I was working with my son on an RDI goal that I had read in a book... probably the old 'pink book' of objectives that I got bootlegged when i wanted to see the a book. like you are wanting. i can't TELL you the number of things I did wrong. I can see NOW why we didn't have progress. I agree with the person above who says that we have to piecemeal things together.. a little of this.. a little of that. To some degree that is true. But several people told me that you can't do ABA half way and get the full results. I agree with that. And I agree with that on RDI. There are behavioral parts of RDI and our consultant is working thru those with us. But without a guide guiding you- you may get negative results and then toss out the whole thing before giving it a fair shake. At the very least, start writing down consultants names that you'd consider going to, call them up, ask for an hour of phone conversation (or 30 minutes) to discuss what RDI is all about- how much they charge- how the whole process works. Each consultant has a slightly different way of laying it out. I have a friend that just started RDI and she layed it out for the consultant. she indicated how she didn't like the secrecy, the cost structure, etc.. and the consultant walked thru that with her. jmo

  14. One and hopefully last comment. The consultant quoted from the RDI website, included in the comment above, is my consultant Amy Cameron. She is one of the best in the field, and her fees are very reasonable. She puts her whole heart into helping us guide our children. She sees my daughter as a person and, not only provides me with great insight on how to help Pamela, she truly enjoys spending time with her during their evaluations. One of the things that sold me on her was watching her run a parent meeting with one of the parents' kids sitting in her lap. Amy not only teaches us about relationships, she lives it.

    When we first met, she explained to me the reason why she became a consultant years ago was because RDI was the first program she found that got to the heart of what autism is, not the surface (behaviors), but deeper into how autistic children perceive, process, and think and how that drives their behavior.

    I am not alone in my respect for Amy's passion, dedication, and empowerment of parents:

  15. We were invited to an RDI "Information Session". After doing some research I see that there is no sound scientific evidence (and by this I mean peer-reviewed papers in recognized journals) to support the technique. It could turn out to be useful but on the other hand it could just be more junk science. In the meantime the promoters will be happy to take our money in exchange for hope. No thanks.

  16. As a father of a child in the Spectrum and as an RDI Consultant in training I would like to say that:

    0. RDI is a so SMART approach that probably 1%-5% of the Autism community get it.

    1. Parents we are NOT machines to make money. We are called to become guides for our children.

    2. ABA is like OIL. Too many business interest behind. Clearly at 2014 we can´t believe the equation Human being = behaviors (1950s?) !!!

    3. There is a great correlation between how family deteriorates over the last decades and the rate of Autism.

    5. I don´t see how I would be able to make as much money as an RDI Consultant as I did before with the job I quite. However I am happier now helping my son, my family and trying to help other families.