Relationship Development Intervention RDI®

Raising the Bar for Autism

Dr. Steven Gutstein, PhD

Director Connections Center
www.rdiconnect.com

Founder, Gilbert Hall School:

www.gilberthallschool.com

President, Foundation for Autism Research and Remediation

(FARR)
www.farrsite.org

connections center™
Building new pathways to change through RDI
February, 2008 www.rdiconnect.com
 Presented by: Carmen Augustin, LCSW
RDI® Program Certified Consultant
Sweeney Augustin and Associates
5225 Old Orchard Road Suite 44
Skokie, Illinois 60077
847-583-9492 ext. 1
Sloop23@aol.com

February, 2008
 What Autism is NOT
• Behavior Problem
• Lost in their own world
• Single etiology or part of the brain
• Mental Retardation
• Speech disorder
 What Autism IS
• Bio-psycho-social, chronic disorder
• A neural collaboration problem
• Complex information processing
disorder
• Many possible co-morbid conditions
• Devastating, even in its milder forms
Two Types of Intelligence and Two
Types of Brain Connectivity
 Static Intelligence
• How you learn rules, procedures and formulas
• How you perform actions that are associated with specific
problems and settings
• How you learn specific skills that can be applied in specific
tasks
• How you remember and communicate specific pieces of
information
How are an apple and a pear the same?
Who was the 16th President of the U.S.?
How do you compute the area of an isosceles
triangle?

IQ tests measure Static Thinking

People with ASD may have excellent Static
Thinking
 Dynamic Intelligence
• How you manage continual
change
• How you solve “unsolvable”
problems
• How you connect your past,
present and future
• How you collaborate with
many different minds
• How you juggle multiple
demands
• How you effectively filter tons
of What you do with what you know in a
information
complex, continually changing, inter-
connected world
 Success rates for the
“high functioning”

IQ > 100
Language within normal range

• Employment = 12%
• Independent living = 3%
• Friendship & Marriage =
<1%
 How RDI is getting there
• Investing in building minds, not
shaping behaviors
• Developing the dynamic abilities
needed for real-world success
• Applying modern, “best practices”
for learning
• Investing in families first
• Including older children, teens and
adult
• Tailoring intervention to each
person’s unique needs
The Real World is MESSIE

• Multiple
• Ever-
changing
• Simultaneo
us
• Surprising
• Imperfect
• Emotional
The MESSIE Curriculum
 Learning to conduct a continuous
process of evaluating and adapting
to an ever-changing world

Going “off course” is

inevitable in the real-
world. Success depends
on rapidly evaluating the
effect of our actions and
making continual “course
corrections
 Learning to manage
Alternative, Multiple &
Simultaneous
information & demands
• Generating and evaluating alternative
plans, solutions and perspectives
• Managing simultaneous goals, demands
& problems
• Juggling the multiple roles we play
• Engaging in multiple relationships
• Integrating simultaneous communication
channels
 Learning to be
“good enough” in an imperfect world

Most real-world problems do not have perfect

solutions. Success depends on learning to operate
on a “good enough” basis - allocating resources to
meet specific standards, depending on the nature
of the problem
– How careful should I be about grammar and
spelling?
– What degree of mutual comprehension is
sufficient in a conversation?
Best Education Practices
Learning must be an active, dynamic
process, where children own their
learning and perceive it as opening
doors to new challenges and
discoveries
 Guided Participation
Children’s cognitive
development is an
apprenticeship. It occurs
through guided participation
in social activity with
companions who support and
stretch children’s
understanding of and skill in
using the tools of culture.”
Barbara
The guide is the Rogoff,
orchestrator and1991
architect of
dynamic learning, designing experiences that
will lead the child to make meaningful
 RDI Dynamic Thinking
Remediation
1. Bio-psycho-social Readiness:
– Body and brain cannot be under stress. They
must be functioning optimally
– Reduce daily environmental stress
– Reduce family stress
2. Customized for unique needs of each child &
parent
3. Carefully evaluating the child’s “zone” of
challenge
4. Long-term emphasis: Marathon not Sprint
5. Providing opportunities throughout the day
for discovery and mastery, through gradual
transfer of ability and responsibility
6. Providing the “cognitive apprentice” with
 The Process of RDI
• Certified RDI Consultants
• Train parents in Guided Participation
• Train other family members and helpers
• Select and train primary school “guides”
• Train school resource teachers, primary
teachers, aides and other staff
• Children take on increasing ownership for their
own progress and growth
• Set up on-line progress-tracking and
communication systems
• Provide a flexible mix of potential daily
experiences that can be customized for each
child
• Use an integrated dynamic/static curriculum in
a developmentally appropriate manner
Gutstein Dynamic Intelligence
Curriculum
• Developmental progression of
objectives for parents and teachers
as well as children
• “Reverse-engineered” into thousands
of very small documentable steps
• Building developmental foundations
• Carefully introducing opportunities
for new cognitive discoveries
• Elaborating discoveries so they
transfer into many areas
 Evaluation of RDI, Study #2

Gutstein, S., Burgess, A. & Montfort, K.

(2007). Evaluation of the Relationship
Development Intervention Program. Autism,
11, 397-412.

•Sample Size = 16
•Treatment Length: Minimum 2 years of RDI
•IQ ranged from 70-124
•Age at RDI start ranged from 21 to 111
months
 Dependent Variables
• Autism Diagnostic Observation Schedules (ADOS)
– Communication Problems
– Social Interaction Problems
• Autism Diagnostic Interview (ADI-R)
– Social Interaction Problems
– Communication Problems
– Repetitive/Restrictive Behavior Problems
• Flexibility & Adaptation
• School Placement
• IQ and ADOS/ADI Change were not
significantly correlated
• Age at Start and ADOS/ADI change were not
significantly correlated
• Amount of behavioral treatment prior to RDI
was not significantly correlated with
improvement
• A negative relationship was found between
amount of behavioral treatment received
during RDI and improvement (-.40
correlation)
 Pre-Post Changes in ADOS
62.5% moved to “Non-Autism” category

14 Pre-RDI

12
13
Post-RDI
10

10
8

Post-RDI Pre-RDI
6
06
4
Post-RDI
Pre-RDI

2 03
Post-RDI Pre-RDI
0
0
Autism Spectrum Non-Autism
 ADOS & ADIR Changes
ADOS Social/Communication: From Mean of 16 to
06
ADIR Social/Communication: From Mean of 31 to
1020
18

16
14

12
Score

Pre-RDI
10
Follow up
8

6
4

2
0
ADOS Comm. & ADI Social ADI Communication
Social
 Changes in educational placement
Initially 7% (1/14) were in mainstream classes
At follow-up, 85% were in mainstream classes
w/o aides
14

12

10

8
Pre-RDI
Follow up
6

0
Special Ed or 1:1 Mainstream w/o aide Home
Aide
Dramatic increase in parents’ perception of their
child’s flexibility and adaptation: From 16 to over
71% of the time