Thursday, December 15, 2011

Theory, Data and Instinct… 3 is not a crowd

The role of each as we help our fellow MAN (not to mention  our children on the Spectrum)
Let me just say I am irritated.  It all started because of facebook ( imagine that!) A friend on facebook posted this article-
and this comment is what sparked this blog post-
"However, oxygen isn’t officially recommended for treating head injuries. And military leaders say they aren’t going to rush to use it for that purpose before it’s vetted."
“We need to base therapies on objective clinical data that cannot be influenced by opinions of people who have benefited,” former Navy Surgeon General Vice Adm. Adam Robinson told Congress in March.
Seriously?   Notice the world officially.  Notice the word Vetted.  Hyperbaric oxygen therapy has been proven to be effective within many conditions, including stroke, cancer and radiation victims.  Lets see,  a stroke impairs neurology…cancer and radiation breaks down the immune system..yet migrains and nerve damage,  we need to see more data?!?!?…which brings me to this article title.  Theory…data…and instinct.  Are we really that paralysed when it comes to common sense?  Here you have our soldiers who have given their service to our country,  wanting relief from this therapy.  Then you have some leaders in the military give the official position that the benefits are not official or vetted ( evaluated).  Notice nowhere in the article do you read that the leaders are like, wow, the theory is sound because the data is sound for other conditions that are related to what you are going through, and more studies are under way… lets help who we can NOW...we do not want you needlessly suffering!  I guess in a better world that would really happen.
When will people who really believe in waiting ( disregarding theory and instinct) understand the stakes?  IS it because it is not them!? Their mother, their child?! Probably,  as I can relate that my thinking IMPROVED once I had to dig deeper to help my children.  Does this general really think it is ok to let these great men and woman suffer as they wait for more official  DATA?  In no other field does logic work this way.  Lets look at  cancer for example, patients are lined up for clinical trials…theory with no data yet.  What have we as a society come too?  IS logic an afterthought?!!    This heavy on data, light on theory mindset needs to end!!  Let face it,  it we use the practice of theory as the framework and data as complimentary, imagine the lives saved, and helped.  Imagine if the makers of cigarettes used theory when making their product??  Common sense tells us blowing smoke in your lungs can t be good!  Look how long that took to reverse !!  Yet, our soldiers need relieve and the data game is being played. 
So what is the comparison between Theory and Data? And where does instinct fall in??  Theory should be the framework, and data is the method that measures the progress of that theory.  Considering data is always years behind actual theories, isn’t it just cruel to say that even though a firm theory is in place to the effectiveness along with preliminary data, we need to wait for empirical Data?  It reminds me of studies coming out now telling us things we already know…. Again years after people were dying from cancer from smoking…oh a study comes out saying smoking causes cancer.  Duh.   Yet,  before we help people with proven therapies,  we need to make sure they “work”. Obviously they do…by single case studies of these men and woman…  Sadly, most intelligent people have caught on that  the politics of science ( not science itself) is a big mess and  certainly when it comes to helping our fellow man or our children,  we are not going to sit around and wait for science to catch up to theory, especially since  other studies that contradict the first studies will come out and then a bunch of guys will sit around and say,  lets do a third study.  Don’t get me wrong,  research and data is important…but data is also subjective and only a part of the puzzle!!!
In my own journey with my 2 sons  and Autism, I have gone back and forth with this topic.
Without going into a huge amount of detail…when deciding what was going to help my own children when I first received the Diagnosis of Autism, I turned to data.  I was fresh faced na├»ve and had some pretty strict guidelines for the route I was going to take for my own children.  Within those few years though,  something happened…and I did not know it then but it would turn my life upside down( not to mention my 2 boys lives!)  But wait  I am getting ahead of myself…
Based on the *data*ONLY,  I chose an intervention for Autism.  When I was looking at options the professionals in this therapy were claiming, “ the only intervention with data behind it” and of course as a parent desperate for answers,  I clung to what * people were saying* to help me in my journey.  Like so many of us, as we gain years of experience in our journey,  we learn a lot…and what I always hope to do is pass on some of this for anyone to mull over as they make their decisions for their family!
This post though,  is really about what took me to the next level.  And that is…understanding why theory is crucial in understanding HOW to help your child with Autism
I believe for me personally, being data driven with how I chose to help my two sons, crippled me in not having a structure on an overall program for my kids. Theory provides the framework for structure..and I honestly knew nothing about the theory behind the intervention I was doing with my then 6 and 2 year old..I was just told that this is what you do with children with Autism, and that studies show it is effective.
See here is the thing…that was fine by me,  until my then 3 year old was making NO progress with all the help he was receiving!  … Tears and more tears….as the doctors words kept ringing in my ears, Severe infantile Autism, he’ll never talk, institutionalize him, etc etc.  This changed the game for me, and because of this game changer, my son, who is 10 now, does not have those core deficits of Autism!  How did he get there?  With a cutting edge therapy that at the time was a new kid on the block.  I made a decision to drive a few states away to attend a conference, listened to THEORY,  and from that theory understood what was lacking in my sons program that was desperately needed!  Came home and started to apply some of the theoretical strategies, and …a huge difference.  This was almost 7 years ago.  So much has happened in the field of Autism since then….the understanding of what is helpful, what the DATA actually says for long term results ( instead of short term skills) and the choice that we as parents should be able to make accordingly with our children.  Understanding theory behind this developmental approach made me look at the *theory* behind behaviorism/conditioning ( ABA/the first therapy we used and left)…and  I encourage you to look up skinner and Pavlov…their theories..their goals for children if you are a parent with a child on the spectrum.  Compare those men’s theories with  Vygotsky, and piaget.( More of the background towards RDI, Relationship development intervention)
BUT let me get to my point!  All these men…and theories..they all have a place in history.  This tug of war between implementing something that works  ( according to preliminary data or waiting until there is sufficient empirical * data* does not take into account PEOPLE!  Yes,  if I LISTENED to all who told me there was no data supporting my choice of intervention years ago ( switching from ABA to RDI),  even though there were preliminary studies and theory, my two children would be very different today.   The Data that I was given for ABA,  is data that is short term studies for skills, is fine for skills, but I want a thinking, social child...and now data shows conditioning is ineffective in long term success of social understanding.  THIS is why it is crucial to look at theory as the framework, Listen to your instinct,  and use data as the complimentary method to pinpoint specific targets within theory.
I really should not be surprised by this utter lack of sense when ignoring theory and instinct when it comes to addressing injuries.  What I am surprised at is that any leader can watch their *men* suffer and say, sorry,  there is not *enough* “Official” data.
I have dealt with this before with an agency regarding Autism…to which I wrote this email ( slightly changed to create a post from it)

 I learned a huge lesson these past 8 years…data will catch up to theory…but my children were too precious to wait…with valuable time lost if I had. My intuition told me my kids were worth it!!  It would not be the first time our kids showed us that the data is secondary!!  A few science driven doctors told me the poor prognosis for my sons...well,  they were wrong.  I am not alone.  Many in the community of Autism know that cutting edge therapies and bio medical treatments are effective for our children...and we will not wait to help them. 

In this same aspect, as I relate the article I read…Aren’t the men and woman in our military deserving of effective interventions that is based on theory and preliminary data!?  Time is too short to wait for them too!!
Kathy

Wednesday, November 16, 2011

The Son-rise Program compared to RDI

 If you have asked the question,  what is the difference between The Son-rise program and RDI, and have found your way here, I hope that this information is helpful to you. 
 The reason I am writing this is because even though The Son-rise  Program acknowledges that  RDI has some similarities on their site,  there is a lot of misinformation that they are promoting as RDI. You can check out their page here-  http://www.autismtreatmentcenter.org/contents/other_sections/floortime-rdi-son-rise-program.php  Yes,  RDI, The Son-rise program and Floortime all acknowledge relationships as a crucial backdrop to the ultimate success of our children.  After that fact, all three take different, unique approaches.  Both Son-rise and Floortime are child led,  whereas RDI is guide led, with the focus on promoting Dynamic intelligence.  The focus begins with relationships, but taking it that step further for the building blocks of understanding perspective and critical thinking as shown by typical children,  is what makes RDI so effective In assisting our children to catch up to their peers on all levels of intelligence ( social and IQ) therefore fulfilling their true potential! click here for more information  http://www.rdiconnect.com/pages/Our-Programs.aspx
 I respect any parent’s choice and want to give a parent correct information… to make an informed decision. As I stated,  this is the purpose for writing this, since I am  a parent who took both her children Through RDI as well as a RDI certified Consultant.  As a side note,  there are many misrepresentations regarding Floortime in this comparison, but that will need to be for another day J  When I discovered the incorrect information on the Autism treatment of America site,  I did email Mr Kaufman.   I asked for Mr. Kaufman to correct the information he has on RDI on his website which to date he has not.  In addition,   I volunteered to have us both collaborate on a comparison which was also declined.  For this reason I stayed with the basic comparison from the Son-rise site, as with comparisons I like to have a well balanced view from both parties.  With that said, please keep in mind there are many more differences and I welcome your questions or comments. RDI4Autism@gmail.com 


Repetitive “Stimming” Behaviors
RDI
The Son-Rise Program
  RDI uses natural authentic activities to create a beautiful dance of Co regulation between parent and child. Central to RDI is the belief that our children want to interact but do not know how to be an apprentice to our guidance.  RDI fosters safety for our children by the assurance that we, as their guide hold the answers to their confusion, therefore creating resilience and competency in mutual engagement.  Parental or support guidance is dependent on what developmental milestone are being addressed 
Advocates “joining”, which means entering the child’s world by enthusiastically participating in their repetitive behavior until the child interacts of their own volition. This is seen as central to creating a willing interpersonal connection.
                   MORE RDI
RDI advocates joining a child in their interactions.  We believe there are many ways to join, focusing on one method called Guided Participation. http://www.education.com/reference/article/guided-participation/ Parent based, guide lead does not mean that we do not foster the mutual interaction and ideas of interaction presented by our children. Quite the opposite. This of course is central to any relationships. Parents learn how to influence their children for discoveries. The specific difference between joining in The sonrise terms compared to RDI is RDI equips our children through an  authentic mutual engagement rather than trying to get an action by following along or the reward of entertainment.  As their Guide in RDI, we reach into the child's world through many different avenues, not just one as with the Sonrise program. This process streamlines joint attention ( as we believe  children crave OUR guidance), therefore affording our children a second chance to gain those missed milestones. We believe our children can succeed if given a do over in a more slow, deliberate fashion.



Repetitive “Stimming” Behaviors
RDI
The Son-Rise Program
TRUE or FALSE? Neither stops nor joins the child.   FALSE.

TRUE RDI
RDI joins the child as their guide, equipping the child with a role that they feel competent in  to move forward on a joint attention level/  Mutual connecting.  RDI follows the example of typical development in increasing competency for our children, therefore reducing their need to withdraw or escape through self stimulatory behaviors.  We all have participated in self stimulatory behavior at one time or another ( twirling hair, banging a pencil)  RDI believes in reaching in to the child’s world , just as a friend tapping their pencil when you start would get your attention,  and then guiding the attention to an authentic joint  relationship that is based on the very basic Me/you/us foundation ( In psychology this is referred to as the intersubjective relationship). http://psychology.wikia.com/wiki/Intersubjectivity
Advocates "joining", as explained above.


                     MORE  RDI
Here is an 1 example of the difference. Please feel free to contact me if you would like more examples. Your child is stimming. You are sitting on the floor next to your child.  In both cases your child feels your presence.  With the Sonrise program, you are to join your child in their stim, for however long that is and celebrate any eye contact, etc. With this process you are following your child, and may be joining in with them for months.  With RDI, the guide, making sure that they are close to their child ( the zone of connection) along with keeping in mind ( The zone of proximal development) http://psychology.about.com/od/zindex/g/zone-proximal.htm  which will gives the child a role that they can be successful in and not want to withdraw from their guide. This is an effective process to draw your child instantly  into a social relationship.  These start out small with very simple co regulatory actions, that could begin with joining a child in their action..moving that to a joint attention activity,  to more advanced actions always just one step ahead of the childs development to ensure that developmental prerequisites are being addressed.  AN example of this would be if a child is stimming within his speech, We will join in with that conversation, guide the conversation to a joint collaberative conversation that promotes thinking, and guide the child to understand the thrill of our Mutual engagement. This system (Guide led) is very precise compared to The Sonrise program where they are waiting for a child to respond positively.   The Sonrise Program does advocate following along in every self stim behavioral ( hand flapping, jumping up and down, etc)  RDI acknowledges for some behaviors that may be counter productive  where the child is in obvious fight or flight mode or there are more reliable ways to reach the child.  In addition, many parents struggle with stimming along with their child for hours, days, weeks, months, waiting for a response.  Within RDI, children respond positively sooner as they grow in certainty that they will not be overwhelmed.  This is just one of the many reasons RDI is so unique and effective in approach.



Red and Green Lights: The Exclusive/Interactive Continuum
Floortime/DIR and RDI
The Son-Rise Program
TRUE or FALSE? Seeks the child’s interaction regardless of the child’s “state.” Facilitators are taught to look for opportunities to create and build interaction as much as possible.  FALSE
TRUE RDI
 We are looking for opportunities to build Dynamic intelligence.  The description above from the Sonrise site is incorrect and misleading.  For a description of DI please click here   http://www.rdiconnect.com/pages/Dynamic-Education-Program.aspx
When a child is in a disregulated state, RDI believes they are then in fight or flight mode because of the unproductive uncertainity that is surrounding them.  This is a core reason that one of the foundations within the RDI program is to recognize this state, and how to co regulate with your child to bring him/her out of fight or flight mode.  This can be one of the reasons that a child is using self stimulatory behavior as a calming mechanism.  We want them to use our perspective, social referencing, and our joint attention as a calming mechanism.  Think of a typically developing baby who has learned to borrow their parents/guides perspective An example of this is here-http://www.youtube.com/watch?v=p6cqNhHrMJA
Teaches how to see, in each moment, where a child is on a continuum - from exclusive/in their own world (red lights) to interactive (green lights). During red lights, children are joined in their world. Teaching and challenging happens only when the child is giving a green light.

  RDI

What is productive vs unproductive uncertainity?  Click  here for a delightful example http://intentionalparents.com/tag/productive-uncertainty/
Making it more personal. Think of a time in your life where you were excited about tackling a job or task.  You had just enough support to productively manage any uncertainty that may happen.  Now think about the times in your life where the well planned event or task took a turn and a few things started going wrong, (murphy’s law, etc)  Depending on the degree of disaster J typically we can all keep it together until that final straw that broke the camels back.  Then we slip into Unproductive uncertainty.  We cant think straight, everything is jumbled, we just want to escape!! We have limited ability to manage all that is going on so we our body’s response to protect itself is fight or flight mode.  Our children with Autism are in this mode more often than not.  By our guidance, we are able to turn the tables on their Unproductive uncertainty by again being their guide OUT!  RDI consultants guide parents on strategies to help regulate their child back into productive uncertainty for maximizing learning throughout the day.



Celebration of the Child
RDI
The Son-Rise Program
TRUE or FALSE?  Does not believe in big celebrations of the child (particularly with regard to eye contact) because of a concern about doing anything which might be construed as ABA-type behavior-shaping reinforcement, which is seen as bleeding social interaction of most of its humanity. When the child engages in some way, the facilitator either remains silent or “spotlights” what the child did in a low-key manner
FALSE
TRUE RDI
Im not even sure where to start here!  This is incorrect.  Since RDI is based on typical development, of course we believe in celebrating with our children.  We also certainly would not do something because of fear of looking like ABA.  I’m not even sure what that means?  To separate RDI and ABA,  one only needs to research the different philosophies of Behavioral conditioning vs the cognitive revolution/the role of intersubjectivity in how we think and therefore act.  RDI is heavy on thinking as represented in  the focus of developing Dynamic intelligence.  The core deficits of Autism show that dynamic intelligence is an obstacle for every child on the spectrum. We do spotlight our children’s victories but there is nothing low key about creating experience based memories.
Sees another way forward with a different kind of huge celebration which adds humanity. Celebrates eye contact, communication, flexibility, and engagement as magnificent and meaningful steps toward the world of others. Uses celebration to express a deep sense of gratitude that the child can understand, enhancing closeness and social engagement.

   MORE on RDI
RDI believes in celebrating with the child in many different ways.  Central to this celebration is making sure we do not rob our child from the competence they feel in an authentic activity by overwhelming them with over stimuli.  An example of this is you and your child are involved in playing or any joint activity.  Using the one step ahead model, they are able to think of the next step ( with your guidance), safely knowing you are their guide and they can borrow your perspective. Spotlighting their success by highlighting the experience seeking and.or sharing that has occurred, you both share those moments of success.  This spotlighting, encodes the positive memory as *US* and builds upon the next step of success.  RDI celebrates Every aspect of an interaction.  We celebrate things like eye contact, etc without calling attention to the action.  Instead we call attention to what is gained in higher level memory building by *looking*.  This helps our kids understand that we are celebrating *why* they knew to look at us.  This way,  developmentally,  the child remembers the success of the action ( what they learned by looking) compared to being rewarded by entertainment because they * looked*.  This overstimulation can be overwhelming to a child but more importantly diverts their memory encoding from their success to now being entertained by the adult for *eye contact*, etc.  This can be confusing to the child in what to actually pay attention too. Think of your own life…  You want to celebrate but in a normalizing way, with plenty of experience sharing and encouragement, not just alot of noise!!  This is overwhelming for most people, let alone children with fragile systems.   The sonrise program does celebrate with children for specific things they are looking for with a lot of bells and whistles and noise. This is the teaching method ( energy,excitement,enthusiam). This first video is how we as parents are supposed to prepare for working with our children according to The Son-rise program 
http://www.youtube.com/user/autismtreatment#p/u/130/-DX3dIz0qpo   
This second video is trying to divert their child's attention to wanting pancakes.  You will see that the adult is doing all the work in the interaction while the child (played by the adult) is being entertained.  The adult is using alot of language and actions and the entire activity is very fast paced.  http://www.youtube.com/watch?v=JKBL42muGkI&feature=relmfu

This can be overwhelming for our children and with the delicate state we want to give them every opportunity to effectively celebrate with them and make sure THEIR success and THEIR discovery stays with them!  ( using more non verbals, slowing our pace, thinking language compared to chatter)

This second video is a therapist trying to get a child to look at them ( role play). http://www.youtube.com/watch?v=Mm746gSqwo8&feature=related
 There is no authentic reason to look other then for entertainment purposes. This is sweet and fun, and can be incorporated as play,  but does little to build a childs true dynamic intelligence.  The goal in this video is to manipulate the child to look...Not because of social referencing, but because of entertainment. Remember the visual cliff video!  We want social referenced to emerge through dependable developmental channels the same way typical children learn to *borrow perspective*.



The Importance of Attitude
Floortime/DIR and RDI
The Son-Rise Program
TRUE or FALSE? Values attitude, but does not make it central to every aspect of program implementation.. FALSE
TRUE RDI
RDI’s focus is on the Guide apprentice model to focus on trust.
This focuses on the safety and trust between parent and child for a  developmental approach that is non judgemental and welcoming. As parents we love our children and RDI has a high rate of parents who in turn become RDI consultants, sharing the feeling of being empowered with other families! In addition RDI believes that our competence as a parent can be compromised because of Autism.  Our children are not responding and so we feel like we are doing all the work just to get some sort of response from our child.  RDI has two programs going and are complimentary to one another.  We have the parent program of objectives where the focus is restoring that trust in your style of parenting ( Autism is NOT your fault).  Parent objectives help you to go through your day and determine when you can implement RDI into authentic activities ( making it less stressful since you do not have to be in a room, away from other family members and children for large periods of time).  The most effective treatment for Autism is when it can be part of your lifestyle in home and the community.  This maximizes results!  The parent objectives guide the parent through every aspect of education, readiness and guiding,  along with attitude.  The child objectives guides the child through typical developmental milestones.  This simultaneous, complimentary method is a constant source of encouragement for the entire family..so yes,  attitude is valued in every aspect!


Sees attitude as vitally important, since having a non-judgmental and welcoming attitude determines whether the child feels safe and relaxed enough to interact and learn. It also determines whether parents stick with a program.


RDI sample objectives ( taken from Dr Steven Gutstein’s Dynamic curriculum

Guide/parent objective
Leading through influence and not control
Healthy and unhealthy dialogues (Attitude)
Participating in a static dialogue that has unwittingly become a "lose-lose" script resulting in a negative experience for both participants (e.g. "Letting you bug me until I lose my temper."), or at least for one (e.g. "I allow you to wear me down once again until I give in").
  • Distinguish between actions children take to temporarily regroup and cope with stress and actions that indicate a complete withdrawal and disengagement from you.


Student/child objective-
 Level one approximate developmental age 6-12 months of age
Experience seeking
Challenge and novelty-
 Demonstrates clear preference for activities where guides add small, ongoing, but logical variations, when allowed to assume a competent co-regulatory role.
Perspective widening objectives
  • Motivated to engage with novel, but safe stimuli from multiple physical and sensory perspectives.
  • When in new situations perceived as safe, seeks out different  perspectives (e.g. Adjusting  position, moving closer, farther away manipulating objects and other forms of deliberate, meaningful exploration).

RDI wants to equip families to remediate their childs Autism according to typical development.  There are many interventions that look at a child and want to try and bring them out of Autism through a different plan.  However,  we believe that  the most effective, and true to families and children, is giving families and children a second chance.    This is why RDI is based on the Guide model, believing that  our children can indeed be effective guided just as their Neuro typical peers!  Check out this paragraph from Dr Gutstein in reference to  this revolutionary belief in our children..that THEY can be successful right from the start!
Guides make ongoing, as-needed adjustments and revisions to maintain an optimal state of challenge and provide a "safe landing," if the Apprentice does not experience success when taking steps into the unknown. Guides seek to remain on or near a dynamically changing edge of competence: Too low and the child's existing neural pathways will handle the problem. Too high and the brain will move into avoidance or withdrawal mode-  Dr Gutstein
RDI believes the parents are the most effective therapists for their children, and is the only program that has a online system equipped with developmental milestones from typical development for the parents to feel empowered by this information that they can fill in their child’s milestones missed the first time because of the effects of Autism.  RDI consultants provide constant support to families through the online system along with meetings, skype, etc.  RDI does not require the parent to attend a workshop and then give them a packet of information to implement a program at home.  We are a fully supportive program where the parent has access to the consultant as well as a huge community of parents also doing the RDI program at their fingertips.  In addition,  there are webinars and discussions that are education opportunities.  There is no other program that has this level of support.  I have noted on the Son-rise website, because of the incredible support system that RDI provides,  The sonrise program is looking to mirror some of what RDI does in 2012, according to their website. http://www.autismtreatmentcenter.org/document.php?sectionid=6&documentid=59&/index.php   This continues to show me that RDI is revoluntary in helping our children and the trendsetter for our children, believing in them and knowing that with guidance and support, Autism no longer has the grip it once did. There are RDI certified consultants in just about every state in the US and abroad. Click here to find a consultant in your area http://www.rdiconnect.com/pages/Find-a-Consultant.aspx …and start guiding your child out of Autism.

Comparing static and dynamic intelligence

Below is a chart that outlines static and dynamic intelligence.

Static thinking is what you know. For example, formulas, procedures (like following a recipe), memorized information (like multiplication tables), habits and routine. You will note that much of the static column is what comes easier for our children because of the effects of Autism on their neurology. The Dynamic column is what so many of our children struggle with. Dynamic thinking involves flexible thinking, experience sharing communication, appraisal and self-awareness. When we deliberate, reflect, worry, hypothesize, daydream, and improvise we are using our Dynamic intelligence






AREA
STATIC INTELLIGENCE
(Static Abilities)
DYNAMIC
INTELLIGENCE
(Dynamic Disabilities)
Thinking and Problem Solving (Cognition)
Associative
Black & White
Detail Analysis
Parts – to – whole
Procedural
Rule-based thinking
Alternative thinking
Critical thinking
Good enough thinking
Grey area thinking (fuzzy logic)
Hypothetical (“what if”)
Improvisational thinking
Reflection
Simultaneous processing
Social & Communication
Desire
Language
Questioning
Requesting
Responding
Scripting
Social Rules
Collaborating
Co-creating
Empathizing
Multi-Channel communication
Perspective taking
Regulating & Repairing
Self
Compliance
Self-description
Self-recognition
Needs
Desires
Preferences

Emotional regulation
Goal-setting
Planning, preparing, previewing
Self-efficacy, resilience
Self-evaluating
Troubleshooting




So how does struggling with Dynamic thinking impact learning? Being able to relate to others is at the core of HOW we learn. Babies have thousands of hours practice in the social and emotional back and forth between themselves and their parents. Children with Autism do not have this chance unless we specifically create for them a deliberate way to revisit what they missed the first time.

Without this opportunity to restore their developmental path, we are fostering use of static thinking only and therefore not preparing our children to a higher quality of life that is possible for them.

Comparing RDI and ABA, as told by a behaviorist

ABA/ RDI A professional comparison Therapy vs. RDI Life Style by Chrissy Poulton   MA ( Masters in ABA)


Typically with ABA parents hire a staff to work with their child. These therapists work with the child during scheduled therapy times. If parents work with their child, they need to set a side therapy time & typically a therapy room is required.

RDI

RDI is a parent based program & is not typically done at specific “therapy times.” RDI is considered a life style program because instead of adding therapy time to a parents already hectic & full day, it is incorporated into what parent have to or want to do in their typical day. RDI can be done anywhere in or out of the house, although at first an environment should be removed of as many unnecessary distractions as possible so the child and parent relationship will be central, ultimately no special rooms or environment is needed.

Parents as therapists vs. Parents as guides

ABA

Depending on the ABA program parents may or may not receive parent training. Assuming they do however, the training consists of teaching the parents how to be therapists to their child. They are taught behavior principles, such as extinction, reinforcement, chaining, shaping, prompting, etc. They are taught to interact with their child the way a therapist would.

RDI

Parents are the primary agents for change and do not take on a therapist role, but rather maintain their role as parent. The role of any parent whether they have a child with ASD or not is to guide there cognitive growth. RDI is not asking the parent to change from the job of a typical parent, however, it is slowing down the entire process to afford the child a re-do on the developmental stages they missed. The role of an RDI consultant is to help the parents in the how-to of re-establish a reliable feedback system that exists between neurotypical children and their parents.

Under some circumstances children may have other guides in addition to their parents. These people are called “extenders” because they “extend” the work being done by the parents. One example of when an extender is needed is when a child attends school. A child in school will need an extender to help create an environment that doesn’t just meet academic and classroom management needs but ensures that the child is provided with opportunities to incorporate their developmental goals as well.

Static vs. Dynamic Thinking

ABA

Just by the way ABA is structured promotes static thinking which you could also think of as black and white thinking.

There are correct answers and there are incorrect answers just as there are appropriate behaviors and inappropriate behaviors. This type of teaching actually works quite well for individuals with ASD in teaching static skills as the ASD brain is extremely good at learning Black & White rules, scripts, and answers. However, this is actually reinforcing static neurological pathways in the brain and therefore, individuals on the spectrum become rigid and inflexible in their thinking and they do not develop the ability to think dynamically or understand that in real life problems for the majority of the time do not have black and white answers and tend to fall into more of what is commonly referred to as “grey areas.”

ABA attempts to “generalize” black + white answers to more grey areas but this is often difficult as they static pathways they are creating are difficult to change. A child taught to answer “I’m ok” to being asked “How are you?” who is then asked to used generalized versions of this answer such as “Good” or “Fine” can do so but often replaces he answer “I’m ok” with one of the other options thinking “good” is the new “correct” answer instead of using “I’m ok”, “Good” and “Fine” interchangeably as hoped.

RDI

Because RDI is not a skill based program, it does not place the same emphasis on “correct” answers. Its focus is more about developing the dynamic function of the brain & the individual with ASD’s ability to think like their guides. So for example, if you think about the question “where is the right place for a

box of cereal to go in the cabinet?” The person with ASD learns with the aide of their guide that there are many “correct” places, although some may be better or worse than others, for the cereal to go. It is in many such experiences with a guide that the individual with ASD will discover how to make “good enough” choices to “grey area” problems.

Lacking Skills vs. Developmental Gaps

ABA

ABA would access a child to determine what skills they lack and then teach to fill in these skill areas. For example, if a child was not pointing and labeling objects, a “labels” program would be implemented. Likewise, if a child could not cut on a line, a “cutting” program would be implemented. Whatever skill deficit there is, a program would be created to address this skill.

RDI

RDI is not against skills as everyone needs to learn what objects in their environment are called as well as how to cut.

However, RDI follows typical development to determine developmentally appropriate objectives for each individual on the spectrum. If a person is able to re-do missed developmental milestones, catching up on skills will not take long, however the reverse is not true. Being able to cut does not guarantee you will be able to understand the perspective of another person.

Below is a list of critical developmental milestones from birth to five. What I hope you will see are not of these are “skills” that ABA teaches or that can be taught in a skill acquisition approach. These are developmental milestones and no amount of skills can replace or compensate for these developmental foundations. These are the foundations upon which meaningful cognitive, communication, social and behavioral development is built.

1. Learns that actions can be coordinated with others, but not controlled by them; and that coordinating actions with others is better than acting alone.

2. Repairs breakdowns in coordination with partners

3. Interprets and uses non verbal communication to have meaningful exchanges with partners, including facial expression, gestures, and voice

4. Communicates with partners mainly for sharing experiences and learning about how others interpret the world

5. Monitors interactions to ensure partners have understood what has been communicated

6. Enjoys being with partners that change their actions and routines; does not like doing the same thing over and over again

7. Takes turns appropriately and at the correct time in a wide variety of interactions

8. Understand that perception is dependent on position and person’s unique experiences

9. Recognizes that everyone can have different perceptions of the same item or event, and that all perceptions are equally important

10. Pretends on his/her own with a partner, and can coordinate his/her imagination with partner’s imagination

11. Understands that friendship is consensual, acknowledges others’ similarities and differences and desires to be liked and accepted

12. Develops more than one solution to a problem, and more than one way to approach tasks

13. Thinks about actions before taking them, and can determine what actions are appropriate for the current setting

14. Understands teasing, offers of support, and degrees of agreement

15. Accurately interprets when others are upset, as well as regulates the degree of emotion tied to different experiences

16. Transitions with little preparation

17. Carries out familiar routines and tasks from memory

18. Uses the knowledge of negative consequences to adjust behavior

19. Takes pride in accomplishing challenging task

20. Understand and regulates own emotions based on the current situations, and recognizes that others may have

similar or different reactions to an event based on their personal experiences

Instruction vs. Fostering Opportunities

ABA

Since ABA is a behavioral program and focuses on skill acquisition and changing behavior, “getting the child” to learn a new behavior or cease to do an inappropriate behavior is key. There are many methods at the disposal of an ABA therapist to make this happen such as rewards and prompts.

RDI

The goal of RDI is for the child to make their own discoveries and progress in filling in developmental gaps. The focus is not on “getting the child” to do anything. This does not mean that the child can choose to walk away from the parent, it just means that a parent can’t make the child learn something, they can only set the stage for the learning to occur. The focus is on providing opportunities for the child to make discoveries. At the same time, parents provide the appropriate level of support and of challenge. The goal here is for the child to learn to think not just elicit a behavior. There may be times that the child does not discover or learn anything new because you can’t “make” someone learn something, but through repeated opportunities presented by the parents they are increasing the chances for discoveries to happen.

Behavioral Disorder vs. Underconnectivity of the Brain

ABA

ABA classifies Autism as a behavioral disorder and as such it is treated by increasing the frequency of some behaviors and decreasing the frequency of others.

RDI

RDI classifies Autism as a Neurological disorder that manifests itself in the underconnectivity of the brain. As such,

this underconnectivity is treated by helping the individual with ASD develop these unconnected areas of the brain by building new connections through well choreographed interactions between child and parent.

Good ABA/ Bad ABA

Some people will argue that those people who do not or did not see changes with their children had a bad ABA program. Speaking from personal experience, I was a FABULOUS ABA therapist and I have videos to prove it. The problem isn’t the therapist, it’s the therapy. ABA does what is what designed to do…change behavior. It was not designed to foster dynamic thinking, episodic memory, flexible thinking, problem solving, or re-do missed developmental stages. Therefore, good ABA vs Bad ABA is a mute point because it has limitations and can only do what it was design to do.

Old ABA/ New ABA

Some people will say that there is a difference between old ABA and new ABA. Old ABA used discrete trials, new ABA doesn’t. Old ABA is done in a therapy room, new ABA is done in the natural environment. The thing is however, that Old and New ABA are both based on the work of Skinner. Skinner’s work has not changed and neither has the INTENT of ABA. Just because the teaching method might change or where ABA is conducted may change, the intent has not changed. The intent is still to increase or decrease the likelihood of a behavior. It still does not focus of cognition or thought.