Friday, August 17, 2012

The true value of our attitude

Attitude is a little thing that makes a big difference. ~Winston Churchill

Wherever you go, no matter what the weather, always bring your own sunshine. ~Anthony J. D'Angelo, The College Blue Book

From the Son-Rise website- RDI Values attitude, but does not make it central to every aspect of program implementation..
True or False?

From the Son-Rise Manual- Be loving and accepting- The attitude of love and acceptance is the foundation upon which all interactions and programs are built.

Kathy, I am fairly certain that you would agree that an attitude of love and acceptance would likely be viewed by the consensus of parents to be a part of being a parent- and yes, love is a foundation of the interactions a parent and child have and strive to have. The love is there intuitively and wholly. Acceptance may ‘feel’ difficult at times, as when the word autism comes into play, life can feel so scary. Acceptance may not be the first thing that comes to mind. How can I accept what I am afraid of? How can I accept what I don’t understand? How can I accept not know how this ‘label’ will affect my child and my family? These thoughts and feelings can lead to internal chaos. Striving only for acceptance is not going to change the genuine inquiries and realities of what this disorder is, what it will mean for you and your family and how to effectively treat it. Love and acceptance-while healthy and good, are not impactful on the process of typical cognitive development itself. Are these things that you have thought and felt along the journey with your children?

So the question is, where do the qualities of love and acceptance fit healthfully and genuinely into the process of learning about and treating autism? Love your child. Love and accept that learning about autism and learning about your child is going to be a process- a process worth appreciating and deliberately seeking. One cannot effectively treat what they aren’t able to clearly identify. Strive to understand your child as a person. Learn about autism in terms of its core. Learn not only about the symptoms that you are seeing, but about the root of where those symptoms are coming from. Learn about typical development. Learn to separate what is ‘autism’ vs. what is my child being a child- being him or herself as a person with a personality? Evaluate programs that address these root issues-choose programs that define and treat autism accurately based on its roots, not on observable behavior alone.

Kim I so remember years ago when I was beginning this journey of remediation, I read many books on development so I could understand that process. I think very intuitively, we as parents have an extraordinary ability to love and accept, and that intuitive process is very natural. Acceptance really gets put to the test when Autism enters the picture. We love our kids, and we accept our kids....but accepting Autism is more of a struggle. That lack of feedback we receive, cuts us to core. This is ok, because we can accept Autism, but as parents, we can also feel empowered that through acceptance comes a clear vision on how to accept, yet provide vast opportunity for our kids to overcome any obstacles that Autism presents them with. Addressing these obstacles doe not mean there is lack of acceptance. Our kids need our help, our guidance. They depend on our wisdom. In typical development, children younger then 12 months of age borrow our perspective. For this reason it is ok to accept where our children are, and at the same time, know how to effectively help them overcome any obstacle from Autism.

So it appears that we both agree that love and acceptance are healthy and good which of course makes Attitude central to our interactions and relationships. For this reason, it is more accurate to say that RDi values Attitude, in every aspect of program implementation, while understanding the many other factors that Autism presents. Without that understanding, a parent could think that their child is not responding solely on the basis of their Attitude not being good enough. I can tell you I had some really bad days with my acceptance, my attitude was poor some of the time...They were far and few between, but even in my very raw human state, progress was being made because I was addressing their core deficits , I knew my child and I knew that for those times I was scared, my boys were even more scared...because life was scary for them! In many ways, we became competent they became more resilient to my guidance, I became more confident in what I was doing for and with them It was an incredible experience.

Kathy, you inspire me greatly. You have embraced the process described above and have come so far. I am looking forward to learning more about your journey...

Thanks Kim! ANd what a process is was. Sometimes I went kicking and screaming and sometimes I had to just slow down and wait, let me change that...what a process IT IS! Ongoing for sure...and of course bringing my kids through remediation, was the realistic attitude through the mountaintop experiences, and the valleys. Central in all was attitude..and so much more!

From the Son-Rise website- RDI Values attitude, but does not make it central to every aspect of program implementation.. 
 The answer is   FALSE

For  more comparisons please Click here

RDI Compared to the Son-Rise Program

Welcome to our first installment of our series helping to answer the question you may be asking...what is RDI? For this particular series, we will be comparing some of RDI’s foundations with those of the Son- Rise program, This idea emerged due to the fact that the Son- Rise program referred to and compared the RDI program on their site, but did not accurately describe or be clear about the RDI program .Our goal here is to give parents an accurate description and comparison for them to make their own informed choice.  Each cornerstone, Kim Isaac,M.S., autism specialist and RDI consultant from Arizona and Kathy Darrow, Autism Specialist,parent of two children who were diagnosed with autism and RDI certified consultant, New Jersey, will discuss between themselves, for you the readers, the importance of developmental guidance, while addressing some comparisons between RDI program goals and the Son-Rise program. Read and reflect on our conversation.. We welcome comments and feedback!! My color in the conversation will be Purple and Kim’s will be PINK.

For a description on The SOn-rise program,  click here
For a description of Relationship Development Intervention
Click here

Hi Kim, I want to say first off that I’m really happy to be able to go through this with you for anyone who is reading this information for a clearer understanding of what RDI is along with the comparison between The Son-rise program and RDI. There may be some specific differences between RDI and The Son- Rise program, as there are also similarities. Imagine my surprise when I saw on their site some misleading statements about  RDI.

So as a parent and professional, I believe when we explore options with comparisons we can make the most informed choice. Parents are the best ones to make the choice for their family This is why, along with addressing the false statements on the Son Rise Site, we will be reviewing their cornerstones as taken right the Son- Rise Manual. For myself, and Kim I know for you, This question is becoming more frequent, One of the questions I was asked when I spoke at Autism One was what is the difference between RDI and Floortime. I believe this is a valid question and one I asked myself when I was exploring what I needed to do for my kids. For me, comparing therapies are not fighting words, they are empowering words so that families can get the best fit!!! WIth that said I hope that anyone reading this can take away the positive message of comparison for clarity!

Let’s begin by talking about what child development is... what Autism is and how RDI bridges the two by addressing typical development. Typical development...something that most of us take for granted until it does not unfold ...well...typically. I remember with my firstborn, I could not wait for that moment, around 4 weeks old that there was the recognition...that hey, you are someone important to me!! Without any words, just through the eyes, there was a connection...based on experience ( you answer me when I cry, you comfort me when I am upset) At just a few weeks, the back and forth relationship has begun. For the infant, this is when learning begins, through their parents, their guide in the world that is huge to them. We as parents, break down each interaction on their level, because when we don’t, we see that they become overwhelmed. We match our actions to their actions. When we talk to them we do not talk in complex sentences, but we simplify. We slow things down for them, we slow down the pace of what we are doing. We play games like Peek a boo which shows them that we are there, and then we are gone! This helps them to learn about their environment, through our eyes. This helps them to see that there is a pattern in our interaction. We wait for them to take an action to our action, and this is how they learn the back and forth of reciprocal relationships. The first two years of life is rich in learning...

It is no surprise that at around 1-3 years of age, we begin to see the effects of the lack of development in children, demonstrated by their lack of engagement, who eventually are dx with autism.. With children who regress, they may have some of the milestones in place and then lose them. due to different factors n individual with Autism can have many different factors. There is regressive Autism and infantile Autism. There can be genetics involved, environmental causes, or both.

The issue for our children then becomes, how do we effectively help them regain what did not develop or was lost? Do we just take a 3 year old and start teaching them what we want them to learn or do with no account for what they missed out on developmentally? Do we teach them how to behave even though they still do not understand the back and forth experience sharing that gives them the motivation to interact based on relationship understanding? I know for meaningful long term success, true meaningful engagement must be obtained meaning milestones must be addressed .A huge part in knowing how to address the core of what our kids are struggling with, is to understand what Autism is.

So what is autism? Every time I am asked this question, I experience the internal ‘gasp’ or pause. It is quite a complicated disorder. A disorder that goes past what the eye can see. Autism is often described as a behavioral disorder or a communication disorder, While clearly, there ar observable behaviors noted from an individual on the spectrum, autism is neither of these.  Autism is a developmental disorder, a disorder reflective of lack of neural development in the brain. Observable behaviors are reflective of mental processes and should not be evaluated or treated as behavior alone.
One cannot treat a disorder accurately and effectively if one cannot define what they are treating clearly . For this reason, in addition to helping a child with their behaviors, or medical conditions additionally present with autism, RDI considers the core reasons behind the behaviors in relation to developmental science. This goes deeper than just looking at what happened before the behavior or the behavior itself. But, what is development exactly? Development is a word that professionals from many different fields use and may have a different meaning or association to each person. So let’s examine this so that we are all reflecting with the same definition as it applies to human development. The general consensus of what development is amongst teachers, psychologists, therapists and physicians is agreed on as: the various stages of physical, social, and psychological growth that occur from birth through young adulthood.

It’s true Kim, development as it applies to humans is what we are looking at…What we do know, is that even though every person with Autism is different in how they present, yet they all have the same core deficits ( in development) with Experience sharing , flexibility, communication, self awareness, and episodic memory. These milestones start emerging in typical development in the early months. For this reason, it makes sense to use the model of typical development as a tool to help our children with Autism. Our children with Autism need a guide, someone who can lead them, otherwise how will they know what is the right thing? We want our kids to be decision makers, being able to pick up the social cues from the environment within each decision they make. We want them to have healthy boundaries, which a guide ( the parent or caregiver) can lead them with.

RDI is a developmental model that uses typical development as its *mirror*...taking the guiding relationship, and restoring this intuitive process within parents to restore their (child’s) developmental milestones. An RDI program takes a family step by step through the process of a developmental *re do*

WIth this review of what typical development is, what Autism is and what RDI is, in our next post we will be taking a look  at one of the statements on the Son-Rise site about RDI along with one cornerstone that The Son Rise program mentions in their manual.

What is RDI ( Relationship Development Intervention)

RDI Connect

Relationship Development Intervention is based on the Model of typical development.  RDI affords children with Autism the same chance at a redo in their development as their peers without Autism.  An example of this is- typically developing children develop resilience and the ability to manage uncertainty in the first year of their life.  Building on motivation, helping a child feel competent and not only to manage uncertainty but to embrace it is part of the foundations of RDI.  This opportunity for a second chance is rooted in Guided participation, which is how we all learned from our parents, and how society passes knowledge onto children who do not have any obstacles preventing them from accepting guidance. ( A book on this topic is apprenticeship in thinking by Barbara Rogoff.) RDI is a precise systemic program for guiding,  broken down with objectives for each stage of intersubjectivity ... For more on intersubjectivity Click here

There are 7 goals for parents that empower them with the tools they need for remediate their child’s Autism, and in the process transform themselves into expert guides, decision makers and able to see themselves as competent parents when addressing Autism…along with learning how to help their children ( ASD or NT) became effective in their own decision making.

These 7 parent goals are


Student assessment, planning, and obstacle management

Personal assessment, planning and support

Set the stage for guiding

Guiding methods

Knowledge management

Applied guiding

The student stages follow typical development to remediate Autism

The 5 child/student goals are

Competence Development

Joint attentional learning

Self regulatory decision making

Co regulatory decision making

Emotional responsibility

Once a family graduates from the Family consultation program they can move on to the next level, fine tuning any obstacles that remain with their child’s/students dynamic intelligence ( in this stage of the program Autism is no longer an issue but families are working on advanced concepts  to effective pass on all learning and experience sharing to their child.)   RDI is helpful to children and adults of any age..believing that all milestones regardless of chronological age must be addressed and cannot be ignored if we want to continue to move forward with a strong foundation. For families who do not start with RDI, many come to RDI after their previous therapy stalls due to that therapy concentrating on specific skills and not addressing the complete developmental trajectory.

RDI advocates when fostering engagements for the child, to frame everyday activities with the focus on pacing and adjustment, along with the mode of communication and uncertainty present…to give a child a small enough challenge to feel competent in contrast to a challenge to great to handle.  Planning and Framing activities allows RDI to be structured but at the same time * family friendly* for each individual family dynamic, making RDI less about therapy and more about helping the child become competent in engagement through activities the family already does and interacting in their social world.

What is the Son-Rise Program

The Son-Rise program is based on 4 pillars-  Making and sustaining eye contact, communication, having an interactive attention span and having flexibility within interactions.   Step 1 of the program is to set up a playroom.  Step 2 is to set up a schedule.  3 Recruit volunteers, 4   Train Volunteers and hold group meetings    5. Plan for support and follow up training. 

It is recommended that a family run a 46 hour a week program with at least 6 volunteers.   The Parent or volunteers stay in the playroom to follow the child’s lead and try to foster the 4 pillars above.  When the child is *stimming*,  the parent or Volunteer is to join in with that stimming until the child stops.

Floortime/DIR and RDI vs The Son-Rise Program
Repetitive “Stimming” Behaviors
The Son-Rise Program
Advocates being “playfully obstructive”, which means endeavoring to generate social interaction but playfully getting in the way of the child’s behavior so they have to interact with you to move you.
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.

Repetitive “Stimming” Behaviors
RDI ( This is what The Sonrise website claims about RDI)
The Son-Rise Program
Neither stops nor joins the child.
Advocates "joining", as explained above.

Red and Green Lights: The Exclusive/Interactive Continuum
Floortime/DIR and RDI
(This is what The Sonrise website claims about RDI)
The Son-Rise Program
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.
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.

Celebration of the Child
(This is what The Sonrise website claims about RDI)
The Son-Rise Program
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.
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.

The Importance of Attitude
Floortime/DIR and RDI
(This is what The Sonrise website claims about RDI..please visit here as we go through what RDI really says about these points)
The Son-Rise Program
Values attitude, but does not make it central to every aspect of program implementation..
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.