Relationship Development Intervention (RDI)

Relationship Development Intervention (RDI) is an approach developed by Drs Steve Gutstein and Rachelle Sheely of the Connections Centre, Houston, Texas to remediate the core deficits in autistic children. 

RDI is based on the stages of development of neuro-typical children and has as its cornerstone the belief that due to an innate or received information processing disorder, autistic children miss out on some of these stages. 

Because they have missed these crucial steps, they do not develop competence in managing change.  This leads them to seek out 'static systems' or environments that are predictable.  This is where autistic children get their need to be in constant control of their environment and relationships ? a controlled agenda is a static system. 

RDI is about revisiting the missed stages, practising and mastering each before moving on to the next one so that children?s ability to communicate well (by managing the change that is an inherent part of any spontaneous social interaction) eventually becomes instinctive.

Most other intervention strategies seek to compensate for deficits rather than remediate them: the difference is like giving someone with a shattered leg a wheelchair for the rest of their life, rather than helping them to learn to walk again.

RDI identifies the core deficits in autism as: rigid thinking, aversion to change, inability to understand other's perspectives, failure to empathize, and absolute, 'black-and-white thinking'.

RDI is a parent-based clinical treatment program where parents are provided the tools to effectively teach flexible thinking skills and motivation to their child.  Children learn these flexible thinking skills initially in environments where change is constant and inevitable, before moving on to practise these skills situations that are progressively more like the real world.

In his study of dedicated researchers throughout the world, Dr. Gutstein found a remarkable consensus among the scientists: even the most capable individuals on the autism spectrum lacked certain abilities necessary for success in managing the "real-life" environments that are dynamic and changing. Dr. Gutstein discovered that six different abilities are essential for success in dynamic systems. He calls these the six areas of Dynamic Intelligence:

• Emotional Referencing:
  The ability to use an emotional feedback system to learn from the subjective experiences of others.
• Social Coordination:
  The ability to observe and continually regulate one's behaviour in order to participate in spontaneous relationships involving collaboration and exchange of emotions.
• Declarative Language:
  Using language and non-verbal communication to express curiosity, invite others to interact, share perceptions and feelings and coordinate your actions with others.
• Flexible Thinking:
  The ability to rapidly adapt, change strategies and alter plans based upon changing circumstances.
• Relational Information Processing:
  The ability to obtain meaning based upon the larger context. Solving problems that have no "right-and-wrong" solutions.
• Foresight and Hindsight:
  The ability to reflect on past experiences and anticipate potential future scenarios in a productive manner.

In a preliminary evaluation (Gutstein 2004), 17 children in the autism spectrum participating in RDI were compared to 14 children receiving other interventions. Changes in the ADOS and school placement were primary outcome measures. The RDI group demonstrated significantly greater improvement in ADOS scores, diagnostic classification and independent functioning in classrooms. Results, while tempered by methodological limitations, provide early support for RDI as an effective intervention addressing important deficits of children with autism.

Supervised RDI is undertaken by families employing an RDI Consultant.  The Consultant?s brief is to assess the child, decide which RDI ?stage? the child needs to start practicing at, and support the family in developing a programme of exercises and lifestyle activities that can be undertaken at home.  The parents act as the ?mentors,? with their child learning to accept the role of ?apprentice? to develop competence in the skills fundamental to good communication and interaction.  RDI activities are videoed daily, and fortnightly composite 30 minute films are sent to the Consultant for appraisal.  The Consultant gives feedback and makes recommendations on how the family needs to strengthen or refine their programme.

The web site of the Connections Centre is located at:

http://www.rdiconnect.com/default.asp