Amanda Schulkowsky EPSE 449 Alternative Treatment Approach: Relationship Development Intervention What is the treatment supposed to address?

Relationship Development Intervention (RDI) addresses the social deficits in individuals with Autism Spectrum Disorders (ASD). RDI treatment is used to help an individual develop meaningful relationships with others by teaching perspective- taking, joint attention, and social referencing. What is the theoretical foundation for the treatment? RDI relies on the philosophy of dynamic intelligence and the science of brain plasticity. Individuals with ASD have a disability in information processing which in turn impairs the ability to make rapid decisions and to adapt to constantly changing social situations. RDI teaches individuals how to cope in different social situations by first teaching simple behaviours such as making eye contact with primary caregivers. The idea is that the brain will begin making connections and change over time (brain plasticity). Once an individual has mastered a certain social skill, the RDI process will build upon the last skill with a more complex skill. As individuals progress through RDI, they will develop the ability to reflect upon experiences, adjust their behaviour when situations change, and participate spontaneously with others. How is the treatment done? RDI consists of a series of developmentally appropriate discrete exercises that are conducted between a parent and a child with ASD. The exercises have been described as a much slower version of normal social situations. The program consists of three levels: novice, apprentice and challenger. Each of these levels contains several exercises that a child must master before moving on to the next level. The novice level contains several exercises with the goal of getting the child to give his attention to the primary caregiver. An example of a novice exercise included in the program is called Unexpected Sounds and Actions. In this exercise, the caregiver will do a random and unexpected action during a conversation with the child. The purpose of this exercise is to train the child to maintain focus on a speaker. The apprentice level focuses on maintaining social situations with other people and the challenger level focuses on the individual learning to adapt to social situations without a script. All of the exercises are found in Dr. Gutsteins manuals and can be implemented by any adult caregiver. Each exercise can take up to a few hours to master, however, they can be done over a few days. The caregivers can track the childs progress on a tracking form provided in the manual. Can the treatment be combined with other treatments? Yes, RDI can be combined with other treatments and approaches. What evidence supports or refutes use of the treatment? To date, there has been no clinical, double-blind research on the effectiveness of RDI. (Gutstein, Burgess, & Montfort, 2007) The only evidence available is anecdotal from

Amanda Schulkowsky EPSE 449 families who have participated in the RDI program. They all reported an increase in flexibility in their children to adapt to the following situations: -unexpected change to familiar routines -unexpected omission of a routine activity -changes to activities without preparation -anticipating an event and encountering another -unexpected actions by familiar people - interruption during a highly favored activity, -stopping a task before it is finished -planning for things that might go wrong -adapting when original plans do not work out, -using familiar objects in a novel way (Gutstein et. al, 2007) Is the treatment potentially dangerous? There is no danger to an individual with ASD who receives RDI as a treatment as it does not affect the physical body. Where and by whom is the treatment being done locally and in the world? RDI was developed by Dr. Steven Gutstein and Dr. Rashelle Sheely who co-founded a training centre called The Connections Centre in Houston, Texas in 2001. Through the centre professionals and parents are trained in RDI. Currently, there are trained consultants in the US, UK, Australia, Canada, China, Japan, Singapore, India, Italy, Malaysia, Mexico, New Zealand, and Switzerland. (RDIconnect, 2010) While it is recommended that parents utilize trained professionals in RDI, parents can also read the manuals on RDI that are available. Trained RDI professionals can be found in British Columbia through the Autism Community Training (ACT) website. References: Curious Minds Autism Supports. (2009). RDI. Retrieved October 8, 2010 from http://curiousmindsbc.com/rdi/ Gutstein, S.E. (2002). Autism/Aspergers: Solving the relationship puzzle. A new developmental program that opens the door to lifelong social and emotional growth. London: Jessica Kingsley Gutstein, S. E. (2009). Empowering families through Relationship Development Intervention: An important part of the biopsychosocial management of autism spectrum disorders. Annals of Clinical Psychiatry, 21, 174-182. doi: 10.1177/1362361307079603 Gutstein, S.E., Burgess, A., & Montfort, K. (2007). Evaluation of the Relationship Development Intervention Program. Autism, 11, 397 412. Retrieved from http://aut.sagepub.com/

Amanda Schulkowsky EPSE 449 RDIconnect. (2010). Certification. Retrieved October 8, 2010 from http://www.rdiconnect.com/