Friday, October 22, 2010

Is RDI® stressful?

We use an autism intervention called Relationship Development Intervention, or RDI®, which we found after trying aba for over three years, coupled with a year of Floortime the last year of aba.

Behavioral and developmental approaches are quite different from one another, and we, like many others I know, began with a behavioral intervention before switching to a developmental approach. This post is not so much about RDI® as it is about developmental approaches to autism remediation. (RDI® is not the only developmental approach. It is one of my top two favorites, and it happens to be our intervention of choice.)

I have been lurking on an an internet thread about whether or not RDI® is stressful for parents.

My answer, yes and no.

A significant amount of stress (IMHO) comes from the fact that in autism, the child has little-to-no shared attention with family members.

In the early days of RDI®, even after three + years of aba and a year of Floortime, I had to have my mommy radar at high alert 24/7. The "radar" is a mother's double joint-attention, my own, and my child's, too. The "radar" works because we, the parent, assume responsibility for the child, too. I can remember hanging on to my daughter's wrist to keep her near me, or she would bolt while we were running errands. You know what I'm talking about: We do OUR part of the interaction, and the CHILD's part, too. Holding BOTH sides of the responsibility ALL THE TIME is a heavy weight.

To borrow from another wonderful developmentalist, I love the title of Dr James D MacDonald's intervention, Communicating Partners. When the child is not a competent communicating partner, stress increases.

RDI® (and Communicating Partners, for that matter) requires the parent to make big changes, focusing on self, as opposed to trying to change the child. By changing the way the parent interacts, the child is given opportunities to interact differently, unprompted, without a goal of "getting" something from the child, and over time, those changes in interaction add up to growth in a number of areas of development.

Shifting to a relationship perspective and changing myself was stressful. It meant that I had to look at limits and boundaries, address them in ways that I had not been. It meant knowing, developmentally, where my child IS, and targeting interaction at that level. (Dr MacDonald's ARM is a nice resource for that, if you're wondering.)

It meant slowing down, shutting up, offering opportunities, resisting the urge to prompt my child in order to get a response from her (which rewarded me). It meant not using prompts that I used to transition my child - boyohboy, did I become aware of learned helplessness that I'd created with those prompts! She'd become the child who didn't have to pay attention to anything because mom did that for her. I had to look at the reasoning behind all the prompting, and when I did, it made no sense, yet it "worked" to get us through our days. I knew I didn't want to do the prompting long-term, yet I had no action plan on how to get us to new places.

It also meant not following her lead all the time. I did not need more experience following her lead. I was already good at that. She didn't need more experience leading me. She was already good at that. One-sided allowing her to lead while I followed does not = a "communicating partner".

Sometimes, I clearly knew what NOT to do, which left me wondering what TO do, instead, in really specific situations. That was stressful. I wished for a little consultant fairy on my shoulder all the time to help me through specific situations (situations that usually happened because of that immature shared attention, where I'd ask myself, "how do I 'get' her to do this?" and I was back to square one about performing, prompts, and rewards.).

Understanding how development plays out, educating myself on stages and knowing what to set aside for later (what Dr Ross Greene calls "Plan C" in collaborative problem solving) could fall into the "stressful" category.

Another significant factor in parent stress as we made a switch to a developmental model is a big move away from the mindset that we always needed to appear to be getting something from the child, performing some sort of odd side-show with them. Not only did I discount the value of simply "being with" my daughter, I completely poo-poo'ed it and shoved the idea aside. Even when we switched to a developmental mode, finding value in "being with" was a challenge for me.

"Being with" is not prompting; it is not following the child's lead. It's not leading the child. Italic It's being in the same room, comfortable together, with no one leading or controlling.

I always felt that if someone peeked in at me, I needed to look like I was doing something with her. That belief put pressure and stress on me to be performing a lot. And development is not about performing.

Settling in with a developmental approach was stressful. Probably more so because of all the behavioral stuff I had to undo in me.

I'm not sure what formal RDI® stage we're in at this point. I can tell you that my daughter's joint attention, coordination, co-regulation, "we-go" has progressed to a point where she holds more of her own, and the stress level has decreased dramatically. For years, I listened to Dr. Gutstein explain the inter-relationship between joint attention, co-regulation, coordination, experience sharing, etc, and I thought I understood what he was saying. Now that I'm seeing all of those "core deficits" inter-relating in front of me in a child who was so delayed, I see and sense the inter-relationships between the developmental pieces more clearly.

A recent realization for me: Getting to a developmental point where the child can share attention on something invisible, a thought, a moment we shared in the past, a concept, and where the child can mentally join and coordinate himself with those "invisibles" = decreased stress for everyone.

Takes time and experience to get there. Times of illness have the stress meter rising. The "autism" is more prominent during periods of dysregulation caused by illness.

The bottom line: Trust development. (Easier said than done.)

1 comment:

merrilewis said...

Hello, I enjoyed reading your post. I have two boys with autism and a girl who is typically developing. We have been 100% for the developmental approaches, and we love RDI too! We haven't been able to afford a consultant, but we got the dvd and try to figure things out. It is fascinatingI

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