Relationship Development Intervention (RDI)

In January 2004, two friends with autistic children mentioned a new therapy that, according to them, showed exciting possibilities: Relationship Development Intervention (RDI). We immediately started researching it. After several months of reading, watching, attending seminars, and experiencing, we are inclined to agree that RDI is a potentially life-changing therapy.

To understand how RDI works, you must first understand the core issues of autism spectrum disorder—what areas of development are affected and what areas are not affected by it. See the chart below.

Developmental Effects of Autism Spectrum Disorder
Developmental Areas Not Affected by Autism Affected by Autism
Emotional Recognizing and labeling emotions in faces Referencing, or reading, faces voluntarily to make an emotional connection
Social Following procedures and using scripts Regulating, or adjusting, her actions in response to what she reads in her partner’s face
Communication Using imperative, or demand-based, language to get what she wants Using declarative, or experience sharing, language with no intended answer in mind
Memory Remembering facts or procedures Remembering events by how they affected her personally, emotionally
Cognitive Thinking in absolutes; rule-based thinking Thinking in context; relative thinking in various situations (for example, how loud is loud enough?)

We discovered that the ABA therapy we had been using focused on the areas not affected by autism. This is in no way to say that ABA is useless; quite the contrary! ABA is useful for teaching facts, procedures, and absolutes to developmentally delayed children. We intend to continue using it for those aspects of Hannah’s learning.

RDI, on the other hand, focuses on the core areas that are affected by autism, the areas listed on the right-hand column of the chart.

How It Works

The founder of Relationship Development Intervention (RDI) studied the development of neurologically typical children from infancy on. He noted especially how they progressed in the areas listed on the right-hand column of the chart above. He was able to categorize that process of development into six levels, with four stages in each. Then he developed activities to systematically encourage and stimulate growth in those stages and levels.

The activities themselves are not a magic formula; they are simply possible applications of the goals and objectives of each stage and level in the process. Parents are encouraged to look for ways to incorporate RDI concepts into everyday activities. Read Autism, Aspergers: Solving the Relationship Puzzle and Relationship Development Intervention with Young Children by Dr. Steve Gutstein for more information. You can also visit www.rdiconnect.com for more details.

How It Looks

When we started RDI with Hannah, we began with trying to get her to focus on our faces in order to share an emotional experience. We used two activities to produce a state of uncertainty (being careful not to push the limit into anxiety), which caused Hannah to look at our faces of her own initiative.

We set up a cloth tunnel, using two chairs, two long poles, and a bed sheet. My oldest daughter, who was helping me, would direct Hannah into the tunnel and make her wait until my face appeared at the other end. She would continue to hold Hannah in place while I counted to three or said, “Ready, set, go!”, keeping both my face and voice very animated. The tunnel served as a “spotlight” on my face; every other visual distraction was virtually eliminated. When I reached the agreed-upon signal, Hannah was allowed to crawl to me. I was delighted to see how much she looked at my face while she crawled, without my telling her to “look at Mommy.” I tried to smile and laugh, making my face clearly communicate a fun emotional experience.

When Hannah reached the end of the tunnel, my oldest daughter would help her climb up on top of a long table, and again keep her in place while I got into position at the opposite end and started the excited verbal signal. Being on an elevated platform created the uncertainty that prompted Hannah to watch my face as she walked toward me and jumped into my waiting arms. (Of course, we were careful to spot her so she wouldn’t fall off the table.) Again, I tried to spotlight my face and somewhat exaggerate a fun emotional experience to encourage her to keep looking.

After several fun times like those, I noticed a significant increase in Hannah’s looking at the faces of those around her. We then took the skill one step further to introduce referencing, or reading, faces: we changed our excited verbal cues to excited, but silent, facial cues. Hannah had to watch my face to determine when she could start crawling down the tunnel or jumping into a pile of beanbag chairs.

Those systematic, incremental changes are what the RDI books provide. However, we can use our imagination, lifestyle, and house setting to customize how we teach and reinforce each stage of developmental progress.

We have also used Dietary Changes and ABA therapy.