Last week I attended a two-day workshop on RDI, Relationship Development Intervention, an approach to working with people on the autism spectrum that was developed by a huband-and-wife team, Drs. Steve Gutstein and Rachelle Sheely. I still feel like I have a very basic, rudimentary understanding about the program, but I am very excited about it. As I've said before, I think that deciding which approaches will work with your child is a very intuitive process, and this one feels intuitively right for Bud. I'll try to explain it, with the caveat that 1) I may not be explaining it well, and 2) I may not be getting it all right.
As Dr. Gutstein said as he opened his presentation, RDI begins with the basic assumption that people on the autism spectrum are human beings, by which he means that the fundamental processes of human development are the same for people on the autism spectrum as they are for neurotypical people. RDI breaks down neurotypical development in the first two years of life into 28 levels, and identifies for each person on the spectrum at which of those levels the breakdown in their development occurred. The focus of RDI is remediation, or going back to that level for a "do-over," getting that skill, then moving on to the next one.
Remediation is a radically different approach to ASD than many of the popular interventions which are focused on compensation; in other words, they identify which skills a child doesn't have and then train them in a very "if this, then that" rule-governed way to get by. The problem is that learning skills in such a rote manner doesn't really help children to function fully in the world. They may be able to learn that when someone says "How are you?" the right response is "I'm fine. How are you?," but it won't make them care how you are. It's that caring element that is at the core of our humanity, and at the root of our genuine, meaningful interaction with other people. THAT is what I want for Bud.
I use this analogy to help understand it: Pretend you're on your way to the wedding of two people you love. The wedding is in an unfamiliar area, and as you're driving there you get hopelessly lost. This is similar to what happens in the development of people with ASD during the first two years of life; they are on their way, and then suddenly they are hopelessly lost. Most interventions for ASD try to help them compensate for this loss; they find a side street and lead you to a different church with a different wedding going on. It might be a lovely wedding with nice music, but it probably won't have a lot of meaning for you. In contrast, RDI will help you retrace your steps and figure out where you took that first wrong turn, then will systematically lead you to the right church and the right wedding. You'll probably get there late; but you'll be there in time to see the happy couple kiss.
And to me, THAT is the key element of RDI that I walked away with; as Dr. Gutstein said, "This is a marathon, not a sprint." This is a long-term goal with a life-changing pay-off. So, rather than mix metaphors maybe we should imagine that you actually need to run the 26.4 miles to this wedding. You won't be able to do it without making short-term compensations along the way: you'll have to stop to rehydrate; you may have to go to the bathroom; you may need to stop and tie your shoe. But ultimately, you will know all along that the wedding is your destination.
And so it is with RDI. Bud will need to learn write letters and color in the lines. He'll need to learn to tell us when he has to go to the bathroom. He'll need to be able to put his pants on, right side out and not backwards. And there are lots of great approaches we can use to help him learn how to do those things. But at the same time, every day in a multitude of small but thoughtful ways we need to work on remediation, on gaining the life skills he'll need to integrate, synthesize, adjust, and respond; and we always need to keep our eyes on the prize, the long-term end of the marathon: meaningful relationships with other people, a real job, the ability to live independently. These are the things I want for Bud, and ultimately, I believe that these are the things he will want for himself. Marathons are hard work; I know that. But it's time to start training.