Getting to the Heart of the Child by Carmen Augustin, MSW, LCSW

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EDUCATION & THERAPIES
Relationship Development inteRvention® (RDi®)
Getting to the Heart of the Child
Carmen Augustin, MSW, LCSW, has over 25 years experience working with children, teens, and young adults with autism spectrum disorders and their families. She is a partner in Sweeney, Augustin, and Associates, a private practice located in Skokie, Illinois, providing comprehensive services to children with special needs and their families. Ms. Augustin is a Relationship Development Intervention Program Certified Consultant, receiving her training and supervision from Dr. Steven Gutstein and Dr. Rachelle Sheely of the Connections Center in Houston. She co-authored “I feel like I got my baby back,” which was included in the book titled My Baby Can Dance: Stories of Autism, Asperger’s and Success through the Relationship Development Intervention® (RDI®) Program. Ms. Augustin is on the professional advisory boards of the Autism Society of Illinois. She has presented at numerous conferences on the subject of autism and RDI®. By Carmen Augustin, MSW, LCSW im’s mom and I were about to swing Tim in the parachute again, an activity he enjoyed. We both nodded excitedly with big smiles on our faces, using everything we had to invite him to climb in – except for the spoken word. He looked at us with bewilderment and then took his index finger, put it under his chin, and began to lift his head up and down, forcing himself to nod, and asked, “What does it mean when you are doing this?” He was 8 years old. The quote is exact – he had beautiful language, yet he did not understand a head nod. A moment can illuminate and transform. When I glanced at Mom, I could see it was just as revealing to her as it was to me. We were in the early stages of our RDI® work, and it was clear that we were on the right path. We created a small moment of uncertainty that gave her son a small moment of discovery. He could figure things out that previously had simply been too confusing, often resulting in withdrawal from social situations. Not this time. This time he persisted and there was no turning back. RDI® was developed by Dr. Steven Gutstein and Dr. Rachelle Sheely of the Connection Center in Houston. It is a developmental model of therapy based on typical child development. We empower parents to take on the active role of guide to their children with autism spectrum disorder (ASD) to create dynamic learning opportunities. RDI® recognizes the extraordinary power of the parent-child relationship. The program restores the typical parent-child relationship, in which
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parents guide their children through an uncertain, confusing, and challenging world. There is no better person for this journey than the child’s mother or father. We know that ASD interferes with children’s ability to integrate or retain the typical learning opportunities that begin at birth with parents. RDI® is an opportunity to invite that process in again with the knowledge that the child has unique challenges in participating in the dance between parent and child. If we can slow down the music, then we can give our children not just the ability to dance, but the desire. Parents are the catalyst for remediation in the RDI® program through their role as guides. Gutstein explains this role in his recent book: The Guided Participation Relationship (GPR) is the cornerstone of parentchild functioning in every society on earth. In this special type of collaboration, an experienced guide carefully prepares situations in which a less experienced apprentice can productively struggle with uncertainty and challenge. Guides carefully balance establishing a safe environment in which the apprentice can feel competent, with cognitive challenges that are just a bit ahead of the current level of the apprentice’s understanding and stretch the apprentice’s mental functioning. This creates the impetus for the formation of more complex and more highly integrated neural networks.1
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This is how children learn – they study their parents and then they borrow what they learn.
In RDI the focus is on the joy of the shared experience between parent and child.
RDI® is meant to be inclusive. Siblings are often included.
Parents take on the role of guide to their child, helping the child see the world through their experience.
“Come hungry, leave happy!”
RDI® recognizes the extraordinary power of the parent-child relationship. The program restores the typical parent-child relationship, in which parents guide their children through an uncertain, confusing, and challenging world. There is no better person for this journey than the child’s mother or father.
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In other words, parents guide children through their experience. One example of this is the first time a parent feeds a child solid food. Almost without exception, the child, overwhelmed by this new sensory experience, spits it out. The parent overrides this experience by convincing the child that these smashed peas are delicious. We amplify our facial expression and voice, exaggerate our movements, communicating reassurance in every act in an effort to get the child to believe that this will be good for him or her. In actuality, for many of us, it is the first time we lie to our children. We don’t believe for a minute those peas are yummy, yet we convince them otherwise, knowing that eating the peas will lead to so many other really delicious things later on.
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With time, the child believes, and in go the peas. RDI® recognizes that parents of children with ASD have engaged this process. It is clear in the guided participation relationships they have with other children. It is equally clear that ASD interferes with that relationship. RDI® is a program that works to get parent and child back on the developmental track. I believe it helps parents get to the heart of the child. Each family that participates in RDI® works with an RDI® Program Certified Consultant.2 The consultant guides the parent in face-to-face session work and support through the online RDI® Learning System (RDILS). The RDILS allows parents and consultants to track progress, document
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EDUCATION & THERAPIES
work via video and narrative, provides parents with learning opportunities, and gives parents the ability to obtain the support of other RDI® parents via parent forums, consultant-led online webinars, and RDIconnect® continuing RDI® education. A Relationship Development Assessment (RDA) looks at the current state of the parent-child GPR. It identifies the strengths and obstacles for both the child and parent and helps parents understand how the autism has impacted the GPR. Understanding the core issues for individuals with autism helps each family and their consultant develop an intervention program that best meets the unique needs of the child and his or her family. In his study of dedicated researchers throughout the world, 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. Gutstein discovered that many different abilities are essential for success in dynamic systems. It is these core areas that are addressed in RDI®. This description and that of each core area can be found on the Web site rdiconnect.com. The examples are taken from my RDI® work. Experience Sharing: Sharing different perspectives, integrating multiple information channels, and determining “good enough” levels of comprehension. Using language and nonverbal communication to express curiosity, invite others to interact, share perceptions and feelings, and coordinate your actions with others. Information gathered in the assessment indicated that Tim responded nicely to verbal information and direction, but he did not reference his social partners as he did, thereby missing out on critical information that we use to understand intention, emotion, and context that helps build our understanding of relationships. For Tim’s parents, this meant altering communication with their son. They began by being vigilant to communicating only when their son was physically oriented to them. Many times this meant delivering communication in close proximity to their son, sometimes using a touch to create a
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moment that stood out as important to Tim. They began to steer their language with Tim back to a more balanced rate of declarative or experience sharing language such as, “What a beautiful picture,” or “That is a big dog.” They increased their use of nonverbal communication, amplifying facial expressions and gestures. With Tim beginning to pay attention to these communications, he was able to glean much more information from each interaction. He was able to use this information to understand intention and read his parents’ calming tones and facial expressions as a way of calming himself and resolving uncertainty. He became an active participant in the interaction. He began to use head nods and shakes and gestures, and he widened his use of facial expression – not because we taught him the skill, but because he began to pay attention to faces, not just the words. As he found meaning, he discovered he could use it. This is how children learn – they study their parents and then they borrow what they learn. Tim was a becoming a competent apprentice to his parents, learning through the guided participation relationship. Dynamic analysis: Determining relative meaning and value of information. Ongoing subjective appraisal of continually changing contextual information to determine the best fit. Ongoing evaluation of change. The ability to observe and continually regulate one’s behavior to participate in spontaneous relationships involving collaboration and exchange of emotions. This is an RDILS post I received from a dad recently regarding his son (who has significant challenges in communication) and his reaction to the family cat dying. Yesterday, our 18-year-old cat, Zack, died. We had to have him put to sleep, and Kaden came along with us to say goodbye. That was Mom’s idea, and I am glad she suggested it. Last night, as he recounted that Zack “got died,” he added these two statements: “Kaden’s not going to get died” ... then a long pause ... and said “Mommy and Daddy are not going to get died.” He clearly got it specifically and, it appears, on a broader level. I have been so amazed by him lately.
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The piece of advice I have to give all parents is to stop being so good. Their children need them to do less in just the right measure at just the right moment.
In these shared words we can “see” how much dynamic thought went into sharing these words with his parents. Each word was thoughtful and precious. Each word conveyed so much meaning and revealed so much of what their child was thinking. Flexible and Creative Problem Solving (Relational-Information Processing): The ability to obtain meaning based upon the larger context. Solving problems that have no “right or wrong” solutions. Developing multiple, equally good strategies for an imperfect world, including “good enough thinking,” improvisation and “work-arounds.” The ability to rapidly adapt, change strategies, and alter plans based on changing circumstances. Just this last week in a session with mom, dad, brother, and child with ASD, I handed the child a bandana. We had just finished a rollicking game of Guesstures and the score was written on plastic with a crayon. We were cleaning up. He looked at me, glanced at his parents, checked out the items left on the table and then took the bandana and wiped the scores off the plastic. A small moment, a beautiful piece of thinking. By doing nothing except handing him the bandana, we gave this child an opportunity to figure it out. He rose to the occasion and was quite proud. We could all see this in his expression. I learned something early in my role as an RDI® consultant. Prior to RDI® I was doing too much of the work. I did not give the children the time and space they needed to figure it out, to struggle just a little. The piece of advice I have to give all parents is to stop being so good. Their children need them to do less in just the right measure at just the right moment. We have a guiding quote in our office: “Don’t just do something, sit there.” It reminds
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all of us that a little time can be all a child needs. Never was this better said than by a 14-year-old. He was playing a game of cards with his dad in a session. Dad was in no hurry, giving his son all the time and silence he needed to make his next move. His son looked up at me and said, “I think if the whole world would just slow down, I’d be OK.” Episodic Memory and Self-awareness (Foresight and Hindsight): The ability to reflect on past experiences and anticipate potential future scenarios in a productive manner. Developing an internal mental “space” to consider, reflect, preview, prepare, regulate, evaluate, hypothesize, and dream. If you talk to me about your grandmother, I will remember my grandmother and I will smile. If you ask me to speak in public, I will say yes, remembering how nervous I was the first time, but I did it, it went well, and when it was over I actually felt very good. If you ask me about taking up piano lessons at 45 years of age, I will remember the sheer terror I felt at recitals as I played “Zum Gali Gali” while everyone else played Mozart or Chopin. I will do public speaking; I will not take piano lessons again. With RDI®, parents help children encode whole memories of events by spotlighting the important moments. We cannot create memories for someone, but we can cause a moment to stand out. Sometimes, by gently touching a child and saying with our faces, “Wow, you did it, you were scared, nervous, upset, but you pushed past and you did it,” we can make that moment of recovery and success stand out and hope that the child will store it as the most important. A child came in with his mother quite upset, feeling that no one understood how bad his autism was. Mom was very calm; we listened and then slowly presented some options that we felt might make him feel better, activities that he felt competent in, which presented him with just enough challenge. We watched as his mood began to shift. As he was getting ready to leave, he looked at me and said, “This place is like IHOP. Come hungry, leave happy.” Mom looked at him and said, simply, “indeed.” A
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“I’m learning to take chances.”
few months later, prior to a session, Mom left a voicemail indicating that her son had had a very tough day. I made a sign for the door to my office. It said “IHOP.” That word, by itself, triggered the memory of leaving happy. He left the yuck of the day outside the door. Resilience: Coping with a “messy,” unpredictable world, where setbacks and errors are unavoidable. Responding to uncertainty in a productive manner. Tim is now venturing out into the community by himself. He has been teased, surprised, confused, and rained out. He has missed a bus, forgotten his groceries, left change, and gotten yelled at by a stranger for going through a door first. He has experienced 100 other little setbacks. But because he has managed all these setbacks, he has also experienced amazing successes. He has gone to the movies with friends, tried all kinds of new foods, ridden his bike distances most adults wouldn’t try, given a speech at his graduation, joined an acting class, written restaurant reviews for an autism Web site, visited friends, ridden giant roller coasters, and is about to get on a plane by himself. Resilience. Where are we now? One year ago, Tim decided he was ready to go to away camp for the first time. After some good research guided by another RDI® parent, the family decided on a camp in another state. Tim called from the airport and left this message: “Hey Carmen, happy birthday. I’m at the airport. The plane was delayed three hours, but I’m getting on the plane now. I think I’m going to have a good time at camp. I’ll call you when I get home. Goodbye.” Experience sharing, dynamic, flexible,
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Tim with ukelele: Tim provides the entertainment at a “fancy party” he helped plan.
resilient, and episodic. I kept that message for months and it put a smile on my face each time I listened to it. It makes me smile to write it. Tim came into his first session after camp (he is going off to camp again this year, flying alone and meeting a friend) with the biggest smile on his face. He was next to his mom, of course, who was standing behind him, smiling even bigger. I could see he simply couldn’t wait to tell me something. “Carmen, I learned to take chances.” And I smile as I write this. Yes indeed. This article is dedicated to every family that I have had the privilege of working with. Your shared RDI® experiences have touched each word.
The following resources can give you more information about RDI® and help you find an RDI® consultant in your area: www.rdiconnect.com The RDI® Book: Forging New Pathways for Autism, Asperger’s and PDD with the Relationship Development Intervention® Program References 1 Gutstein, S.E., (2009) The RDI® Book: Forging New Pathways for Autism, Asperger’s and PDD with the Relationship Intervention® Program. 2 www.rdiconnect.com
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