Friday, February 26, 2010

intersubjectivity deficits within ASD

 The lack of development within the Intersubjective relationship for a child with ASD is one of the most documented deficits within the research of Autism. Developmental psychologists like Alan Sroufe, Alan Fogel, Barbara Rogoff, Peter Hobson, and Daniel Siegel, all have written books concerning this topic, along with joint attention, theory of mind, and Guided Participation. The research from these psychologists was the starting point when creating RDI. Peter Hobson, the author of "the Cradle of thought" is a Professor of Developmental Psychopathology at University College London and is currently involved in a study for RDI methods for the association between social and cognitive development across these areas in children with autism receiving treatment.
The following two links show research regarding the IR.


http://www.aifo.it/english/resources/online/apdrj/apdrj202/autism.pdf

The next research paper describes the deficits of children with ASD and is exactly the focus of the Relationship Development Intervention program.
http://www.uchsc.edu/psychiatry/research/Autism/Intersubjectivity_in_Young_Children_with_Autism.pdf

So along with theory I wanted to give you a few links from RDI moms incorporating this information into the lives of their children on the spectrum and families. Their discoveries this week as we continue this process of truly understanding the intersubjective relationship ( and how to remediate this deficit) is truly inspiring to me in addition to my own children and their progress!

Tammy   tells us how a trip to the post office was very enlightening as she was able to people watch different levels of intersubjectivity in action.

Jennifer  tells how she used some RDI strategies within the IR helped calm her daughter

JB lets us see the cutest little boy in action demonstrating some typical development within the IR. I also wanted to point out in this blog, Mom reminded us that Intersubjectivity is Not the same as a child simply looking, or even referencing.

Penny  talks about when she first realized the concept of Theory of mind.

Wednesday, February 24, 2010

The breakdown of Guided Participation

Guided Participation. What is it and why does RDI focus on the guided participation relationship as a means to restore a child back to their developmental track?

20 + years of research by experts in fields of mental health, development and environment coined the term Guided participation to represent how all societies use this method to guide their young. For a neuro-typical child, the parent immediately forms the connection and the child gives feedback according to that relationship. As early as 6 weeks, there is a role as guide for the parent and an apprentice for the child to learn from the actions of the parent. That baby is learning to be an active participant in their relationship with their caregiver. The parent does most of the work in the beginning and gradually by 1 years old, as the child is further developing theory of mind, both caregiver and child have an equal role and responsibility that consists of a natural flow of give and take feedback.
But what happens when there is a breaking point in that developmental milestone? What happens when a child cannot provide that meaningful feedback to the parent? Quoting page 129 from “the RDI book” from Dr Steven Gutstein- he says “Autism is not dx by the presence of any specific behavioral problems. What is distinctive is not the commission of specific things that the child does but rather the omission, when the child does not do, or is unaware of.”

For my own children on the spectrum, I clearly remember with each of them where I was not receiving that feedback. With my older son, of course knowing nothing about Autism, I did not recognize this until he was almost 3 years old. For my younger son, I knew there was a lack of feedback before he turned 1. Not knowing about relationship development intervention at this point, I desperately looked for ways to get him connected to me. This typically involved a lot of prompting and therapy to try and get my children to look at me, etc. What I tended to do with the lack of feedback, is do all the work in the interaction. Or I would just assume my child was not interested and this resulted in non therapy hours letting my child go off and stim or watch TV. I felt pretty incapable of successfully bringing my children into my world without me doing all the work.

10 years ago Autism awareness looked differently then it does today. This lack of feedback from my son, well, honestly, many people told me I was spoiling him, etc. This caused a lot of guilt for me…a lot of self doubt. I loved being with people but I was getting to the point where I did not want to be around people because as a parent of a child with Autism, I am sure you can relate to what others say who do not live in our shoes. And to that fact, I say that my children have taught me more then I could of ever taught them!
When I learned about RDI, I was floored when the programs description as I researched it explained to me about this breaking point in development. Someone was actually able to scientifically explain to me what I was *feeling* in my relationship with my children on the spectrum. I felt validated! That does not happen often when you are navigating through this journey. Since that point, RDI has proven time and time again to empower me in my jouney with my children.
So I thought I would empower you, the reader, Just in case you are having one of those days…that you need a pep talk! :)
There are different reasons for the neurological breakdown that results in Autism. There is regressive Autism and infantile Autism. I happen to have one of each… Lucky me ~grin~. Genetics can play a role, and triggers from the environment play a role. I believe that there is a genetic disposition and something in the environment triggers that vulnerability within the connections of the brain. One of my children benefits from some biomedical support because he also has gut issues that needed to be addressed to maximize his remediation. No matter what the origins, the end result is Autism. This tipping point, as Dr Gutstein Explains in his book, disrupts the child’s ability to develop the pre- requisites for the basic Guided Participation relationship that neurotypical children exhibit as they are able to continue on their path of development.
So what does this mean for us, as parents, who may feel incompetent when dealing with this breakdown. It means Autism is NOT our fault!!! Personally, for me, it set me up for a vicious cycle of compensation where I was doing all the work in my relationship with my child. I grew tired of the lack of feedback. I kept thinking I was doing something wrong! Think about in any social situation, when you are talking to someone and they are looking around. It is clear to you that their mind is elsewhere. They are not paying attention. They are not giving you the same feedback you are giving them. What do you do? For me, I either stopped interacting or yelled at them for not paying attention. :) When your own child does this to you, it digs down into your innermost *mommy* feelings of failure.
As a consultant, I address this with parents within one of the objectives within RDI. On page 131 of the RDI book, Gutstein reminds us, as parents that it is very difficult to compensate for the vulnerabilities with our children to get them to the point of remediation. He goes on to say that in his experience, the majority family members with an ASD child are among the most capable parents and grandparents, yet because of this breakdown, they struggle to carry over this expertise with their child with ASD.
For me, I felt like it was because I was told I had to teach my ASD child differently than a neurotypical child. I struggled with this for years until I found RDI. Restoring the natural process of development in my ASD child made sense to me…to follow the developmental path to fill in gaps of development in a more slow deliberate manner as a second chance for them.
Having the complete developmental curriculum at my fingertips in the operating system within RDI has empowered my family to know that my children will achieve a quality of life…all my children, ASD or Neurotypical. They are both back on their own developmental track.
Restoring our child’s developmental path is not impossible. You, as parents, have the capabilities to do this. Your child’s Autism, and their continued struggles, are not something that you did, or did not do. The breakdown OF the GPR is the cause. I salute each and every one of you as we go through this journey together!
So promise me that you will feel empowered when you look at your child. I am sure of their potential!

Saturday, February 20, 2010

Intersubjectivity

What is intersubjectivity?
I was pulling into Taco bell a few days ago for my son…he so desperately wanted a taco and I had a coupon, so there ya go! :) I slowed down, had my blinker on, but could not turn in because someone at that exact moment was walking in the driveway. It was only a moment that I had to wait for this person to cross, meanwhile the car behind me beeped at me. ….so I calmly said to my kids, now there is a good example of that person lacking intersubjectivity. My 6 year old said, Inter what? My teens just rolled their eyes.
So what is it…and why is RDI focused on restoring intersubjectivity through the process of Guided participation? Oh Guided participation is just a fancy way ( and the term that developmental scientists use to acknowledge how typical children learn- check out the book, Apprenticeship in thinking by Barbara Rogoff.) to say the process of a guide in a relationship, and we believe, in RDI, that children with Autism deserve a second chance at typical development through this guiding process. Therapies that are skill based work on teaching skills to children with little regard to what these kids are missing in the developmental track. They believe they can bypass development. What happens is the child will make progress that 1st year of skills, but those skills are instrumental in nature. Sure it is great that they can now sit still, and ask for juice...but the same progress can be made developmentally, while working on filling in the social and relationship gaps. That is not possible in a skill based program. What I have seen time in time again and even with my own children, is that then we have to go back and undo the uneven learning posed by skill training to get to the root of Autisms issues…understanding the *dance* of relationships.
Back to Intersubjectivity…the scene at taco bell. Ok, it is a bit of a dramatization…but at the same point I wanted a simple illustration. That person behind me, could not take my perspective. It was about HIM….not about US being on the road. He could not SEE why I took the action to stop instead of get out of his way. It was, at that moment, all about his needs. We obviously all have moments like these…so what I am referring to with lack of intersubjectivity with Autism is not as simplistic. We all have the foundations in place to be able to take on someone else perspective. Children with Autism do not.
The importance of understanding the Intersubjective relationship in regards to Autism is crucial. It is the basis for how we development mental engagement. Subjectivity is our appraisal, thoughts, feelings, memories, perceptions, etc of something, and Inter is that bridge between people. On this blog ( at an earlier post) I talked about the study showing that 18 month olds understand that others may not have the same feelings as they do about a subject. We already know that children with ASD struggle with relationships and perspectives. So where do we go back too?
There are five stages of the IR.
Children between the age of 3- 9 months have established primary intersubjectivity. They know that your actions and their actions go together. They take an action to your action. Think Peek a boo. The child is engaged with you and stays with you and the interaction. Both parent and child have a role in peek a boo…and a typical child will stay with his role.
Secondary Intersubjectivity is from 9-15 months. The child starts to be able to read reactions from not only how they feel but how you feel? They care about your reaction. I am reminded of a child who is learning to walk and falls….and looks at you for your Shared reaction….because that trust is there and they can accept your reaction to how they feel! If you react minimally and calmly, they typically will not cry. If you jump up and exclaim, Oh my are you ok?…They could share your perspective and start to cry. They are not hurt, but they are able to grab your reaction within the intersubjective relationship.

Typically with Autism either the primary or secondary IR has been affected. Because of Autism, the childs development has stalled in this area. RDI will go back to this stage in development and start to remediate the deficits that contributed to this not fully developing. Only then does the child have a strong foundation to continue on their developmental track. An example of how RDI works on Intersubjectivity at the 3-9 month old level ( since we certainly cannot play peekaboo with an older child) is through a process of co regulation. This co regulation can be fostered in any interaction that is done with the child. For example, simply by brushing your teeth with your child in a co regulated manner ( no commands, but slowly helping your child to focus on both you and he brushing teeth together), we can slowly help your child to understand that other people have a perspective, and a role in an interaction.

Stay tuned for the last three stages in the IR!
If you have any questions or comments, please post here or email me privately at k.darrow@verizon.net .

Friday, February 12, 2010

Theory of Mind

Taken from the book- "No, and why parents need to say it"

Some years ago, the Berkeley psychology professor Alison Gopnik and one of her students, Betty Repacholi, conducted an experiment with fourteen-month-old toddlers. Repacholi showed the babies two bowls of food, one filled with Gold¬fish crackers and one filled with raw broccoli. All the babies, naturally, preferred the crackers. Repacholi then tasted the two foods, saying "yuck" and making a disgusted face at one and saying "yum" and making a delighted face at the other. Then she pushed both bowls toward the babies, stretched out her hand, and said, "Could you give me some?"
When she liked the crackers, the babies gave her crack¬ers. No surprise there. But when Repacholi liked the broccoli and hated the crackers, the babies were presented with a diffi¬cult philosophical issue—that different people may have dif¬ferent, even conflicting, desires. The fourteen-month-olds couldn't grasp that. They thought that if they liked crackers everyone liked crackers, and so they gave Repacholi the crackers, despite her expressed preferences. Four months later, the babies had, by and large, figured this principle out, and when Repacholi made a face at the crackers they knew enough to give her the broccoli


This above study shows a very important example of when a children developmentally understands some foundations of Theory of mind.

For our children with Autism, many have not been able to seperate that others feel differently then they do and put that into practice when they are interacting. RDI (R) addresses this in their program as it guides the parents and child through the developmental stages beginning exactly where your child left off on his developmental track.

What has been your experience with your child and this very important developmental milestone?

Welcome

I have created this blog to talk about remediation and how remediation is possible with Autism spectrum disorders!!

The definition of remediation-
The act or process of correcting a deficient so that it no longer is an obstacle.

Autism is a cognitive developmental disorder. By correcting where the developmental path went astray in the brain, we can remediate the effects of Autism on that individual. This is done by a do over, giving the child or adult a second chance at development. The only program to date that does this in a step by step fashion ( breaking down each developmental step in typical children) is a program called RDI.
http://www.rdiconnect.com/

I am a Mom of 2 children on the spectrum, 2 neurotypical children, and I am an RDI (R) consultant in training.

I hope that you will find this blog helpful in your journey with Autism! My goal in becoming an RDI consultant is to help other family achieve the success that my own family has....and I am thrilled to be able to have that opportunity.

Here is my website!
http://mysite.verizon.net/vze3ww4z/

and Yahoo group
http://groups.yahoo.com/group/Autism-remediation-for-our-children/

Visit me on Facebook
http://www.facebook.com/home.php?ref=home#!/group.php?gid=84889719037&ref=ts
and
http://www.facebook.com/home.php?ref=home#!/pages/Mastering-Milestones-in-Autism/216175073875?ref=ts

I would love for you to post questions if you are new to RDI!!