Tuesday, March 9, 2010

Our children's future!

Here is a recent study concerning outcomes for Quality of life for our young adults on the spectrum aging out of the educational system-

quality of life into adulthood

This is obviously not good news.  That said, I do believe we have made strides in how we,  as a society, view Autism and how we treat the deficits of Autism.  While there are still treatments that focus on behaviors and getting a child to perform static skills,  studies like these show that the long term benefits to teaching skills in hopes of generalization to thinking is very limited.  We now know that children with Autism can obtain theory of mind in a developmental fashion just like their Neuro typical peers.  Theory of mind/mindfulness however cannot be taught as a set of discreet skills to master.  A child's developmental gaps must be remediated and the neurology of the brain will  begin to repair itself.  Developmental/Cognitive programs like RDI(R) Relationship Development Intervention, provides a child a do over in development.   On page 15 of "The RDI Book"  Dr Gutstein states that Dynamic Intelligence ( Theory of mind) and Neural integration have a circular relationship with one another.  Dynamic Intelligence is a product of a neurally integrated brain.  Neurally integrated brains development through dynamic problems that challenge the brains current neural architecture.  The observable product of dynamic neural development us Dynamic intelligence."

Static vs Dynamic intelligence chart

Keeping in mind when we refer to IQ,  we are looking at static skills.  Someone with a 4.0 grade average from Princeton or YALE is not guaranteed a quality of life ( good job, marriage/relationships, etc) simply on their IQ.  The determining factors take into consideration ones ability to have the mindfulness of all those dynamic functions mentioned on the chart.  Life is not the sum of knowledge and IQ,  but of experience and being able to share experience and perspective.  This is NO different for a child on the spectrum.  They may have some obstacles in their neurology for this to come naturally,  but that is certainly no reason to concentrate on static abilities only with the thought that they are not needed,  or that they *can't* do it. 

When I look at my own children,  of course I want them to do well with static skills.  Those tend to come naturally for them...as I definitely can't memorize like my boys can!  However,  I know I needed to look further then *school* and sitting in a classroom learning skills.  Beyond school is an entire world that does not play by the *rules* and is constantly changing.  How would I prepare them for that?  How can I make sure they don't fall into the statistics of functioning as a child with ASD,  getting by, only to have the demands of adult life too much for them to handle.  As the study shows, we need to do better!  We can't sit by and hope that they will develop dynamic thinking by teaching our children static skills.  We know that brain neurology does not work that way. The ability to solve problems, prioritize demands, have meaningful relationships and achieve long terms goals is acheived by the foundations of developmental neurology which are in place in a typical functioning child.  We can have the same for the child with ASD as we go back to  their * breaking point* in neurology and fill in those gaps.  That is building a mind on a strong foundation.  Our kids deserve that second chance!!

Tuesday, March 2, 2010

Level 5

The fifth level of intersubjectivity is in regards to after 36 months in a typical child, and after stage 3 in the RDI objectives. This level represents My mind - past, present and future to Your mind ( child) past, present and future. Both minds are able to collaborate their experiences with one another. Included are the abilities of reminscing and reflection!  This level is a level where of course there is always room for improvement. As adults we want to be able to balance our plans with a partners plans, and collaborate with one another instead of one person trying to control the entire interaction.  Also included in this stage is being able to look at a situation that another is going through and put yourself into their perspective ( or to think of the different possible perspectives then just what meets the eye)  Speaking of that,  take a  look here , here and here  to take a comical look on what happens when we lack being able to apply the intersubjective relationship to a situation!

 As far as what I see in my child with ASD, they both are able to share about the past experiences, the present and collaberate on the future. For a child, a good clue that they are could be in this stage is they are able to just come up to you, and say something like Mom, remember when * fill in the blank* and it is an experience or an interaction that you both can reflect and share on. One thing that could be a clue that a child with ASD may not have all the levels in place is that the conversation is very rote. The Parent is asking all the questions* how was your day, what did you do? etc* and the child is just responding. The parent is doing the work in the conversation to keep it going. Without that work, the conversation would fizzle pretty quickly.
 RDI addresses the different elements of the intersubjective relationship in Guiding the child and working on those first foundational skills. This work ensures there are no gaps when these elements are  remediated. An example of gaps would include having to prompt a child for the interaction. If a prompt is needed to have a child *look* at the parent, then that child is not developing the intersubjective element. Without gaze, a child cannot take on the caregivers perspective. You can see how, with RDI, getting to the root of the intersubjective relationship goes much deeper then just getting a child to be social or learning skills only. In RDI, we believe we must start at the beginning. Starting anywhere else is insufficient in order to progress through the natural developmental stages.

My goal as a Mom was to restore these developmental milestones for my children with ASD.  As an RDI consultant my goal is to help other parents restore this relationship within their child .

Intersubjectivity - levels 3 and 4

The third level of Intersubjectivity are for the ages from 15-24 months.
Inter is My actions/My intention and subjectivity is Your actions/your intentions ( child). This demonstrates the expectations of knowing the partners next actions without him or her telling you. Since my younger son on the spectrum is in stage 4 of RDI, he has this level of intersubjectivity mastered since this is a milestone for a 2 year old. An example of this includes one morning when  I was cleaning up, I had a bunch of wrappers and papers in my hand to throw away. My son and daughter were dancing in the living room and a wrapper must of flown out of my hand back onto the floor. I glanced back with the intention on coming back to that once I threw everything away. What happened next was my son picked up the wrapper and ran to the kitchen ( I was heading back from the trash when we met up) he walked around me and threw the wrapper away. He then went back to his fun time with his sister. He was able to take my intention of throwing the items away, and without me saying a word, he picked up that I dropped the item and he was able to carry out my intention of throwing the item away. This was all without saying a word to him, which is very important when assessing if your child has this level mastered.  I of course said, "thanks Jes!" I sort of chuckle with this level because I think that children at this age ( or children with ASD at this level) happily interact with you and feel very competent when they can help. This level gets alittle clouded once the teenage years come into play since then I am sure my teen would simply say ( well I figured you were coming back to get it)~grin~ So the thought is there :) There are many more examples of this level. I know for my Neurotypical daughter she would play and be able to know the next step in the interaction because of my previous intentions and actions.

Then we come to the fourth level. This level continues at ages 24-36 months. At this level, partners are balancing reference points. it goes from level three where the child knows intentions, to level four where the child trusts the parent and knows intentions, but is also developing that awareness of balance in blending the parents perspective within their own perspective. This level is the higher functioning of curiosity. They certainly dont call it the terrible twos for nothing! Sometimes I will hear that the terrible twos go well into the threes! :) It just depends on how long it takes for the child to balance that external and internal reference points to be able to blend perspectives. What this would look like is a child would take your perspective ( if you were to hand them an item and say *Yuck*) they would more then likely say yuck too...take on your perspective. Where you would see the development of this fourth level is if they then take another look at the item and want to also make their own conclusion. For example, the Child thinks...Mom says yuck, must be yuck. Wait, I don't know, let me look at it again.  The child would then revisit the item to try and work out *their* feeling compared to Mom's feeling.   Before this level, the neurotypical child ( and the child who is around stage 3 in RDI objectives),  took your perspective pretty much without question.