Saturday, January 22, 2011

The Dawn of thinking (ASD and Theory of mind)

Chapter 3 The Cradle of thought

What can RDI do for your Family/Child?

In reading chapter 3, a question was in the forefront. Ok, so we know that children on the spectrum lack Theory of mind. From my 11 years of experience with Autism, both as a parent and a professional, this is undisputed. But before I continue with the question of what RDI does for the child on the spectrum, we need to think about what our own determination of theory of mind is. Do we believe that our children on the spectrum can have that intersubjectivity within their relationships? Do we think this knowledge is crucial when determining what intervention best fits our beliefs? In exploring this belief we determine the direction in which you choose to help your child with Autism. Questions like, how does this help my child with perspective, or how will my child understand inferences compared to black and white thinking?

I wanted to mention here, the complexity of the lack of *sharing another’s state of mind* is evident in both infantile Autism and regressive Autism. This is a core deficit of both forms with different triggers. In many children on the spectrum, regardless of either Diagnoses, a co occurring condition of sensory integration, or inflammation of the gastrointestinal track must also be simultaneously addressed alongside theory of mind. Bio medical treatment and/or brain integration help heal the assault on the brain, but the core deficits must always be addressed in addition to getting the child’s immune system working properly.

This Chapter, and woven throughout the remaining chapters of the book, explains what RDI can do for a child on the spectrum…through the lens of intersubjectivity which leads to theory of mind.

Looking at the *dawn* of thinking...and the definition of primary intersubjectivity .

Primary- Actions and emotional state of a baby up to 9 months old

Inter- Something happening between two people

Subjectivity- Your unique appraisal, thoughts, perceptions, feelings memories and dreams

For a baby about 3-9 months of age, Intersubjectivity is about *us* Think of the games we play with them , peekaboo, etc. Very Simple actions that are centered around both people involved. On the foundational level, 9 month old’s are able to accept the initiation of peekaboo, manage their attention, respond to both attention and lack of attention. These actions are referred to as being able to emotionally regulate with the other person.

In the coming chapters of The Cradle of thought, we will go through all the stages of intersubjectivity. Since the foundational milestones in RDI are based in the ability to share with another’s mind ( being conscience of another’s conscienceness), most children who start RDI start here regardless of the therapies they may have received in the past. This is where families learn about the Guide Apprentice role that we intuitively do with typical children ( we are their guide, and they are our Apprentice to the world as we teach them). With the Diagnoses of Autism, we fall into the role of following them around and reversing what is done with typical children. I should mention here to reach into a child’s world with Autism, we do not have to give up the role of Guide. As we guide our children to regulate with our actions and roles, this forms the ability for joint attention which is crucial to a child as young as 3 months. Think of Peek A boo…without the child being able to share joint attention with the Mother/Father, you can visualize how that would affect the emotional connection. This primary stage is huge as these functions in development lay the groundwork for all future understanding of how we, in our relationships, depend on collaboration and shared perceptions .

Secondary Inter Subjectivity begins from 9 months - 15 months….which I will save for Chapter four “The Cast of thought”.

So let’s take a look at the very basic primary stage that a typical 9 month old has mastered . A few of the mastered milestones of this stage is –

Managing attention

Acceptance of initiation/invitation

Response to initiation failures

Response to initiation successes

Coordination of emotional tone (happy, sad, etc)

Coordination of emotional intensity (a little excited or very excited)

Balance of communication (verbal, non-verbal, etc)

As you look at the mastered milestones, you’ll notice that these milestones are very necessary to have meaningful reciprocal relationships. It is incredible to me that a 7 month old has the foundational skills to begin to understand friendships and meaningful relationships because of their emerging theory of mind, knowing that social interaction are about *us*, Their thoughts begin to move out of instrumental * me* and into the next stage where they want to share experiences.

What I have found as both a parent of 4, 2 diagnosed on the spectrum, who had to help both move out of instrumental mode along with professionally seeing many children who were trained for many skills but their theory of mind was never addressed…is You cannot skip this crucial stage without consequences. Over and over social skills groups try to address the lack of social understanding with our children, and while their attempts are well meaning, their methodology is just another rote way to try and build upon a weak foundation because basic milestones have never been met. A parent will say to me, if only my child could get a friend!! Or they will let me know their biggest challenge is initiating friendships with their peers. Now look back at those primary milestones…This is where the function of learning about friendship begins.

Another common thread that I hear with parents is regression . Again, our children are just like any other child, and they need these basic milestones in place to have a strong build upon. Yes, it must be done in a more deliberate, precise way as they did not get the milestones the first time due to their own triggers that caused Autism. But in no way can they be skipped in hopes that they can be taught how to fake it with scripts, without having the intentionality of wanting to seek out relationships from their intruistic motivation.

What can RDI do for your child and family? The piece of mind knowing that you are affording your child a second chance at milestones that were missed the first time, protecting him against regression, and giving him/her the foundational skills to build meaningful friendships ( just as their peers learned it) as he progresses in his treatment for Autism.  These milestones are needed no matter where your child falls on  the spectrum ( debunking the *rumor* that RDI is just for Aspergers or HFA) as my own 2 children were PDD and Severe Infantile Autism.


1 comment:

  1. Kathy this is a great explanation of theory of mind. I especially like the way you have made explicit the developmental milestones that are mastered (in typical development) by 9 months of age - it really shines a light on what's missing from 'social skills' programmes and helps people to understand why they don't work.