Are you just beginning the journey with a new diagnosis of autism spectrum disorder?

Are you at a crossroads where you are not getting the results you had hoped for?

Have you followed others’ advice until now, but after some personal experience you are feeling more aware of what autism involves for your family, and you think there might be an intervention that suits your family better?

  • We realise that everyone needs to work out what is going to suit their personal preferences and circumstances and that RDI won’t be feasible for everyone or even everyone’s choice. But we are eager to let you know it’s around and to help you find what works for your lifestyle.
  • We are good at explaining what RDI is about, but even so, until you start using it, and discovering how it is a way of life approach rather than “therapy time”, it’s hard to grasp how different it is from other interventions.

Are you wanting to be sure you know what all the options are?

  • We don’t feel we can give the best explanation of other services. We know that some autism services’ websites try to describe RDI but fall short of describing important facets or are even wrong on some aspects. And fair enough. If you haven’t used RDI, you won’t really know enough to tell others. It’s important to speak with families who are doing/have done RDI or with an RDI certified consultant if you have questions. It’s a good idea to speak with parents and therapists using other approaches too.
  • What we will do is give you a list of other intervention approaches at the bottom of this page, so you can get their own descriptions from their website (where possible) and speak with them directly if you are interested.  When there was no direct website, another source of information has been provided.

How to Compare intervention approaches

  • Some RDI Consultants have been Applied Behaviour Analysis (ABA) therapists before they discovered RDI so they are in a reasonable position to explain how ABA and RDI are different.  However, we realise that there are many variations in how ABA is provided, and is not a specific therapy itself. It is range of different strategies and techniques to teach people with autism spectrum disorder new skills and reduce their difficult behaviour. So we’ll just use the following comparisons as a way of explaining what RDI is and isn’t, rather than of what ABA is. We also hope that this will provide you with a template of aspects to consider when you research other therapies.
  • ASD is a neurological disorder affecting the way the brain is wired. Neuroplasticity means that the brain pathways that promote sameness and disconnect can change.
  • The child missed developmental milestones in social and emotional awareness – usually in the first year of life – due to the growth-seeking drive being diminished by ASD.

Put at Bottom

  • We are often asked if doing ABA and RDI together is a good idea. Our response is usually – no, it would be too confusing for the child and impede their progress. While both have some overlapping intervention goals, they operate from very different principles and use different methods. With ABA your child will typically be given verbal (and sometimes physical) prompts and a structured stepped procedure to achieve a specific skill. They will be reinforced for compliance. It’s about practice to achieve a particular behaviour or skill to achieve basic independence in living skills. It uses and encourages static thinking. With RDI the focus is on the process – how the brain is activated, thinks about and organises what’s happening and the child’s interaction with others. This makes it a flexible and dynamic process.
  • For example, with ABA, learning to clean teeth would be about the steps involved:
    • getting the toothbrush,
    • getting toothpaste
    • opening toothpaste
    • putting a small squeeze of toothpaste on the brush
    • putting lid back on toothpaste
    • putting toothpaste back
    • practising brushing up and down
    • spitting out
    • turning on tap
    • rinsing mouth
    • rinsing toothbrush
    • turning off tap
    • putting toothbrush back, etc.

Which steps are easiest for your child would be determined and they would receive support and praise for doing those and verbally prompted and physically assisted for the rest. You’d record which steps were done independently and which ones assisted and probably end the task with a high five. Following those steps and gradually gathering more independent in doing all the steps correctly and effectively is the goal.

With RDI, we use teeth cleaning as a great way for parent and child to connect with each other.

  • With little children, we’d have the child standing on a step to be closer to dad’s height so they can be face to face.
  • There would be no verbal prompting about the process. It would happen without words, but may include a few fun and timely sounds.
  • Dad might get his brush and hold it with an quizzical look on his face and look at his son.
  • He might then get the toothpaste (if his son doesn’t get the hint) and hold it out to his son to take off the lid (presuming he can).
  • Then he might hold his toothbrush near the toothpaste to see if his son will squeeze some on for him.
  • Dad would be making sounds and expressions to encourage his son’s engagement with him and make this fun.
  • Next dad might accept the toothpaste and prepare to put some on his son’s toothbrush – but his son isn’t holding his toothbrush yet, so either son gets the hint, or dad might put toothpaste on his son’s finger instead.
  • When they are both ready with their toothbrushes, dad will open his mouth wide to show his teeth and slowly apply the toothbrush, grinning and using his eyes to engage with his son.
  • The son might just watch, or he might decide to do what dad does.
  • He won’t to it quite the same as dad, but that isn’t what dad is aiming for. He’s using this time to connect and have fun, making toothbrushing a together time, rather than a chore to learn.
  • They might have fun trying to spit out at the same time when they’ve finished, with dad dramatically puffing his cheeks out trying not to spit out until his son is ready
  • They might even have a go at taking turns to clean each other’s teeth, if his son’s teeth need some adult attention.  

Typically, in this way, although the goal wasn’t learning to brush teeth, the son is keen to do what dad does and enjoy his company, so he learns the skill in the process and they have lots of interaction and fun as they go.  The parent will often set up a video recorder on a tripod unobtrusively and record short interactions with their child so that they can review what they were doing and their child’s response, so they can adjust what they do next time. They also share relevant videos with their consultant via an online learning platform.

A note about research

Research is in the early stages for many interventions even though they may have been established over 10 years ago. It’s a slow process. Some types of therapies are a lot harder to research. Specific skills like learning to feed the dog or increasing vocabulary can be measured, but relationships, flexibility, dynamic thinking, and self esteem are more complex. It is also important to look at the research and check it measures the types of results that you are seeking.  A long list of research papers is not relevant if it doesn’t support progress in the goals you want. Interventions that are supported by large organisations or universities that have the staff and funding to do research are more likely to have a body of research. So don’t use “evidence based” as your sole criteria.

“Increasingly, researchers have been suggesting that the idea that there is a best treatment for autism is counterproductive and misleading” (Carr and Granpeeshah, 2008). I wholeheartedly agree with this statement. The individual differences observed in both children and their families call into question the notion that any one approach—or even one category of approaches can meet the needs of all children and families.  Barry M. Prizant, Ph.D., CCC-SLP, “Straight Talk About Autism” Autism Spectrum Quarterly • Spring 2009  (Something more recent would be good.)

Everyone’s strengths, challenges, preferences and circumstances are very different, so choose what suits your child and your family best.

Some sites that may help you choose an intervention:-

Be aware that the information on these sites may not be up to date and the information they provide may not be accurate. We provide no warranty for the information on these sites. We know this is the case for RDI so it is likely to be so with other services too, but it’s a starting point.  

List of Intervention Approaches  

This list has been adapted from Table 6 in the 2011 Review prepared to show eligibility of interventions for funding under the Helping Children with Autism (HCWA) Package by Prior, M., Roberts, J. M.A., Rodger, S., Williams, K.& Sutherland, R.(2011), A review of the research to identify the most effective models of practice in early intervention of children with autism spectrum disorders. Department of Families, Housing, Community Services and Indigenous Affairs, Australia.

Comprehensive Programs

Service Based Treatments Specific to Autism

  • PlayConnect facilitated playgroups for young children with ASD

Family Based Including Parent Training

Therapy Based

Single Element Components Addressing One Aspect of ASD

Other Autism Information

Books about or related to Relationship Development Intervention

  • The RDI Book – Forging New Pathways for Autism, Asperger’s and PDD with the Relationship Development Intervention Program by Steven E. Gutstein
  • The Relationship Development Intervention (RDI) Program and Education by Steven E. Gutstein
  • My Baby Can Dance – Stories of Autism, Asperger’s and Success through the Relationship Development Intervention (RDI) Program Edited by Steven E. Gutstein, Hannah R. Gutstein & Carlotta Baird.

Comprehensive Information for parenting children with ASD

  • The Autism Discussion Page on the Core Challenges of Autism – A toolbox for helping children with autism feel safe, accepted and competent by Bill Nason.
  • The Autism Discussion Page on Anxiety, Behaviour, School, and Parenting Strategies – A Toolbox for helping children with autism feel safe, accepted, and competent by Bill Nason.

Families’ Journeys

  • Love Tears and Autism by Cecily Paterson
  • A Child’s Recovery from Autism by Hanna Rotbaum

Background reading related to Relationship Development

  • Apprenticeship in Thinking. Rogoff
  • The First Relationship: Infant and Mother. Stern
  • How Children Learn the Meaning of Words.  Bloom
  • Joint Attention: Communication and other Minds. Elian, Hoerl, McCormack, & Roessler
  • Emotional Development: The Organization of Emotional Life in the Early Years. Sroufe