Monday, April 19, 2010

What Eggsactly Is RDI? Part V

Last month, I started meeting with a group of families in my town who are interested in learning about RDI. We meet every other week and discuss chapters in The RDI Book, and this week we will cover dynamic communication in Chapter 3. As we talk about the early phases of implementing RDI, remembering our journey and thinking about what someone new to RDI might need to know has lead to this series. I promise you this is my final post on what I understand about RDI at the beginning of the fourth year of our journey.

Video You may wonder why I record so many of our activities. These videos document what Pamela can do, clearly and unequivocably. They represent mounting evidence of her growth in dynamic thinking and our growth in guiding her. They also help me see nuances that I missed during the interaction and let me go with the flow because I know I can watch it later. Watching the videos and editing them helps you learn from your victories and from your mistakes.

I skipped uploading one segment where I failed miserably! I had secretly written Pamela's name on an egg in white crayon. I expected her to be surprised and delighted. I was so focused on product (her reaction) that I fell into the trap of direct questions and prompts to elicit the desired effect. Pamela saw her name and wasn't a bit interested in it. It took me about three minutes to get over my disappointment, which I masked in a flood of talking. While watching the video, I scolded, "Badly done, Tammy!"

Recording is a time-consuming hassle, especially when you had the most wonderful interaction, and later notice the video cut off your heads! Moviemaker doesn't like the VOB files from my camcorder, so I must convert them before editing. The sound went out on my computer so, until I get it fixed, hopefully under warranty, editing has a new wrinkle. The thought of uploading it to someone who is an expert in GPR and dynamic thinking isn't easy. Then, I spend a little more time typing my objective, what worked, what didn't work, what questions I have, etc. I have a hard time taking constructive criticism, and my consultant Amy frames it gently to lessen the sting. As inconvenient as it sounds, taking the time to record, observe, process, and reflect is worth the effort.

If a picture is worth a thousand words, then a video is worth a mega byte of words.

Framing in Different Stages
Almost anything you do in your daily life, whether routine chores or holiday activities are RDIable (is that a word). The key is how you frame the activity. For example, in Stage 1, we addressed nonverbal communication. I placed all necessary tools and things on the table. Pamela's role was to hand me objects, and mine was to take the next step. I looked at the object (a tablespoon), while she pointed to objects and checked my reaction until she found the right one. In Stage 3, I worked on monitoring me for new actions while she did her role. In Stage 5, which is when children are ready for building friends, I will invite someone over who has about the same level of social competence and let them color Easter eggs together while I watch and scaffold when necessary.

Same-But-Different Thinking of activities in a "same-but-different" point of view helps our children embrace novelty better. Early on, interaction patterns help with this. I take a pile of rolled-up socks and set up an assembly line to put them in the basket: sock-me-Pamela-basket. Once I get a great rhythm, I add a teeny variation (dropping it into her hand, doing an airplane into her hand, etc.). It's not all that different from the silly games parents play feeding infants. The interaction pattern is the same, but the delivery is slightly different. After I move the basket upstairs, I have the same interaction pattern, but a different destination: sock-me-Pamela-drawer. Half of the way through, I do same-but-different pattern by swapping roles: sock-Pamela-me-drawer. If it's a really good day, I try a new interaction: the job of getting the socks in the drawer is the same, but the interaction pattern is different.

For coloring eggs, I used a more sophisticated version of same-but-different. Pamela always got the warm water, but sometimes I poured and sometimes she poured. Sometimes I poured the vinegar into the spoon and she dumped it into the dye, and, at other times, we reversed roles. One color (red) required no vinegar. The biggest same-but-different moment came when Pamela wanted a purple egg in the video clip below. She tried to combine the red and blue dyes, but I stopped her because we would have no more red and blue. I had on-hand food coloring for such a situation. This time she needed boiling water, not warm water. She needed a teaspoon of vinegar, not a tablespoon. This time, she counted drops, instead of using a tablet. Now, she is much less resistance to change and novelty because we set up same-but-different moments in our activities.

Eye Gaze You may notice how well Pamela follows my eye gaze. When I look in a specific direction, she looks there, points, and checks my face to see if she's on track. She learned to do this three years ago. I set up two cups in at opposite ends of a long table. I looked at Pamela, smiled, and looked at the cup. Unfortunately, she thought I was following a pattern: left, left, right, right, etc. She spent about two weeks getting it right half of the time because she was trying to crack a pattern that did not exist. One day, inspiration hit me. I grabbed an empty toilet paper roll to spotlight what I was doing. This time, it clicked! She realized that the direction of my face was the key, not keeping track of a pattern. From that point on, we hunted for treasure, looked for ingredients for baking, found items on my mental shopping list at the store, etc. through eye gaze. Three years later, Pamela does it without thinking.

Monitoring The final process I would like to spotlight is how I made sure Pamela had opportunities to monitor. In this clip, she kept track of the microwave and turned to check the time before thirty seconds were up. She counted the right number of drops of purple food coloring (twenty-five). Not only can she monitor me, she can also monitor other things. I am making sure that she can track two objects in her working memory, which is part of the dynamic interactions in the brain, currently researched to better understand the coordination of attention and action.

Is there more I could say on this subject? Oh, yeah! However, by now, you are probably glad for my restraint . . .

Friday, April 16, 2010

What Eggsactly Is RDI? Part IV

Is an autistic child who doesn't speak nonverbal or noncommunicative?

There is a huge difference. Infants are born noncommunicative: their actions and vocalizations express how they feel for they don't intend to communicate with another mind. It takes the average infant about 15 months for horizontal integration (i.e., nonverbal communication) to come online. Even though they may not have any words, they communicate. Not only that, every time they point to something, say Easter eggs, and look back to check their parent's face, they have the desire to know if they share the same feelings. That motivation to share their inner world and learn more about other inner worlds is the foundation for building dynamic thinking.

RDI tries to model this process and redo missed developmental milestones, first, by helping the parents learn Guided Participation Relationships (GPR) and, second, by guiding the parents guiding the child to master nonverbal communication. From March 2007 to May 2008, we managed to learn enough about GPR to guide Pamela from Stage 1 (infant level) to Stage 2 (one- to two-year-old level), lone ranger, with the help of a bunch of dear cyberfriends. Our consultant, Amy Cameron, filled in some gaps in our GPR and got us started with vertical integration, or executive function skills. Pamela is well on her way for she worked up to stage 3 (two- to three-year-old level) in July 2009. At present, RDI has twelve stages in the child objectives.

The brain's boss, the pre-frontal cortex, manages mental processes that control and regulate behavior, attention, memory, language, motor skills, etc. in adapting to ever-changing, real-life situations. People who don't understand executive function expect an articulate, highly intelligent Aspie with impressive static skills (music, art, mathematics, memory, computer skills, etc.) to be successful. Their struggle lies in dynamic thinking, the domain of executive function. The following list of pre-frontal cortex functions explains why ASD adults with great language, high IQ, and solid education struggle to stay employed, live independently, and develop relationships in which both parties find real companionship:
  • Start and stop tasks (or why transitions are hard for our kids).

  • Persevere when challenged (or why our kids melt down when the going gets rough).

  • Recognize when novel situations are significant (or why someone threw a tantrum because he didn't know that rain meant no beach).

  • Develop alternative plans when unpredictable events disrupt routines (or why your reliable teen unloaded dirty dishes after someone interrupted the dishwasher cycle to take a shower).

  • Inhibit inappropriate behaviors (or why you nearly died of embarassment when your sweet girl looked at the veins of an elderly lady's hand during the sharing of the peace and said, "Is it old?").
We are seeing the early stages of executive function in Pamela. While coloring Easter eggs, she monitored me with her peripheral vision while executing her role. In the video below (the one I showed in Part II of this series), Pamela looks like she is ignoring me at first. While she was opening and exploring the box, I watched her attentively and she stayed focused on her task. When I did something different (take the egg stickers) 45 seconds into the clip, she stopped what she was doing and watched me. She went back to her task while I flipped over the bag but glanced at me when I grabbed the egg bands. She returned to her task and started filtering out my actions because she categorized them as the same (taking and moving stuff). At the 1:25 mark, I grabbed the cup--the same action as before (taking and moving stuff). Then, I did something completely different and Pamela immediately filtered in that odd act of mine (putting the cup to my eye). She dramatically shifted her gaze to me. When she realized my actions were insignificant, she shifted back to her task. I started punching holes in the box (something completely different), so she split her attention between sneaking glances at me and working on the cups. When she struggled to open the bag of dye tablets, she began to monitor me more closely because she needed reassurance. At the 2:24 mark when I deliberately paused and gave her my full attention, we looked at each other. I nodded to reassure her about the bag and she decided I must be telling her to get scissors.

Do you understand the beauty of the elegant dance I just described?

This truly is a monumental shift in dynamic thinking for Pamela!

How did this happen? We slowed down our interactions, giving Pamela time to observe, process, think and do (or not do). While we apply static skills, quickly without thinking, dynamic skills take time and thought. They cannot be rushed. For an autistic person, they require even more time: time to split attention between monitoring another person and doing one's role, time to process that something different has occurred, time to think whether or not it is significant, and time to decide how to respond if necessary.

Reading demonstrates how important both static skills and dynamic intelligence are. Children must learn to learn phonics and recognize sight words automatically, which is why Charlotte Mason endorsed teaching both, a static skill. She also knew that a dreary page full of repetititive words are "one of many ways in which children are needlessly and cruelly oppressed." She made teaching dynamic by starting with nursery rhymes, which provide novelty and productive uncertainty, and by suggesting many activities that offered enough variation to keep attention fresh. She discouraged parents from coming up with nonsensical patterns to practice phonics because reading ought to be a search for meaning. She reviewed word patterns by dictating sentences for children to spell. She suggested that, if a passage had unfamiliar words, the child could leave a blank space, giving them something meaningful to discover in the ensuing lesson. Finally, she let children retell the passage and what they understood rather than having them answer a bunch of static questions requiring little thought. Narrating back a reading involves a sense of story, summary, inference, prediction, etc. Charlotte Mason's ideas were brilliant because she gave children an active role in reading and thinking. She spotlighted meaning in every lesson because she intuitively recognized the link between dynamic intelligence and reading comprehension.

Sensory issues and challenges with vertical integration go hand in hand. When a child is hypersensitive to sensory stimuli, she is monitoring everything, filtering in nearly everything, and filtering out very little. Too much of this overwhelms the brain, leading to meltdown. When a child is hyposensitive or hyperfocuses on something that absorbs his interest, he is monitoring very little, filtering in nearly nothing (except the source of obsession), and filtering out nearly everything. Children with severe sensory issues benefit from sensory integration therapy or HANDLE.

Like many children in the spectrum, Pamela used to fear balloons. Her automatic reflex (static thinking) was to scream and cover her ears at the sight of a balloon. Last May, she started experimenting with water balloons. She enjoyed filling them and tossing them on the brick patio. Her screams were a mixture of joy and excitement. Eventually, she made tiny balloons no larger than a bubble gum bubble and asked me to pop them. She squealed in a happy way. Her residual automatic reaction was still squealing, but she was teaching her brain to a new algorithm for monitoring balloons. They could be exciting and fun, instead of terriying. In time, she worked up to popping larger air balloons by sitting on them and eventually stomping them. She even had me pop large balloons with a pin in her presence. She filled her episodic memory with positive experiences, and her fears are much less than before. She invented this process of desensitization all on her own, another sign of her dynamic thinking.

Wednesday, April 14, 2010

What Eggsactly Is RDI? Part III

For years, I believed that Pamela couldn't learn nonverbals for I believed her brain was hard-wired not to communicate in that way. I mainly focused on speech. We worked so hard for every word and every sentence that, when RDI felt like taking taking a step backward to focus on nonverbals. Since Pamela did not have the habit of paying attention to my actions and body language, all she needed to process was words, or text, a script without any stage directions.

To give you an example of what our children might be missing by relying upon only words, I typed up a script of the beginning of the video posted below.

Me: Ooooo! Very nice!
Pamela: Good.
Me: What color do you want to do?
Pamela: Green.
Me: Green. Okay now, with the green, we're going to have to add one tablespoon of white vinegar. We need one tablespoon of white vinegar.

Did you catch everything that was going on? Probably not.

I rewrote the script with different channels. Imagine you have five color-coded wires that carry specific stimuli. In an instant, our brains process information from all five wires into one packet of meaning, which I placed in capital letters. Infants spend the first year-and-a-half of life, learning how to interpret each wire of information and process it all into one packet of meaning. Isn't the brain amazing?

Black = text
Green = actions
Red = head movement/facial expression
Purple = point or other hand gestures
Blue = voice changes

I follow Pamela's track with my eyes as she carries a cup of water and hands it to me. PAMELA KNOWS I WANT THE WATER. I put my finger in the water TO TEST THE TEMPERATURE. Pamela she watches me with her hands up IN ANTICIPATION. She wiggles her fingers AND FEELS NERVOUS. My voice takes on a high-pitched intrigued tone.
Me: Ooooo! Very nice!
THE TEMPERATURE IS PERFECT. Pamela opens her mouth and drops her hands TO RELAX.
Pamela: Good.
I shrug my shoulders and lay my hand on the table palm up TO INVITE HER TO SIT.
Me: What color do you want to do?
Pamela sits.
Pamela: Green.
I look down TO STUDY THE BOX and pick up the cup of water. Pamela watches my movement. SHE IS TRYING TO FIGURE OUT HER ROLE. I pour while I talk so my voice pacing has starts and stops.
Me: Green. Okay now, with the green, we're going to have to add one tablespoon of white vinegar.
I grab the bottle of vinegar and speak slowly. I'M NOT SURE SHE UNDERSTOOD.
Me: We need one tablespoon of white vinegar.
I touch the cup of green dye TO SHOW WHERE THE VINEGAR GOES. I clasp my hands together and stare at Pamela. I'M WAITING FOR HER TO MAKE A MOVE. Pamela stands up to get the tablespoon. PAMELA UNDERSTANDS ME CLEARLY.

One of the broad goals of establishing a Guided Participation Relationship (GPR) is to present opportunties for your child to look to you for information, not pure words, but multi-channel information, and begin to piece together what it all means. At first, this task is incredibly difficult. It may be only possible to focus on one channel at a time: smile versus frown, head nod versus head shake, nah-uh versus uh-huh, happy sound versus sad sound, etc. Picking ingredients already sitting on the table to put in a bowl, shopping for ten items on a list, going on a treasure hunt at the park, looking for lost toys, playing I spy, putting away silverware, etc. are ripe for this kind of broadband communication, or horizontal integration (the brain process sensory information into meaning).

Reviewing elements of GPR from yesterday in this clip, we have some productive uncertainty. I told Pamela to get warm water. Warm is an ambiguous word. She doesn't easily distinguish between fractions of a cup, tablespoons, teaspoons, and fractions of a teaspoon. I didn't realize the clean tablespoon was in the dishwasher, so she searched quite diligently before asking for help. I really don't have any sensory issues, so my helplessness at having wet fingers surprised her. Pamela was slightly annoyed! Pamela's active role was to fetch things. We didn't follow any clearcut interaction patterns, but, in later clips, we randomly took turns pouring water and vinegar.

Zone of Proximal Development (ZPD) GPR requires thinkspace. I know where Pamela is in various areas of her development. The key to making uncertainty productive is to know what is within reach for your child. I would not expect a young, impatient child to search through drawers for a tablespoon, only for it to be in the dishwasher! I would have everything needed on the table, ready to go, for wee ones with short attention spans. I would plan a five-minute task and be ready to switch to something else. I would not expect a child with fine motor delays to handle boiled eggs without dropping them. The ideal is to have a child work on the edge of where she feels competent without pushing so hard that she screams and cries out of frustration. Constant dysregulation might be due to working outside the zone too often. The book Awakening Children's Minds by Laura Berk explains ZPD and other elements used in RDI, including references for actual research studies.

Framing In framing an activity, keep in mind the child's ZPD and your objectives. If you are a beginner at RDI, focusing on yourself is more important than what your child accomplishes. In setting up an Easter egg activity, if your child has fine motor delays, you might want to set up an assembly line of scooping a treat into a plastic egg (the child) and then putting on the top (the adult). If you do your productive uncertainty correctly, interest usually lasts longer than expected: suppose you get through three eggs and your child scoops treats into the egg easily, you might make a face of anticipation (the kind you use when playing peek-a-boo) and then grab the wrong color top. Or you pick the right color top, make the face, and drop it. "Uh-oh!" Or you wink, say, "Sh!", and sneak a bit of the treat. Or you switch roles. Variation often extends attention span, but eventually it wears off, so have a second step planned: putting stickers on the eggs to decorate them: you peel and they stick. Have a third step, take turns putting an egg into a basket for the Easter bunny to hide later.

Framing means setting up the activity in a way to spotlight your objective, which in this case would be learning the intricacies of GPR. Even now, once I start an activity, I think about how well I am guiding Pamela. Am I going slowly enough for her to feel competent? Does she have an active role? Am I limiting my words and exaggerating my nonverbals? Am I using declarative language?

Scaffolding While framing is what you do before an activity, scaffolding, another element covered in Awakening Children's Minds, is what you do during the activity. Scaffolding is giving a child just enough support to create productive uncertainty while staying in the zone through warm, encouraging interactions and modeling helpful self-talk. I did not offer to help Pamela until asked. I didn't fuss about failing to find the tablespoon and, while I searched, I modeled thinking out loud to help her see how thoughts guide our behavior. I stayed upbeat, even when I could not find it myself, so that she learns to remain calm and neutral during problem solving. Scaffolding is dynamic because we give more support when walking on the very edge of competency and less support for something nearly mastered. Some days require more scaffolding than others because we all wake up on the wrong side of the bed sometimes!

Social Referencing By the age of twelve months, infants can do some social referencing, which is paying attention to their parents' nonverbal communication when solving a problem. In the visual cliff experiment (click here for the video), parents place their infants on a crawling table set up to look like a cliff. Infants recognize the potential danger, stop, and look to their parents for guidance. If the parent smiles, the infant keeps crawling. If the parent looks fearful, the infant refuses to budge.

Social referencing greases the skids of otherwise awkward situations. A lovely scene in the new production of Emma illustrates this. At her first dinner party at Hartfield, Harriet Smith references the behavior of her guide Emma Woodhouse into Highbury's high society. When unsure how to wear a napkin or spoon soup, she carefully watches Emma for clues. Later, when Harriet believes herself in love for the third time in a year, Emma cautions her to check her feelings and "Let his behaviour be the guide of your sensations." That is really referencing in a nutshell, letting the behavior of people you trust guide you.

It takes time to weave all these elements together real-time on the fly and capitalize on opportunities as they arise. The other day, Pamela and I headed to the post office to mail the census form. I parked parallel to the spot where the blue mail boxes are, only three cars back. Pamela has mailed stamped letters all by herself before, but never metered mail. I was curious to see if (a) she would notice the envelope lacked stamps and (b) she would reference me to solve the problem. Since this situation is in her ZPD and making a mistake would not be the end of the world, I framed it by deciding not to mention anything. Sometimes, deciding what not to do is as important as deciding what to do. She scampered down the sidewalk to drop off the envelope. I scaffolded her by staying in the car and waiting to see what she would do. Pamela stopped at the box for stamped mail and then flipped the envelope around a couple of times. When she realized it had no stamp, she hesitated and looked at me. My heart leapt for joy. I shook my head, so she stepped to the metered box and mailed the census form. The true test of mastery in RDI is not getting the targeted response in a series of repetitive drills, carefully generalized. It is seeing the child apply the objective in the real world, unprompted, because it just makes sense.

Tuesday, April 13, 2010

Snoopy Dancing, or Guess Who Just Got Nominated for Palmetto Boys State?

Congratulations, David!

We are so proud of you for getting nominated--one out of seven juniors from your high school--for such a prestigious camp this summer. Together, we built the foundation through our many years of homeschooling. This year, your first year in high school, you remained true to yourself and maintained your character!

"Only boys with outstanding qualities of leadership, character, scholarship, and loyalty and service to their schools and community should be considered." PBS

"Sow an act, reap a habit; sow a habit, reap a character; a character, reap a destiny." Many sources

"'Sow an act,' we are told, 'reap a habit.' 'Sow a habit, reap a character.' But we must go a step further back, we must sow the idea or notion which makes the act worth while." Charlotte Mason

"Provide a child with what he needs in the way of instruction, opportunity, and wholesome occupation, and his character will take care of itself: for normal children are persons of good will, with honest desires toward right thinking and right living." Charlotte Mason

Saturday, April 10, 2010

What Eggsactly Is RDI? Part II

Guided Participation Relationship (GPR) Yesterday, I promised to talk about a Guided Participation Relationship, the process parents study intensely in the first few months of RDI. The following video of Pamela and me opening the egg coloring kit illustrates it well. GPR is how parents help children gain new understanding and skills by working together. We frame and reframe our roles to challenge the child mildly and avoid overwhelming them. RDI helps parents figure out how to guide autistic children into following their lead without commands.

Keep in mind that the ease with which Pamela actively participates with few commands or prompts from me is the result of three years of work. Don't worry if your child can't do this right now! It's okay. Pamela couldn't do it either.

Productive Uncertainty We haven't colored eggs from a kit in ages for a variety of reasons (visiting family, having family visit, creating natural dyes, trying Ukrainian wax, etc). It's been at least six years! Pamela solved several problems, but only one was entirely new: collapsible egg cups. An interaction needs enough uncertainty to challenge without overwhelming her. Too much challenge leads to meltdown, which is unproductive. No uncertainty leaves no problem to solve (also unproductive). One element of GPR is knowing how challenging an activity is to your child and giving the right amount of support to create moments of productive uncertainty.

Active Roles Pamela relied on several strategies that infants master: she trusts me and stays in close contact. All good relationships build on trust! She monitors what I do and gets involved when she can. She pays attention to any instruction I give, whether it's verbal or nonverbal. We don't rely upon heavy-duty commands and prompts, which tends to make children passive: they are waiting for the next prompt. Since Pamela now has toddler-level strategies, I let her take an active role in figuring out the first step. I invited her to sit by moving her chair, and she did. I give her plenty of time to study the box. She confirmed with me our purpose, "Coloring." My first reply was too indirect, she asked again and I replied, "Yes, we're coloring." Wanting to know my perspective is one form of social referencing because I am her compass.

Interaction Patterns Pamela decided to open the box but referenced me first ("Open it"). She pulled the contents and I moved what we didn't need out of the way. I flipped over the bag with the collapsible egg cups curiously and left it alone. Again, I patiently waited for her to decide what to do with the bag. She referenced me before opening it. Another element of GPR is thinking about roles and interaction patterns. In this case, her role was to open the cups and add tablets to them. My role was to punch the perforated circles out of the box to make a drying stand. Basic interaction patterns are assembly line, turn-taking or reciprocating, and simultaneous. Our interaction pattern was doing different, but complimentary things, simultaneously, almost like toddlers do parallel play.

Horizontal Integration You may have noticed the wide variety of communication Pamela understands: gestures, head movement, facial expressions, sounds, and words. Infants become masters of nonverbal communication in the first eighteen months of life by splicing together the separate channels of information into meaning. Something as simple as a wink completely alters what we say. This foundation is horizontal integration, or broadband communication. Children learn to think with their eyes--a term coined by Michelle Garcia Winner whose blog is RDI-friendly, before focusing on higher-level thinking.

Vertical Integration Pamela has learned to monitor my actions for anything different and consider if it's worth taking her own action. When I opened up a collapsible cup and put it to my eye like a spyglass, she turned her full attention toward me until she realized I was being silly. Monitoring people, filtering out fluff, and filtering important information that needs careful thinking is called vertical integration. Children started doing this after they have mastered the basics of nonverbal communication.

Intersubjectivity When Pamela struggled to open the bag of tablets, I paused and she immediately looked up because I was doing something different (more vertical integration). We exchanged glances and nodded to each other agreeing that she needed scissors (more horizontal integration). I checked how closely Pamela matched the tablet to the color of the cup's rim and gave her indirect approval, "I guess that will work." She let me know she was finished by saying, "Good." We took on new roles: I became the reader and Pamela became the collector. I told her what we needed. At first, she disagreed about getting a measuring cup and said, "Without." After I reassured her, she looked in the wrong place. I let her search until she decided it was time to ask for help. I answered her by turning my gaze to that of the cabinet. When I explained the next step, "It says 5 ounces of" and she anticipated me, "Water." I paused dramatically and said, "WARM water." She replied, "It's warm," and headed to the sink. Pamela understands the importance of sharing her thought-life and values what I think, which is called intersubjectivity.

In GPR, adults use tools like productive uncertainty, active roles, and interaction patterns to help children integrate their brains by problem solving. Sometimes we do too much to protect our children from error (ahem, the science fair project too perfect to be the work of a student). The danger of doing too much for an autistic child is creating a world where nothing is out of place, and, with their exquisite eye for sameness, the child demands a more and more predictable world. Introducing unproductive uncertainty, slowly while helping the child calm down when slightly dysregulated, introduces novelty in a controlled setting. Assigning active roles guides them on the path of searching for meaning. Interaction patterns provide a same, but different framework for children to address new problems. When child learns a turn-taking pattern to toss dry clothes in a basket, later she can apply that to many other situations: putting rolled-up socks into a basket and later into a drawer, putting silverware into a drawer, building a tower of blocks, etc. Turn-taking builds the foundation for higher level skills like having a conversation and playing games.

We resist the temptation to create a perfect product (thereby doing too much to make it happen) by focusing on the process, not the end result. Actually, long-term, the hoped-for end result is to integrate the brain vertically and build executive function. During our interactions, I wonder, "Am I giving her enough time to observe, process, and think? Am I giving her enough novelty without flipping her out? Does she find her role important enough to search for meaning and feel good about her contribution? Are our roles and communication balanced so that neither of us are exerting too much control? Am I giving her opportunities to interpret both verbal and nonverbal information? Am I talking too much again? Is she really monitoring me or tuning me out?" Is your head spinning? Mine sure did when I first started learning the intricacies of GPR!

You will see in later clips that we drew on our eggs with crayons. Some of my eggs turned out quite psychedelic, failing to match my vision of loveliness. Pamela's eggs had mainly scribbling and a couple of pictures and words. I dropped one and cracked it, and so did Pamela. Our eggs were not worthy of Ukranian artistry. However, they were good enough for us and we both learned new ideas about coloring eggs.

Friday, April 09, 2010

What Eggsactly Is RDI? Part I

Pamela and I decorated eggs last Monday. The occasionally blurry clip illustrates how much more integrated her brain is. While coloring eggs with crayons, we took turns singing bits and pieces back and forth. She enjoyed my play on the word blue. When we shifted to using the egg handle, a new skill, she became very quiet, paid attention, and lifted the egg out on her own. Once she went back to coloring, Pamela relaxed and played. Not only did she multi-task here, but her executive function skills kicked in: she knew when to banter and when to sharpen her focus without prompts and correction.

For new readers, Pamela could not do any of this three years ago. Last year, I blogged video clips of Pamela before and after and, if you want to see the difference, click here.

Three years ago, I remember looking at videos of families doing RDI and smugly thinking, "That looks so easy! Pamela can do that!" Not being able to do the simplest things like smile at me as we each opened a bag of Jell-o rocked my world. She could not even watch what I did and copy it without heavy verbal prompting, which is what you don't do in RDI. Even though she was smart and capable, she could not interact in ways that some of the lower functioning teens on the videos could. I finally realized that Pamela really operated like an infant in social and emotional milestones.

What a shock!

Right now, I'm shepherding some parents through reading The RDI Book (a must-read) and giving them strategies for beginning RDI. I have heartily recommended my consultant (Amy Cameron), who is the best. However, some people want to have a clearer understanding of what it entails before taking that step. I would be a hypocrite if I didn't support them for we tried implementing RDI for 15 months before we hired Amy.

What is RDI? I think RDI is a two-pronged approach at giving people in the autism spectrum the chance to develop relationships (not just follow a script or set of rules), to find meaningful work and their purpose in life, and to live as independently as they can. Many people with autism are highly intelligent and can do some amazing things. Their struggles with understanding people and dynamic situations prevent many from leading full lives.

Why RDI? The point of RDI is to go back to those developmental milestones from infancy on and do them over with an exaggerated GPR. We remediate autism, which is not the same thing as curing: we hope to develop whatever potential for dynamic thinking our children have. RDI is not a race to achieve XYZ before the child reaches a given age. It is a marathon, not a sprint. It is a lifestyle, not a therapy.

What are the two prongs?
(1) Parents learn the intricate details of a Guided Participation Relationship (GPR is a term coined by Barbara Rogoff in her book Apprenticeship in Thinking).
(2) Parents teach children to think dynamically through a GPR, which enables them to progress in social, emotional, and communication milestones.

Are you saying I don't know how to parent? NO!!!!!!! Most of us have both typical children and autistic children. Even parents with an only child instinctively apply GPR with children outside of their family. The reason why parents need to study GPR is that the autistic child did not respond to how we typically parent due to the brain and/or immune and/or gut issues their bodies were undergoing. We slowly changed their parenting style as the autistic child became less and less able to follow.

Is my child too old? Children and adults in the autism spectrum are benefitting from RDI. Pamela had just turned 18 years old when we started. Some consultants specialize in teens and adults.

Why is The RDI Book big on theory and short on application? The book has the latest and greatest information on RDI: how the young brain develops, what the autistic brain does differently, why they recommend interacting in ways completely opposite to most advice on teaching and parenting ASD children, what research documents GPR and dynamic intelligence, what guide and apprentice mean, etc. Certified consultants help you with the application of RDI.

Is a consultant necessary? A consultant will help you apply RDI in your unique family with its own unique circumstances. The consultant evaluates where parents are in GPR and where the child is in dynamic thinking. You get access to e-learning modules, webinars, archived webinars, and extensive and well-organized parent and child objectives through the twelve stages they have outlined. My consultant is three-and-a-half hours from me, and RDI's computerized objective system keeps us on track as a long-distance family.

How do I pick one? Finding the right consultant for you is vital. Your family and the consultants need to mesh well: the consultant is guiding you and you guide your child. Follow your gut: it is far better to pick the consultant right for you and drive four extra hours. You might want to pick on specialized in speech, sensory integration, teens, etc., depending on your situation. Get with other families on autism email lists to find out who they recommend and why. Call several candidates until you find one who communicates well with you. Ask for their pricing schedule and focus on the ones who don't nickel and dime you to death (ahem, my consultant has a flat fee and that works for us).

Will I need a consultant to babysit me forever? The job of a consultant is to work herself (or himself) out of a job. Once parents make it through all their objectives and everyone agrees they are ready to fly solo, parents can assign their own child objectives for a small monthly fee to get access to the computer system. Some families decide to let it go entirely when they see their child making steady progress.

What if I'm a skeptic like you were? What you don't believe me? I'm shocked. Just joking! :-) Find a group of like-minded parents in your town or online who are interested in reading The RDI Book together and discuss what each chapter means and how it looks with an autistic child in real life. Join an email list focused on RDI (I'm on HS-RDI and Autism-Remediation-for-Our-Children). Glean as much as you can from the RDI connect site and consultant websites. Subscribe to parent blogs and consultant blogs too (four goodies for newbies are Horizons DRC (three certified consultants), Kathy Darrow (in training), Laura DeAngelo (certified), and Laurel Joss (certified)).

Stay tuned for a post on Guided Participaton Relationship or how parents guide their children . . .

Wednesday, April 07, 2010

They Say It's Your Birthday!

Like most typical young adults, Pamela loves her music: classical (Tchaikovsky, Mozart, Bach), disco, jazz, Basia, and the Beatles. Two years ago, she designated herself as the music navigator in the car. Then, she started listening to iTunes on the computer and eventually borrowing iPods from her brother or Dad. Did she ask for an iPod for her birthday? No! Pamela is way more savvy than that! She requested an iPhone. Since she rarely talks on the phone, we compromised and gave her an iPod Touch!

Autism is a funny thing because development is so scattered. Pamela is chronologically an adult, but her dynamic thinking is like a toddler. Even though she reads books at a 5th/6th grade level, she enjoys reading picture books, which are at the same level as her expressive language. On top of that, she can do one thing most people will never do: memorized calendars. She can tell you the day of the week you were born, given your birthday and year. The key to teaching a person with such varied abilities is to work in the zone of proximal development (where she is in that particular area). Her dynamic thinking, which drives her social and emotional development, did not take off until we started focusing on infant level milestones three years ago. Rather than worry about being so far behind, I am thrilled with how far she has come: instead of thinking like an infant, she thinks like a toddler!

The Friday before Pamela's birthday, Steve could not help himself. He bought an iPod Touch and could not wait until March 23 to give it to her. He decided to play a trick on Pamela by telling her he had bought a collection of DVDs instead. He kept it very short, and the moment she saw her real present, Pamela went from pulling at her shirt nervously to clasping her hands with wonder to flapping her hands while running a victory lap. The next day, the two of them shopped at Barnes and Nobles where Pamela picked up The Cat in the Hat Beginner Book Dictionary to replace the battered one we bought fifteen years ago.

Monday night, Pamela's birthday eve, we invited my parents over for some cake and ice cream (all within the boundaries of her special diet). Steve had to travel on her birthday, so we celebrated it early. Birthdays generate so much excitement that Pamela plugs her ears before we start singing. We also keep our sense of humor intact for moments like Pamela opening a musical card and closing it after five seconds. Fortunately, the book A Treasury of Curious George fared better. If she does not like a present, she will express herself clearly. Fortunately, she liked all her gifts this year, except for the check from her grandparents in Louisiana, which she accidentally ripped up when opening the mail!

Her third birthday gig was on her real birthday. I brought brownies and ice cream to her watercolor class, and her classmates gave her cards and a vase of flowers! Their sweet gesture touched my heart, but Pamela was not quite sure of how to react. Since she has never received flowers before, she did not gush like a typical twenty-one-year-old female would. However, she opened the handmade card, looked at it carefully, and put it to her ear to see if it would sing to her. Later, I explained to her classmate that Pamela gets overwhelmed by presents and reacts unpredictably, sometimes, flat and underwhelmed and, at other times, flapping and overwhelmed. Her outward behavior does not always reflect how she truly feels.

All in all her birthday was wonderful!

Tuesday, April 06, 2010

How the Grippe Stole Easter . . . Almost

It all started Wednesday, a fine spring day. Pamela and I delivered three and twenty meals on wheels. Along the way, we met a lovely little luna moth, our first ever, and we finally understood why they enchanted Oliver so much in The Four-Story Mistake.

Near the end of our journey, my eyes grew a bit watery, but it could have been the pine pollen, coating everything until it looked like some fairy had been a little too heavy with yellow pixie dust or a giantess in T-ville had opened a bag of cornmeal that blew up in her face and covered the county. The last two houses were smoky between the occupants with a fondness for tobacco and a wood stove. I chalked it off to the remains of the day.

By the time I picked David up from school, fits of sneezing attacked me, quite capable of building six-pack abs in a few days. The drippy eyes and itchy throat pointed to seasonal allergies, so I grabbed a lemon-berry slushie from Sonic for comfort. We zipped through Wallie world for some OTC allergy medications, purchased only for the spring onslaught. [Photo Credit: Brenda at Lee's House of Monograms]

Later, I headed off to Bible study as usual with an extra supply of tissue. The sneezing grew worse, and my head began to spin ever so slightly. The rather large fellowship hall grew hotter and hotter, so I began to wonder about hot flashes. My mind wandered and I could not track the lively discussion about the book The Prodigal God. I got out of there as soon as possible, went home, and collapsed into bed.

Alternating between couch and bed, I slept until Saturday morning at noon, except for necessary duties. With Steve in Illinois through last Thursday night. . . dogs . . . David . . . noodles for Pamela . . . a load of laundry . . . dishes. . . in between head aches . . . muscle aches . . . pains . . . chills . . . fever. I made one trip to Wallie world for Edy's fruit bars (miraculous stuff), broth, chicken noodle soup, tissue, juice, and toilet paper (we were out). I belong to the old school of flu-fighting. If you have a healthy immune system, then God's little white soldiers do their duty. Fevers are for killing nasty things in your body. Eruptions of mucous are for those little nasties that can make a hasty retreat. Tiredness is to force you to stay in bed where you belong. Two to three days of absolute misery avoids two to three weeks of bronchitis. And, when the grippe grabs you Wednesday and you have to sing on Sunday, no pain, no gain!

We took things slow and easy on Saturday, doing a little in between catnaps. Before heading to bed early, I stumbled upon something on youtube that got me into the Easter spirit: recordings of Handel's Messiah with a score that scrolls along with the music. I selected the brilliant Amen chorus and could not resist softly singing the alto line which I have memorized except for a few snarky parts that these nifty little videos might solve! And beneath all that mucus lay my voice. With careful cough management, I could sing as high as an F, all that was needed for choir. I prayed to God to give me a sign at the Easter sunrise service. If I could sing the hymns without collapsing into a coughing spell, then I would take it as His blessing for singing at the indoor service.

Before dawn, I emerged out of my house, blinking like Rip van Winkle at the fairyland near my house. The pink, magenta, and red azaleas had bloomed as did the sunny Carolina jasmine. The carefully cropped wisteria waved at us, wafting its sweet perfume. The weather was picture perfect, not too hot and not too cold. The cool fresh air soothed my face. Spring had sneaked up behind my back while I was sleeping through April Fool's Day, Maundy Thursday, World Autism Day, and Good Friday.

Farm fields surround our church on three sides, so the setting was gorgeous, mist blanketed the fields, a light blue sky that blushed in the spot where the sun would debut. Just as the pastor started speaking, as if on cue, a large flock of geese flew in V-formation overhead. From time to time, cardinals and mockingbirds serenaded us, crows crackled, and cows made their presence known. Another flock of geese headed into the pink beam when the sermon began. The pastor talked about the burning hope flooding the hearts of different disciples with joy as the good news spread, and the sun appeared on the horizon, also burning and flooding our hearts. All of creation celebrated Easter with us. The birds and cows sang the last hymn, and I did too! After sharing breakfast in the fellowship hall, we headed home. Steve ran, and I recovered and felt good enough to sing with the choir. Again, singing the joyful music flooded my heart with gratitude.

In bed that night, all the blessings of this Easter washed over me. It came without candy and baskets and bunnies. It came without dresses and dinner and egg hunts. It came without feasting and parties. By the world's trappings, we had one of the worst Easters on record!

Easter is about relationships, the horizontal relationships with our dear ones. My husband did not fuss because I had no goodies. My son had patiently took on extra duties when I was too woozy to get off the couch. My daughter showed absolute resilience and compassion by not freaking out by this unexpected disruption of the holiday. We shook on it that we would color the Easter eggs on Monday (and we did). My parents who normally coordinate with us in preparing a scrumptious banquet had worn themselves out gardening, and we contented ourselves with sharing a pizza instead. My choirmates exclaimed, "We missed you Thursday and are glad you are able to sing this morning!"--particularly striking since I was the most under-dressed person in church that morning: all I had energy for was throwing on my black outfit, boots, a necklace. Makeup was beyond me.

At the formal service, our pastor spoke on our vertical relationship with God (Father, Son, and Holy Spirit). No matter what happens in this short, difficult life, whether it's autism, the flu, traveling husbands, etc., we have hope for a better life in eternity: not because of anything we have done. If left up to me and my ability and my accomplishments, I would be hopeless. Even though my plans for Easter amounted to nothing, Sunday was an awesome day for this reason:
We have peace with God through our Lord Jesus Christ, through whom we have gained access by faith into this grace in which we now stand. And we rejoice in the hope of the glory of God. Not only so, but we also rejoice in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not disappoint us, because God has poured out his love into our hearts by the Holy Spirit, whom he has given us. You see, at just the right time, when we were still powerless, Christ died for the ungodly. Romans 5:1-6