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Autism Vox

Engaging Floortime (9): RDI and Floortime

by Kristina Chew, PhD on July 29th, 2006


A child who can’t cope may become fearful, unwilling even to interact with his or her parents because it might lead to something threatening. The child’s withdrawal in turn deprives the parents of the feedback that would help them provide their child just the right balance between reliable and comforting support on the one hand and challenge and stimulation on the other. [my emphases]

This is how columnist Linda Seabach paraphrases Dr. Stephen Gutstein’s paraphrase of a “large body of autism research,” as she writes in the July 29th Rocky Mountain News. Gutstein has developed the Relationship Development Intervention™ Treatment Program for Autism Spectrum Disorders–the RDI™ Program. Seabach (while noting that “I’m in no position to endorse an entire program”) writes that Gutstein, along with his staff, is giving a workshop in Denver this weekend on RDI, and that

Over the past several years he has been pioneering an approach to autism and related conditions that focuses on showing parents how to rebuild, or at least strengthen, the emotional connections with their children that have been stretched beyond breaking.

Engaging Autism: Helping Children Relate, Communicate and Think with the DIR Floortime ApproachThese notions of parents having to “rebuild, or at least strengthen, the emotional connections with their children” and of children becoming “fearful” and “unwilling to interact with their parents” because such might lead to something “threatening”……….. and the child’s “withdrawal”—these statements about why autistic persons have “difficulty dealing with the vast unpredictability of everyday life” put much emphasis on the “emotional connections” between a child and his or her parents and on certain “interactions” between that child and his or her parents. As such, these statements (which, I acknowledge, are Seabach’s paraphrase of Gutstein’s paraphrase of the autism research) recall those by Stanley Greenspan in his book Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate and Think, in which the parents’ unsuccessful interactions with their child is said to “contribute” to that child’s being “at risk for ASD” (see my post on Engaging Floortime (3): Floortime for Parents).

There are additional similiarities between Greenspan’s Floortime approach and Gutstein’s RDI. Both emphasize the need to look at “core deficits” (Greenspan) or the “inner core” of one’s child (Gutstein). Both emphasize “relationships” and “emotions” and “development” and implicitly critique behavioral approaches to teaching autistic children (such as ABA). Both describe “the joy in connecting: a path for people on the Autism Spectrum to learn friendship, empathy, and a love of sharing their world and experiences with others” (see the RDI website).

  • Greenspan’s DIR model is “developmental, individual-difference, relationship-based.” [my emphases]
  • Gutstein’s RDI stands for “relationship development intervention.” [my emphases]

There are some key and some core similiarities not only between Greenspan’s and Gutstein’s treatment approaches, but also in their views of what autism is and how it develops, and of how parents “contribute” to this in their “interactions” with their child.

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POSTED IN: Education, Family, Health, Media, Parenting, Psychology, Treatment

9 opinions for Engaging Floortime (9): RDI and Floortime

  • alexander's daddy
    Jul 30, 2006 at 5:19 am

    Kristina,

    I think it might be interesting to look at psychoanalyis today which I believe Greenspan is a practioner of. Many, if not all I believe still cling to Bettleheim.

  • Kristina Chew, PhD
    Jul 30, 2006 at 7:03 am

    I\’ve been struck at the kind of language both Greenspan and the RDI method use. Gutstein\’s background includes work in treating suicidal adolescents; Greenspan\’s biography on his webpage lists him as \”Practicing Child and Adult Psychiatrist and Psychoanalyst.\”

  • veronica
    Feb 1, 2007 at 2:02 pm

    As a parent who started with Floortime and moved on to RDI I agree they are very alike. I also have no problem with the statement that normal parent child interaction can and does harm the child. The idea is that without the neurological make up to handle typical interactions that the kid gets scared and pulls away. Floortime and especially RDI teach the parent to interact with the child in a way that the child can handle then to work up to a more typical interaction. The harm is unintentional and is not caused by unloving parents. Is a parent who does not know their child has Type I diabetes a bad parent when they give them an occasional lollypop. No and when the parent finds out the child has type I diabetes the parent then changes how they interact with the child. They change the child’s diet and exercise. That’s what Floortime and RDI do they teach the parent how to interact with their child so as not to overwhelm them while still helping them to grow. That is a good thing.

  • Kristina Chew, PhD
    Feb 5, 2007 at 4:06 pm

    Veronica, thanks very much for your observations about your experience with both Floortime and RDI. I think it is because of the history of autism, and the still very recent influence of Bettelheim, that I feel wary of any mention of a parent “harming” a child in regard to that child’s development, and in regard to the parent being described as potentially hindering the child’s growth and the child thereby becoming delayed. It is the principles and philosophy behind Greenspan’s thinking that I have hesitates about, not the actual therapy and programs.

  • Autism Vox » Autism Therapies From Alpha to Omega
    Mar 20, 2007 at 11:00 am

    […] series on autism, describes a number of different therapies for autistic children—Floortime, RDI (Relationship Development Intervention, TEACCH (Treatment and Education of Autistic and related […]

  • Regan
    May 9, 2007 at 7:19 am

    Kristina,
    I had to comment that this point of view is not exclusive of ABA, although it is considered somewhat controversial, mostly because the interpretation often hits people as warmed over Bettelheim, especially when this author takes the view that autism may purely be shaped by environmental contingencies. In any event, I thought that I should mention it.

    Here are some of the references, just in case you have time to read them and perhaps compare to the other models. I have no idea whether Dr. Drash has been influenced by Bettelheim. I am pretty sure that Dick Malott has not been.

    An Analysis of Autism as a Contingency-Shaped Disorder of Verbal Behavior
    Philip W. Drash, Ph.D., BCBA,
    The Analysis of Verbal Behavior, 2004
    http://dickmalott.com/autism/autism_shaped/

    Preventing Autism Now: A Possible Next Step for Behavior Analysis
    Philip W. Drash, Ph.D., BCBA,
    Presented at: Association for Behavior Analysis International 30 th Annual ABA Convention, Boston, MA, May, 2004
    http://dickmalott.com/autism/prevent_autism_now/

    This point of view was also put forth by Dr. Martin A. Kozloff in his book, Reaching the Autistic Child, in that the contingencies of reinforcement between parent and child start out defective and increase over time to non-productive interactions. He speculates at some point in the book, what would happen if this were detected early and headed off at the pass by anticipating and deliberately engineering productive cycles of interaction before histories of behavior were established. This book was written in the early 70’s, at a time when Dr. Kozloff was actively engaged in clinical practice with children with autism and their parents.

  • Dr. Derrick Hassert
    Jun 5, 2007 at 12:29 am

    I’ve just started reading some of the work from Drash and I have to say I was at once struck with a strong whiff of the infamous Dr. Bettelheim. I couldn’t believe someone was rejecting the notion that autism had a genetic and neurological basis. Yes, behavioral therapy can work wonders with autistic children, but how can one suggest that environmental contingencies are causing (the term he uses) at 6 or 8 months of age? There must be, at the very least, a neurological predisposition at work.

    In any case, Drash nearly undermines his whole argument in the second article linked to above by noting that one way to screen for those at risk is to look at the genetic concordance. Why would one even take such data into consideration if autism didn’t have a strong genetic basis?

  • Tim Heater
    Sep 28, 2007 at 12:48 am

    I am a parent of a boy who has ASD OR PTSD OR Reactive Attachment Disorder… I am just about wiped out caring for my five year old. I am sorry if this is off topic but, does Greenspan’s book or DVD series have specific tools parents can use? I heard him on “The Infinite Mind” today and it raised my hopes for “hands on” work/play I can use with him. Tim Heater tsheater@aol.com

  • Kristina Chew, PhD
    Sep 28, 2007 at 12:59 am

    Greetings—
    By specific tools, do you mean concrete suggestions for things you can actually do? Greenspan does describe some specific activities that one can perform, though (if you’re reading Engaging Autism) one has to go through the chapters to find these. He has an earlier book called The Child with Special Needs that (I think) outlines some activities somewhat more straightforwardly.

    If I may ask, are there reasons for the uncertainties about your son’s diagnosis?

    Best wishes—

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