SCIENCE IN AUTISM TREATMENTPage 1 Vol. 7 No. 3 Newsletter of the Association for Science in Autism Treatment Summer 2010 Relationship Development Intervention: A review of its effectiveness Table of Contents by Thomas Zane, Ph.D., BCBA-D RDI Review of effectiveness ................................... 1 Message from David………. ..................................... 1 SIAT Team ……………………………............................... 1 Relationship sharing‖ and flexibility in thinking. He Clinical Corner: Defending Parents Decisions ...... 3 Development has outlined the types of methods and ASAT Committee Members…….……. ....................... 4 Intervention (RDI) goals built into RDI, including Sweet Charity ........................................................... 5 is a treatment for ―dynamic‖ analysis, flexible problem Clinical Corner: What is VB? ................................... 6 autism developed solving and resilience. As of September Letter from Josh ...................................................... 7 Interview with Kathleen Moran ............................... 7 by Dr. Steven 2009 there are currently over 200 ASAT Donor Wall ...................................................... 8 Gutstein from certified RDI therapists. This number Research Review: Responding to Joint Attention 10 Texas. According has steadily increased over the past Research Review: Change in Core Symptoms ..... 11 to Gutstein, RDI several years, suggesting increasing Research Review: Real-World Effectiveness ........ 11 has a focus of interest in this treatment. Consumer Corner: Insurance Funding ................. 12 increasing social ASAT Board of Directors ........................................ 14 awareness A search found only one published Facilitate That: Part 2 of James Todd Interview ... 16 through the use of article that attempted to evaluate the effectiveness of RDI ASAT Advisory Board ............................................ 18 ―dynamic‖ (Gutstein, Burgess, & Montfort, 2007). The purpose of this ASAT Sponsorship ................................................. 19 Treatment Summary: Sensorimotor Therapies .... 24 intelligence. RDI study was to determine whether children who participated in Statement about Chelation ................................... 24 methods are RDI treatment improved in selected measures related to Announcement: Facebook Page .......................... 25 employed by the autism. The authors reviewed the files of 16 children who Legend of Loxley‘s ................................................. 26 parents of the ranged in ages between 20-96 months, representing various Rockin‘ for Autism Awareness .............................. 26 children in RDI diagnoses of autism (e.g., Asperger, Pervasive Development ASAT Advertising Policy ......................................... 27 therapy, since the Disorder – Not Otherwise Specified [PDD-NOS] and Autism). Media Watch Update............................................. 28 general goal of the These children had been receiving treatment based on the RDI ASAT Cartoon ......................................................... 29 treatment is more model for at least 30 months. The authors attempted to natural and complete interactions among family members. measure three variables to assess whether or not the children Gutstein calls RDI a ―cognitive-developmental‖ parent training improved due to the RDI intervention: (1) a subset of 13 items program (2001). The program attempts to impact ―experience (Continued on page 2) Watch examples of effective teaching methods for children with autism here: http://www.asatonline.org/intervention/videos.htm Message from ASAT President, David Celiberti, Ph.D., BCBA-D Greetings! I wanted to open with a ―Happy Summer‖ but am mindful that we have scores of SIAT subscribers in the southern hemisphere who are in their winter season. We now have our first Alaskan subscriber and have international subscribers in almost 100 countries. As Josh will discuss in his letter, presently the newsletter has nearly 5000 subscribers, which reflects a dramatic increase over previous months. This was accomplished in large part, with the help of the Association for Behavior Analysis International (ABAI). Following an e-blast to ABAI members, we received over 500 first-time subscribers within one week! Thank you ABAI for your support! (Continued on page 28) Science in Autism Treatment (SIAT) Team Co-Editors Clinical Corner Editorial Consultant From the Archives David Celiberti, Ph.D., BCBA-D Lori Bechner, M.A., BCBA Elizabeth Dyer, M.A. CCC-SLP Pamela Colosimo, Ph.D. Joshua K. Pritchard, M.S., BCBA Consumer Corner Treatment Summaries Advertising Science Corner Kate Fiske, Ph.D., BCBA-D Tristram Smith, Ph.D. Marianne Clancy Daniel W. Mruzek, Ph.D., BCBA-D Events Research Reviews Denise Grosberg, M.A. Sharon Reeve, Ph.D., BCBA-D Kathleen Moran, M.A. ASAT, PO Box 188, Crosswicks, NJ 08515-0188 http://www.asatonline.orgASAT Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment Page 2 For a short description of RDI, please see: http://www.asatonline.org/intervention/treatments/relationship.htm Relationship Development Intervention continued... (Continued from page 1) Wallen 2009). Thus, there is an Due to the weak research methodology from the Autism Diagnostic Observation assumption that the participants in the used by Gutstein, et al. (2007), the lack Schedule (ADOS; Lord, Rutter, Dilavore, Gutstein, et al. study could have of fundamental research methodology & Risi, 2002) and the Autism improved on the measures due to and the existence of only one formal Diagnostic Interview-Revised (ADI-R); reasons unrelated to RDI (such as assessment of the effectiveness of this (2) the results of a ―flexibility maturation or other, concurrent autism treatment, RDI should not be interview,‖ developed by Gutstein, et interventions). considered to be a treatment that has al., in which parents used a self-report evidence of effectiveness. There is no Science in Autism Treatment Likert scale to rate the degree to which There are two other issues related to existing research base for concluding they thought their children exhibited the research design that prevents one that RDI has been proven to be ―rigidity‖ in their behavioral adaptation from concluding that RDI was effective. Thus, as with other and thinking; and (3) educational responsible for improvement in the treatments that have no valid placement of the participants, which participants. First, an important effectiveness data, care providers involved parents and teachers criterion for a well-designed study is should carefully consider whether RDI reporting the type of school placement proof of treatment implementation (i.e., is appropriate to use. Researchers in which the children resided (ranging procedural integrity; Gresham, Beebe- must begin to do well-designed from mainstreaming with no special Frankenberger & MacMillan, 1999). research studies attempting to simply education services to full-time Gutstein and colleagues not only failed determine if RDI is causally related to placement with special education to provide detailed information about any improvement of any measure support). what exactly the RDI treatment related to autism. Hopefully such protocols were that were employed, but studies will be done to determine if RDI Gutstein and colleagues collected data they also failed to provide any check on is effective. However, until that time, Volume 7, Summer 2010 on these measurements prior to and whether or not the treatment providers treatment providers and other following the children‘s participation in actually implemented the RDI caregivers would be advised to RDI for an average of 18 months. strategies as Gutstein, et al. intended. consider using other treatments that Following treatment, Gutstein, et al. Thus, this study fails to meet this have a proven record of effectiveness reported: (a) improvement in ADOS particular research quality criterion. (e.g., applied behavior analysis). diagnosis, (b) improvement in ―age appropriate flexibility‖ to routines, and A second essential criterion for References (c) more children participating in less ―believability‖ of research is that of restrictive, more mainstreamed measurement reliability (e.g, Gay, et al. Fraenkel, J. R., & Wallen, N. E. (2009). How educational placements. The authors 2009). Specifically, researchers are to design and evaluate research in concluded that RDI was a ―promising required to provide evidence to support education, Seventh Edition. New York: McGraw-Hill. program for remediating critical the belief that the dependent variables Gay, L. R., Mills, G. E., & Airasian, P. (2009). experience-sharing difficulties…‖ of measured in the study were measured Educational research: Competencies children with autism (p. 409). They reliably. This is often accomplished by for analysis and applications, Ninth hypothesized that the RDI treatment having a second independent observer Edition. Upper Saddle River, NJ: was causally related to the positive measure the participants at the same Pearson. changes in the children; that is, that time (and then comparing results), or Gresham, F. M., Beebe-Frankenberger, M. RDI appeared to be responsible for the by demonstrating that standardized E., & MacMillan, D. L. (1999). A improvement. instruments have pre-determined selective review of treatments for children with autism: Description and reliability and validity. In the current methodological considerations. School Upon careful examination