RDI Fun

“Wow! The sun is really reflecting light off that building,” I remarked at breakfast last Thursday. I made a show of gawking through the kitchen window.

Martin, seated at the counter, fiddled another second with a toy, then turned to look out the window.

Score!

“It’s so bright it kind of hurts my eyes,” I said.

Martin shifted his gaze to me and replied, “It’s bright.”

Double score! I scrawled a few words in my countertop notebook and let several minutes pass while Martin ate breakfast.

“When the sun is still rising, it’s much lighter outside these windows”—I inclined my head to the kitchen window and other west-facing windows—“than it is outside those windows.” I finished with a dramatic point across the room to the east-facing windows.

Martin checked the kitchen window once more, then compared the east-facing windows.

Score! I made another note and let a few more minutes pass.

“It looks like it’s starting to get cloudy,” I said.

Pause.

Nothing.

I decided to add some “scaffolding.”

“I was looking out the window,” I said, “and I noticed that it looks like it’s starting to get cloudy.”

My words alerted Martin. He looked at me and then out the window. “It’s cloudy,” he said.

Score!

And so we went, through breakfast. Observation. Reaction. My gaze. Martin’s gaze.

This odd game is part of a behavioral therapy, Relationship Development Intervention, or RDI, that we do with Martin. Although I meet regularly with our RDI consultant, the program is intended to be family-based and driven through everyday interactions. It rests upon “guided participation,” wherein I serve as a mentor to Martin, helping him master the basics of social interaction. RDI for ASD covers approximately a gazillion milestones, and I have found it challenging to get my arms around the program.

Nevertheless, our consultant is patient, and on occasions like last Thursday’s breakfast, I see the logic behind the RDI strategy. Right now we’re working on Martin’s ability to read facial expressions. Ideally, Martin would show sustained interest in me during breakfast. He would check my face regularly, and if he noticed me staring in some direction, he’d also look there, for clues to what’s going on.

That’s what neurotypical persons generally do. For example, this afternoon I walked into my bank and saw several patrons and staff craning their necks to look at the high ceiling. So I looked, too. I just did. And before I had a son with ASD, I would never have thought twice about the moment. (A ceiling vent was emitting ash, it turned out.)

Martin, on the other hand, does not automatically make such observations, at least not yet. So I’m teaching him to do so. I look out the window. I give Martin a chance to notice and to look out the window, too. If he doesn’t, then I add some “scaffolding”—that’s RDI-speak for “extra help”—by making some verbal observation. I give Martin another chance to catch my clues. If he doesn’t, it’s time for more scaffolding. I might point, or make my comment more explicit, such as when I said, “I was looking out the window and ….”

At all costs, I avoid using the imperative. Martin, look out the window, is a no-no. So is an imperative hidden in a question, like, Can you look out the window? RDI sets a goal of 20% imperatives, and 80% “observations,” “emotion sharing,” and so forth. That’s probably the toughest component. When you have a child on the spectrum, the day can easily dissolve into 99% imperatives. Martin, eat your breakfast. Martin, chew. Hurry up! Martin, can you put your shoes on? Martin, come here and brush your teeth.

We’re also playing little games to work on facial observations. Over the weekend I placed three identical boxes upside down on the rug and hid Martin’s miniature guitar under one. With facial expression alone I indicated which box was harboring the guitar.

Martin showed no interest whatsoever.

I scaffolded. I removed one box, arranged the other two on either side of me, and nodded dramatically toward the correct box.

Martin started to get up.

I scaffolded some more. “I think the guitar is there,” I said while nodding.

Martin perked up and lifted the correct box.

Mini-score! Score with extra scaffolding!

I’ve got the mantra ingrained by now: ASD recovery is a marathon, not a sprint.

Even the little victories count.

(Careful readers might be wondering why the rising sun shines brighter through our western windows than our eastern windows, given the sun’s proclivity to rise in the east. The anomaly happens because a taller building blocks our eastern exposure, while our western exposure is open to, across an expanse, office towers whose windows throw the sunbeams back toward us. Ah, city life.)

What’s Disappeared

It’s accounting season. Adrian’s assistant has prepared a summary of what our family spent last year on recovering Martin. Supplements, therapies, unreimbursed doctor bills, plane tickets to see specialists, that sort of stuff. It does not include expenses associated with Martin’s restricted diet, like buying only organic or making weekend farm visits for meat. Nor does it include my kitchen make-over, continually purging plastics and aluminum in favor of glass or stainless steel.

Even without the foods and cookware, the total is a large number. Not astronomical. Not bank-breaking. But large.

“Did you think it would be this much?” Adrian asked me.

I replied, “I’m looking at it like this: If someone told us last January, ‘Give me this amount, and within a year Martin will respond to his name, will make eye contact consistently, will interact with friends, will move like a neurotypical child, and will speak in complete sentences,’ we would have written that check, right?”

“Of course,” Adrian said.

He seemed mildly offended that I’d asked the question. But I was on a roll.

“And if someone told us last January, ‘Give me this amount, and within a year Martin’s lethargy and toe-walking and aimless drifting and low muscle tone and sleep problems and clumsiness will be gone, and his echolalia will be nearly gone,’ we would have written that check, right? Because that’s where we are. That’s what’s disappeared.”

Adrian waved his arm in agreement, putting an end to my roll. “We would have paid ten times so much. You know that.”

“So let’s keep it going,” I said.

And we fist-bumped.