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RDI®: Effective Intervention or Effective
Suzanne Letso, M.A., BCBA, Chief Executive Officer and Co-founder of the
Connecticut Center for Child Development, Inc., and parent of a son with
There is now a substantive and growing body of research that clearly
demonstrates that the application of educational strategies based on
applied behavior analytic learning principles can result in significant
learning outcomes for children diagnosed with autism spectrum disorders
(Sallows & Graupner, 2005; Howard, Sparkman, Cohen, Green & Stanislaw,
2005; Eikeseth, Smith, Jahr & Eldevick, 2002; Green, Brennan & Fein,
2002; Smith, Groen & Wynne, 2000; Weiss, 1999; Smith, 1999; Matson,
Benavidez, Compton, Paclawskyj & Baglio, 1996, Perry, Cohen & De Carlo,
1995; Birnbrauer & Leach, 1993; McEachin, Smith & Lovaas, 1993; Harris,
Handleman, Gordon, Kristoff & Fuentes, 1991; Lovaas, 1987; Anderson,
Avery, DiPietro, Edwards & Christian, 1987; Fenske, Zalenski, Krantz &
McClannahan, 1985; Wolf, Risley & Mees, 1964; Ferster & DeMyer, 1961).
There are now over 600 articles published in peer reviewed journals that
demonstrate the efficacy of applied behavior analytic teaching
strategies for children with autism spectrum disorders. A recent
literature search located 102 articles alone published in the Journal of
Applied Behavior Analysis as of September 2005. However, in spite of the
large and expanding body of research, there continues to be consumer
interest in other intervention strategies that have questionable
empirical evidence demonstrating enhanced learner outcomes (Jacobson,
Foxx & Mulick, 2005).
The Relationship Development Intervention® (RDI®) is one such
intervention strategy that has become increasingly popular with parents
across the nation. This growing popularity may be due to a number of
factors, including the paucity of well trained and qualified behavior
analysts and educators, the variability of provider effectiveness, the
inherent difficulties associated with designing effective educational
strategies for students with either high functioning autism (HFA) or
Asperger’s Syndrome (AS), the difficulties often associated with
grafting outside consultants into school programs, the scarcity of
formalized behaviorally based curricula designed specifically to address
the complex needs of students with HFA or AS, and both the financial and
emotional costs of operating an intensive behavioral program. In
addition, the aggressive marketing strategies employed by the for-profit
domestic business corporation, The Connections Center™, which is the
sole provider of RDI® products and services, has likely contributed to
the widespread interest in this intervention package, despite of the
lack of substantial evidence of its effectiveness to date.
It is doubtful that this intervention would be so popular if there were
not at least aspects of the program that were perceived to be helpful to
parents and children. However, the underlying assumptions that have
resulted in the conceptualization of this program are based largely on
hypotheses, not facts (Gutstein, 2002).
Steven Gutstein, Ph.D., and his wife Rachelle Sheely, Ph.D. are the two
directors and incorporators of The Connections Center™, established in
August 1995, and are the “co-founders” of RDI®. This business is
registered as a for-profit domestic business corporation under the name
of Gutstein, Sheely, and Associates, P.C., (assumed name certificates
filed with the Texas Secretary of State are identified as “Relationship
Development Innovations” and “RDI Connect”) D/B/A The Connections
Center™. Additionally, Rachelle Sheely, Steven Gutstein, and Connections
Center™ employee Carlotta Baird established the Relationship Development
Research Institute™, a non-profit Texas corporation in December 2003.
Both Dr. Sheely and Gutstein are licensed clinical psychologists.
Defining Autism Spectrum Disorders
In the video, “Going to the Heart of Autism: The Relationship
Development Program,” (2005), Dr. Gutstein states that there is “a
research consensus” that autism spectrum disorders are “a change
disorder” and are characterized as follows:
Failure to develop flexible collaboration of neural sub-systems needed
for the brain to process information related to change
Failure to develop competence in dynamic systems
Failure to develop the motivation to master increasingly complex dynamic
Desire to remain in static systems and amplify the static elements of
Self-concept based on static competence
All other characteristics such as language deficits, sensory deficits or
excesses, and behavioral deficits or excesses are considered
“co-occurring conditions,” not signs or symptoms of autism spectrum
Although Dr. Gutstein asserts that there is now widespread agreement
amongst researchers that these represent the “core deficits” of autism,
these statements are not supported by the evidence. The diagnostic
criteria for Autistic Disorder are defined in the Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition as follows:
“A. A total of six (0r more items from (1), (2), and (3), with at least
two from (1), and one each from (2), and (3):
(1) qualitative impairment in social interaction (abridged)
(2) qualitative impairments in communication (abridged)
(3) restricted repetitive and stereotyped patterns of behavior,
interests, and activities (abridged)
B. Delays or abnormal functioning in at least one of the following
areas, with onset prior to age 3 years: (1) social interaction, (2)
language as used in social communication, or (3) symbolic or imaginative
play.” (DSM-IV TR, (2000), American Psychiatric Association, see pages
74 – 84 for complete description Autism Disorder, Asperger’s Disorder,
and PDD NOS)
Other recent resources that identify autism spectrum disorders as
inclusive of symptoms other than social deficits include:
“Research on Screening and Diagnosis in Autism: A Work in progress.”
Journal of Autism And Developmental Disorders, (1999), Volume 29, Number
6, 435-438, Marie M. Bristol-Power, National Institute of Child Health &
Human Development, and Giovanna Spinella, National Institute of
Neurological Disorders and Stroke, National Institutes of Health.
“Autism and pervasive developmental disorders.” Journal of Child
Psychology and Psychaitry 45:1 (2004), pp 135-170, Fred R. Volkmar,
Catherine Lord, Anthony Bailey, Robert T. Schultz, and Ami Klin.
Diagnostic Criteria Impacts Educational Efforts
The evidence suggests that there is not a research consensus that
supports Dr. Gutstein’s hypothesis that autism has been, or should be,
redefined to include only signs and symptoms of social deficits, or that
other signs and symptoms should be considered separately from the
diagnosis of autism. While this may seem like a small point, it has
become the catalyst for the design of curricula and educational
programming that focus only on remediation of these social deficits
rather than on all of the unique behavioral deficits and excesses often
demonstrated by individuals diagnosed with autism spectrum disorders.
Comprehensive programming for children with autism spectrum disorders
should be determined on an individual basis (Wright & Wright, 2004) but
should typically include programming in the areas of language and
communication, self-help skills, problem solving skills, social skills,
development of interpersonal relationships, pre-academics, academics,
health and safety skills, play, leisure, and recreational skills,
pre-vocational and vocational skills, and remediation of behaviors that
interfere with learning and impact quality of life for children and
their families. The ultimate goal is for “life in the least restrictive
environment” with as many choices of living, working, recreating, and
socializing as possible (Bannerman, Sheldon, Sherman & Harchik, 1990).
Therefore, what we teach may be best measured by the social significance
of the goals we select, the social appropriateness of the procedures we
utilize to teach those goals, and the social importance of the effects
of our efforts (Baer, Wolf & Risley, 1968). This includes, but should
not be limited to remediation of social deficits (Taylor, Hughes&
Richard, Hoch & Coello, 2004; Volkmar & Wiesner, 2004; Lord & McGee,
While the RDI® approach does include some innovative instructional
strategies for social skills training and enhancing social engagement,
improvement in this area will not necessarily remediate other behavioral
excesses or deficits associated with this disorder. Unfortunately, some
of the marketing materials and chat statements (see www.rdiconnect.com)
may lead the reader to believe that it is not necessary to teach these
children to talk because 85% of children with autism will learn to talk
without intervention (Going to the Heart of Autism DVD), and that
stereotypic behaviors will eventually just dissipate, (Dr. Gutstein’s
Live Chat Transcripts 12/29/04 as follows: Allan: “does the hand
flapping go away in all cases?” Gutstein: “yes it goes away in every
case.” Bevc: “What do you mean it goes away in every case??” Gutstein:
“We don’t have any kids who’ve been doing RDI for 2yrs+ that are regular
flappers.”). There is no evidence to support these statements, and left
untreated, these behavior deficits and excesses may actually become
Although there is not yet any research that actually demonstrates the
efficacy of the RDI® program design in its entirety, or of specific
educational strategies, it is important to note that there are some good
ideas encompassed by this approach, and some creative suggestions for
programming. For example, many “Discrete Trial Instruction” programs
rely very heavily on using questions or overt physical or visual cues as
the discriminative stimulus (S) to evoke a response from a student. RDI®
strategies incorporate the use of nonverbal gestures and facial
expressions as well as verbal (declarative) statements that are not
questions to evoke language. Although these are still actually SD’s that
may result in a social or verbal response (Cooper, Heron & Heward,
1987), greater variety of SD’s utilized or more subtle SD’s may result
in an increase in responsiveness.
While the use of more declarative statements may be beneficial, at least
for some students, it is as yet not known if this modification will
result in improved language acquisition or enhanced comprehension. It
may turn out to be a very effective strategy for some learners and is
certainly worth exploring as a teaching strategy. However, one of the
RDI® rules of thumb is to use a ratio of 80% declarative language to 20%
imperative language (Dr. Gutstien’s Live Chat 11/03/03). There does not
appear to be any actual evidence that supports this claim. This
arbitrary “one-size-fits-all” rule could actually prove to be
detrimental, particularly for those students who do not yet demonstrate
substantive receptive and expressive language skills.
Other possible benefits of the RDI® approach include a parent training
program that (in behavioral terms) may teach parents contingency
management, shaping, delivery of social reinforcement, and some
instructional strategies. The program does not require intensive
commitment of time or money compared to traditional ABA home programs.
Because the program allows parents to identify how much time and when
they incorporate interactions with their child into their lives, there
may be an increase in parent participation in the education process, and
an increase in parents feeling both competent and successful.
Additionally, parents spend their time on social skill development that
is important to them, which may increase their motivation to interact
with, and teach their child.
There are approximately 300-400 RDI™ instructional strategies that focus
on social skill development (Gutstein & Sheely, 2002a; Gutstein & Sheely,
2002b: Gutstein & Sheely, 2003). Many of these instructional strategies
are derived from various sources including behavioral curricula (Fovel,
2002; Leaf & McEachin, 1999; Maurice, Green & Luce, 1996), and Dr.
Sidney Greenspan’s work (Greenspan, Wieder & Simons, 1998); some of the
ideas are novel, or at least creative interpretations of existing
strategies. While not all of these programs are unique to RDI®, it does
represent a good compendium of social skills programs, which may be
useful to both parents and educators.
The problem is not any particular program per se, but with some aspects
of implementation, and the marketing and branding strategies that
overstate what the research has actually demonstrated to be effective
for children and their families. For example, while the following
treatment setting may result in the desired goal, it may not represent
the least restrictive environment in which learning can be reasonably
expected to occur. And, for many students with HFA or AS, such a
restricted setting may not only be not necessary, it may be completely
“People who conduct Social Skills training generally do so in natural
settings, such as a classroom or shopping mall, believing that the
skills will more likely be used if they are learned in the setting in
which they are needed. If the goal is to teach instrumental behaviors
and social scripts, such as waiting in line at a booth in a mall food
court, or sitting quietly during circle time in the classroom, natural
settings are clearly preferable.
However, natural social systems are far too complex and noisy to learn
Social Referencing for people with Autism. We begin treatment in a
highly controlled setting with minimal competition and distraction for a
child’s attention. Windows are well covered. There are no wall
decorations. Objects are behind locked cabinets when not specifically
needed for an activity. There is no permanent furniture, except for
strongly reinforced beanbags. We ask parents to configure similar
settings in their homes.”
Excerpted from “Solving the Relationship Puzzle: A New Developmental
Program that Opens the Door to Lifelong Social & Emotional Growth,”
Steven Gutstien, 2000, Chapter 5, Principles of Treatment, pg. 71.
It can be relatively easy to include some RDI® programs into an ABA
program, although it may be necessary to re-write these programs so that
objectives are clearly defined and measurable. One example of an RDI®
program that can be incorporated is as follows:
Definition: “Seeks out face-to-face gazing to intensify joy and
excitement, soothe distress and attend to Coach’s communication,” (Gutstein.,
S. & Sheely, R., (2003). The RDI® Program Progress Tracking System, pg.
Revised behavioral definition: Child will initiate eye contact with
adult within 10 seconds of adult’s verbal or non-verbal communication
and/or if a child engages in a fear response and will imitate adult’s
However, not all RDI® programs can be re-written so that objectives are
clearly defined and measurable. One example of a RDI® program that may
be difficult or impossible to measure is as follows:
Definition: “Communicates memories indicating that the highlight of
interaction is co-creating new activity frameworks as an equal partner”
(Gutstein., S. & Sheely, R., (2003). The RDI® Program Progress Tracking
System, pg. 5).
The problem here is that we can possibly assess verbal behavior as a
measure, but verbal behavior is not necessarily an indicator of what
someone thinks or believes. Furthermore, there actually is no evidence
that “co-creating new activity frameworks as an equal partner” is a
necessary component of instruction, nor one likely to enhance learner
The ‘research’ posted on the RDI® website in support of this educational
approach is as follows:
“RDI and the Ability to Generalize Learned Social Skills,” Sara Spencer,
B.A., M.A. completed this study in 2004 as a thesis for her Master of
Arts Degree in Education Admin. & Policy Study at CA State University ,
Sacramento . This study has not been published and is not part of the
“Improving Social Referencing Skills in Preschool Children with Autism,”
Donna Morrison, OTR, Certified RDI™ Consultant, completed this research
as a thesis for her Post Professional Master of Science degree in
Occupational Therapy at Columbia University . Like the above-mentioned
study, this study has not been published and is not part of the ‘public
“Asperger syndrome and the development of social competence,” Steven
Gutstein, Focus on Autism and Other Developmental Disabilities,
September 22, 2002 . This article is actually a discussion paper of Dr.
Gutstein’s theories and philosophy and does not provide any evidence of
“Preliminary Evaluation of the Relationship Development Intervention
Program,” Steven Gutstein, manuscript accepted for publication by The
Journal of Autism and Developmental Disorders. This is the only
‘research’ study that has been widely publicized as evidence of program
efficacy. However, the results of this research have been significantly
overstated, and the methodological problems with this research have been
minimally reported, and in some contexts not identified at all (Gutstein,
The abstract (summary) written by Dr. Gutstein of this preliminary
evaluation of the RDI® program is as follows. “The Relationship
Development Intervention program (RDI) was designed to remediate
deficits in Inter-subjective Engagement, a critical impairment in
autism. In a preliminary evaluation, 17 children in the autism spectrum
participating in RDI were compared to 14 children receiving other
interventions. Changes in the ADOS and school placement were primary
outcome measures. The RDI group demonstrated significantly greater
improvement in ADOS scores, diagnostic classification and independent
functioning in classrooms. Results, while tempered by methodological
limitations, provide early support for RDI as an effective intervention
addressing important deficits of children with autism.”
In the “Discussion” section of this evaluation, Dr. Gutstein identifies
a number of flaws that significantly limit interpretation of the results
of this evaluation process.
“Results are based on examination of a small sample of relatively “high
functioning” children. Few children in either group had significant
“The variety of measures used to evaluate cognitive functioning make a
valid comparison impossible.”
“Future studies should make sure that RDI and non-RDI groups are
comparable and that standard cognitive measures are employed.”
“Similarly, the assortment of measures of language functioning made it
difficult to evaluate its potential influence.”
“Additionally, older children and Teenagers were not studied. Thus, the
effects of age, cognitive and language functioning on treatment
effectiveness are as yet untested.”
“The current results were obtained using consultants from a single
setting – the clinic where RDI was initially developed.”
“The efficacy of training other clinicians to provide effective RDI
consultation has not been determined.”
“Finally, the retrospective nature of the study, precluding random
assignment or matching procedures, opens up the possibility of a
self-selection bias where important variable led to parents choosing RDI
vs. another intervention method.”
There are also a number of significant concerns not cited by Dr.
Gutstein, including the following:
The RDI® group received 5 more months of treatment than the comparison
group, or roughly 30% more time in treatment.
The description of both RDI® group and comparison group treatment
protocols is inadequate to allow an interpretation of what the
treatments were comprised of, making a replication of this study
The RDI® group had an average IQ 12 points higher than the comparison
group. This represents a significant difference in cognitive ability.
The RDI® group was approximately 1 year younger than comparison group
(on average, 6 years of age vs. 7 years of age). This is not only a
significant difference that can clearly impact outcomes, it also means
that the second measure of treatment effectives, i.e., a change in
student placements is invalid due to the fact that the RDI® group,
simply by virtue of their age, would probably have been transitioning to
a school placement anyway. In addition, given their level of functioning
and cognitive ability prior to treatment, the RDI® group may have been
reasonably expected to have been placed in a regular education classroom
This study was conducted by the person/agency that is in a position to
derive significant financial benefit and professional acclaim from
positive outcome results. That is, the researcher is potentially biased
because he has a financial stake in the outcome.
And finally, “the retrospective nature of the study, precluding random
assignment,” also means that not only might there be parental “selection
bias,” but Dr. Gutstein may also have been biased in his selection of
student records that he reviewed as part of this evaluation. We do not
know how many student records were considered, or how many students were
treated, versus how many students where included or excluded for the
discussion of results.
RDI® Marketing Strategies
One very troubling aspect of the marketing of the RDI® program is that
the description of results of this preliminary evaluation have been
stated on the website to be far more significant than actually indicated
in this study. For example, the following statements regarding this
research can be found on the website, rdiconnect.com:
Remediating Autism Through Relationships:
“The initial study on the RDI® Program is the first study to ever
demonstrate that a clinical intervention method can change a child’s
diagnostic classification on the Autism Diagnostic Observation Schedule
(ADOS).” While not technically an inaccurate statement, it is highly
likely that readers not familiar with autism research will interpret
this statement to mean that this is the first study ever to demonstrate
that any clinical intervention can improve a child’s autism, rather than
that this is the first study ever to utilize the ADOS to evaluate
results, which is what it really means.
What to expect from the RDI® program:
“This is an initial study and the research paper points out a number of
reasons to limit conclusions. However, there is no doubt that the RDI®
Program has been proven to be an extremely powerful method of addressing
the core deficits of autism spectrum conditions.” This is not what the
research demonstrated, and is a significant overstatement of the
“We found children improved dramatically within months of starting the
RDI program.” As a “stand alone” comment, this is not substantiated by
the research and is quite misleading.
Introductory Guide for Parents:
Page 19, “We found children improved dramatically within 18 months of
starting the RDI® Program,”
Page 21, “However, our research demonstrates that the RDI® program
dramatically increases children’s motivation to communicate and to use
meaningful reciprocal language.” This is not only an overstatement of
treatment effects, the evaluation itself did not even discuss
“children’s motivation to communicate and to use meaningful reciprocal
In addition to statements on the web, and in articles that appear to
significantly overstate the research findings and understate the
limitations of the evaluation process itself, these additional
statements were cited in presentation made by Drs. Gutstein and Sheely
sponsored by the Elija Foundation entitled, “Getting to the Heart of
Autism: The Relationship Development Intervention Program,” regarding
the above research:
“Preliminary demonstration of potential to impact core deficits of ASD’s,
high parent satisfaction and empowerment, high involvement of fathers,
There may indeed be high parent satisfaction, increased involvement of
fathers, and reduced direct costs associated with implementation of an
RDI® program. However, the research did not discuss these potential
outcomes, nor provide evidence of such outcomes.
Overstatements of research results are just one of the marketing
strategies of concern. In addition, the certification of “RDI™
Consultants,” the extensive use of parent and provider testimonials, and
the “Relationship Development Assessment™” (RDA™) are some of the other
marketing strategies that appear to be utilized to create exclusive
product and service branding, and a revenue stream for The Connections
Center™. (Please note that when purchasing products or services,
payments are made to “Gutstein, Sheely, and Associates, P.C.” directly.)
There is nothing wrong with an individual or an agency marketing their
products or services, or deriving a significant income from the sale of
those services. However, thus far there is little or no proof that the
RDI™ process will generate results.
The RDI™ Consultant Certification Process
Certification and licensing processes are supposed to demonstrate that
any particular individual meets some minimum standard criteria of
education, experience and/or performance in order to become certified or
licensed in a particular area of expertise. Either state agencies or
independent associations or organizations will conduct certification
processes completely independent of any particular training agent or
provider of services. The purpose of this is to provide consumers and
employers with an independent determination of an individual’s ability
to meet certain minimum standards, without prejudice or financial
pressures to pass or not pass any particular applicant. When one agency,
such as The Connections Center™, is both the sole training agent and the
sole certifying agent, the value of the entire process is suspect, and
may be compromised by the potential for this to be a self-perpetuating
system of creating an exclusive branding of an intervention package
rather than a litmus test of any particular individual providers’
knowledge, experience, education, or abilities.
The application for admittance into the RDI™ Consultant training program
states applicants must have at least a bachelor’s degree, although a
bachelor’s degree in any particular discipline or profession is not
specified. Of the 53 certified consultants on the web as of 9/28/05 , 20
of the RDI™ consultants listed either indicate no advanced degree, or
indicate a bachelor’s degree as their highest level of education. Of
those with advanced degrees, not all are in professional disciplines
typically associated with the field of autism education, such as
individuals trained to be marriage and family therapists and social
It is interesting to note that The Connections Center™ is listed as a
certified consultant, and they have 4 stars indicating that they have
successfully completed the certification or re-certification process for
the last 4 years. This raises the question of who tests and evaluates
Drs. Gutstein and Sheely, as they appear to be the only individuals
capable of training and assessing participants.
The certification process consists of 3 segments of 4 days of training,
6 hours per day, with supervision “done completely through videotaping
and Internet feedback.” No specific testing mechanism is identified,
therefore an email inquiry was sent to Dr. Sheely which stated, “If
there is a “certification test,” what percentage of the people who take
it actually receive their certification?” Dr. Sheely’s complete response
in an email dated September 26, 2005 is as follows:
“Assessments are built into each step. For example, beginning and
intermediate trainings include a written exam. Professional supervision
is all feedback for implementing RDI. The advanced training is a case
presentation and also includes a written exam on structuring dyads.
Additionally, we require attendance on the chats and also have an annual
recertification which demonstrates that you’ve kept up to speed with
chances as they’ve occurred – usually a case presentation.” This
response did not actually answer the question. It remains unclear if all
participants who complete the process are certified, or if some
percentage do not meet minimum standards, or if there even are any
established minimum standards for successful completion.
The Relationship Development Assessment™
A significant component of the RDI® Certification Process is training on
utilization of the RDA™. (Note: There is no evidence that this
evaluation tool as been validated as a testing protocol either as a
stand alone testing protocol, or as a component of a diagnostic or
evaluative process.) The RDA™ consists of three components; RDA1, RDA2,
RDA3 addressing administration, scoring and intervention planning.
Although the instruction book states that the evaluator should tell
parents the RDA™ will not yield a diagnosis (Gutstein & Sheely, 2002c),
the net result of the evaluation is the identification of “co-occurring
conditions,” determination of the priorities for treatment of these
conditions, and includes a determination of a treatment plan for the
following: “Attention Deficit Disorder, Anxiety, Phobias, Panic states,
allergies/food intolerance, specific speech/language disorder (e.g.
apraxia, word retrieval), depression, attachment disorder, eating
disorder, hearing, learning disability (e.g. Dyslexia, Dysgraphia)
memory deficits, mood swings, obsessive-compulsive disorder,
oppositional-defiant or conduct disorder, proprioceptive, visual-motor,
siezures, Tics or other neurological conditions, sleep disorder,
visual-perception, vision, toileting, and other,” Page 57, Relationship
Development Assessment Treatment Planning Forms (Gutstein & Sheely,
So, in spite of the caveat that the RDA™ will not yield a diagnosis
(“Make sure the Coach leaves the interview understanding the gist of the
following: “The RDA is not used for diagnosis but for intervention and
treatment planning.” Pg. 9, Gutstein & Sheely, 2002d), for all intents
and purposes, it appears to do just that. It is important to note that
many of the above conditions are generally determined by someone with an
advanced degree and training, such as a SLP, clinical psychologist,
medical doctor, or other professional trained well above the bachelor’s
degree or master’s degree level of education.
The above stated email that was sent to Dr. Sheely included a second
inquiry about the RDA™ process. The inquiry was, “I also had a chance to
review the RDA and had a question about how to determine co-occurring
conditions. Is this done through a document review, direct observation,
a combination of the two or some other means?” The entire email response
from Dr. Sheely was as follows, “We use a good case history, obstacles
and strengths check lists and observation.”
Generally speaking, diagnosticians utilize a variety of formal and
informal testing protocols prior to making a diagnostic determination,
with at least some of these diagnostic tools that have been formally
norm referenced. The RDA™ process is of concern not only due to the lack
of norm referencing and empirical validation of the process, but also
because it appears that a determination of the presence or absence of
significant medical conditions, as well as treatment plans for those
conditions, is being conducted by individuals who do not possess
sufficient qualifications, other than their designation as a RDI™
It is also notable that the RDA™ process includes a cost/benefit
analysis (page 58) comparing the RDI® Consultants’ proposed treatment
plan to other plans in terms of financial costs, time requirements, or
other direct or indirect costs, (Gutstein & Sheely, 2002c). In a
traditional marketing and sales environment, this would be considered a
selling tool to demonstrate the “features and benefits” of the products
or services being sold that is of particular utility when the
salesperson is attempting to convert a potential customer from a
competitor’s product, and when the cost of the proposed products or
services represents a large financial investment.
Last, but certainly not least, is the concern that The Connections
Center™ is essentially “selling hope,” to desperate parents. Heartfelt
testimonials about how the RDI® program helped their child abound on the
website and in RDI® literature. What parent would not want their child
with ASD to be more socially available? What mother would not want their
husband to be more comfortable interacting with their disabled child?
But the question remains, should this be the primary treatment modality
for these children that we cherish, or a resource for ideas about how to
attempt to enhance social skills training as part of a comprehensive
program designed to address all of the complex needs of individuals
identified with ASD?
Here are some quotes from the RDIconnect.com website:
“Learn how you can feel empowered today and hopeful about the future.”
“You can receive one-on-one support, so you feel confident every step of
“Over 4 days, you will leave behind a sense of crisis & prepare for a
new, rewarding lifestyle.”
“Start in a way which feels comfortable and empowering.”
“It promises to change our view of what treatment may achieve.”
“The RDI Program breaks the cycle of failure…for both the parent and
“Dramatic improvement in meaningful communication and desire to interact
“Going beyond short-term compensating to life-long solutions.”
“The foundations of Relationship Intelligence underlie success in life.”
“Finally, families reported that the RDI Program model made it easier
for both parents, but especially fathers, to participate and to accrue
the benefits described above.” (In reference to “feeling like a
competent parent for the first time.”)
In summary, the theories and philosophies underlying RDI® strategies are
not supported by evidence, nor is there widespread “agreement among
researchers” that concur with many of the theoretical conclusions that
are the basis for the RDI® treatment design. The diagnostic criteria of
ASD’s have not been modified, nor is there widespread agreement among
researchers or clinicians that a modification that limits diagnosis
based only on social deficits is either warranted or appropriate.
Much of the RDI® terminology is different, which makes it difficult to
compare to other autism interventions, but many of the strategies are
actually the same or similar to strategies used in many ABA and non-ABA
programs. There are certainly some benefits associated with the RDI®
educational approach, including some creative curriculum and
instructional strategies, parent training, and an enhanced focus on
social skills training.
However, there are number of clinical concerns, and a profound absence
of evidence supporting many RDI® claims. Future research may prove these
concerns to be unwarranted, but at this time there is insufficient
evidence to support these efficacy claims, and eliminating other aspects
of a child’s individualized education plan to focus solely on RDI® goals
and objectives may not adequately address a child’s complex needs.
There are also numerous concerns about the marketing strategies and
branding strategies utilized by The Connections Center™ including
utilization of the RDA™, the RDI™ Consultant “certification” process,
overstatement of research findings, and extensive use of testimonials.
While proponents contend that an RDI® program is less costly than an
intensive ABA program, it is only less costly if it results in good
outcomes for children, their families, and communities. If it wastes our
children’s precious time, then the cost is incalculable.
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