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G507 Relationship development intervention; a developmental perspective to autism management
  1. DN Patil1,
  2. ACB Setti2
  1. 1Department of Paediatrics and Child Health, Hwyel Dda University NHS Trust, Withybush General Hospital, Haverfordwest, UK
  2. 2Child Health Centre, Hywel Dda NHS University NHS Trust, Withybush General Hospital, Haverfordwest, UK

Abstract

Introduction/Aim The aim of this paper is to present the experiences of two familes of children with autism spectum disorder (ASD) using a particular intervention.

The deficits of individuals with ASDs can be divided into homogeneous “primary” deficits, which define the disorder, and heterogeneous “secondary” deficits, which may or may not be present. Primary deficits reflect poor development of dynamic neural functioning and the failure to develop dynamic intelligence.

NICE Guidelines The management and support of children and young people on the ASD(August 2013) recommends that interventions for core ASD features include training of parents, caregivers, and teachers to increase joint attention and reciprocal communication using video-feedback methods appropriate to the child’s developmental level.

One such intervention, Relationship Development Intervention (RDI), uses the principle of typical development of Dynamic Intelligence via Guided Participation relationship, which either never gets to develop or gets disrupted early in the development of a ASD child.(development psychology research)

RDI is implemented through intensive parent education to reconstruct their natural “guide” relationship from a developmental perspective, modelling and role-playing, regular videotape review of parent-child performance, and school staff training.

Methods This intervention has been used on my own son for 3½ years and another child with an ASD for 1 year. They were followed through regular videos and Relationship Development Assessment (RDA) of the child and parents every 6 months.

RDA consists of a semi-structured observational assessment (RDA-RV) focusing on three interpersonal parent-child processes: shared attentional focus, ability to co-regulate an interaction, and ability to share emotional experiences.

Results Both families showed Improvement in their child’s ability to interact and engage, accept and adjust actions with parent modelling and pace adjustment, understand changes and variations with continuity, and co-ordinate their actions with others.

After RDI for 3½ years One child was able to 1) understand and use nonverbal cues, gestures, and facial expressions; 2) explore new situations and activities, participating with other adults to learn; and 3) handle group activities/peer games like almost any normal child.

Conclusions The results show overall improvements in functioning related to ASDs. An examination of the literature reveals a growing body of empirical evidence and best practice recommendations supporting the practices embedded in RDI.

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