Rhonda Lane shares an amazing journey about how RDI helps all kinds of families and not only those affected by autism.

Recently, I have had the privilege of working with families of medically fragile children who have begun the RDI process. I hope that sharing my observations and experiences will encourage others to use RDI with this population as well.

 The usefulness of RDI with the medically fragile community has been compelling in every aspect of its use. I work in a day treatment facility for medically fragile preschoolers from infancy through 5 years of age. A child has one or more of the following medical conditions at our center:  a tracheostomy which is a breathing tube in the neck for children who cannot obtain enough oxygen by breathing through their upper airway, various types of feeding tubes for children who cannot eat by mouth and/or oxygen tubes for children who cannot obtain enough oxygen by breathing on their own. Other children may need a protected environment until injured body part(s) have healed, such as multiple wounds, burns or body parts that require artificial means to keep them open (i.e. external tubes to keep a burned esophagus open until it is healed). Some children have suffered a sudden trauma such as an animal mauling or endured a gas explosion or swallowed poisons. Other children have been medically fragile since birth due to extreme prematurity at birth or traumatic births.  The three families with whom I currently partner in the use of RDI are clients who have been medically fragile since birth.  

One child was a product of an extreme premature birth of 23 weeks. This now 7 year-old child was not expected to survive. Her skin was under-developed to the extent that when anyone touched her skin it tore and peeled away. This led to permanent scars on her skin.  Her doctors had to place a tube down her throat so many times that scarring occurred to her vocal cords and resulted in permanent hoarseness. She was so small when born that she could fit into the hand of her grandfather. She has undergone multiple surgeries to correct crossing eyes and worn patches over one eye over the course of a couple of years in order to develop the muscles of the other eye. Her visual scanning continues to be a challenge and she wears glasses in order to see as clearly as lens correction will allow. She was fed by a tube in her stomach until the age of 4 when she attained total feeding by mouth. As with all severe premature infants, her respiratory system was particularly compromised. This resulted in recurrent asthma attacks, bronchitis and pneumonias. The immaturity of her neurological system at birth resulted in moderate motor planning problems and muscle tone weakness. These movement challenges have made gross and fine motor tasks difficult for her which have negatively affected her play, self-help, speech and expressive language skills.  She has also been diagnosed with a word-finding problem. This challenge has been evident when she uses incorrect words in conversational speech and repeats words that she has just heard herself or someone else say. As if these challenges were not enough, she has also demonstrated a significant response delay in any motor task (including speech). As the world moves on to the next interaction, she is just responding to the first one and before you know it, she is left behind in the on-going evolution of interactions that make up our everyday lives. 

Initially her grandparents, who are now her adopted parents, responded as most individuals would in a life or death situation such as this, by doing everything in their power to keep her alive. When she finally came home after 5 months from the Neonatal Intensive Care Unit, it was necessary for the medical care to remain diligent. She became their "Little Miracle". The parents' main objective was to keep her alive and healthy, tending to her every need. Protecting her from illness, physical, mental and emotional stress was of primary importance. One can see that in a survival situation such as this, it would be easy to lose the guided participation relationship.  Instead of a GPR, the Parent-Child relationship developed into a Servant-Master relationship.  Every need of the child became the focus of the parents.  Keeping her the least sick, the least stressed, the least frustrated, the least upset meant keeping her protected from disease and situations that would cause her stress, frustration and unhappiness. Subsequently, a pattern developed to the point that "Little Miracle" saw that the world was there to serve her every need and desire. This was what she expected and deserved. She knew nothing else. As she aged, this resulted in more and more severe negative behaviors. Some examples of these inappropriate behaviors were frequent and severe temper tantrums when she did not receive what she desired, throwing objects or hitting and kicking peers and adults to get what she wanted, not cooperating in apprenticeship with adults  which subsequently blocked new learning, decreased facial expressions, decreased referencing of peers and adults. She was especially difficult with her father as he particularly allowed her to do whatever she wanted. This made life much more challenging for her mother and for "Miracle" as well. 

RDI has given the parents the knowledge, i.e. the who, what, when, where and why, and the permission to be the guides.  For the first time, they were educated about their child's deep and desperate need for them to be her guides.  They were released from the bonds of protectionism, which enabled her to depend on them more and more for her every need and whim.  They are learning the tools of empowerment which allow the child to become a young girl who is finding her way toward independence through experiences supported by her parents in such a way to allow her to feel competent. They have been able to visualize a new future for their child.  Not one of sickness and dependence, but one of abilities, confidence, pleasure in learning, being an apprentice and being in cooperative, co-regulated interactions with the two people closest to her...her parents.  This story is not finished for "Little Miracle".  The journey has just begun.  But her future looks the most optimistic, joyful, meaningful and the most connected with others than it has ever been in her 7 year-old life. Thank you RDI, for vastly improving the quality of life for this "Miracle" and her parents!

Rhonda Lane is a speech-language pathologist of 31 years with an emphasis in autism, auditory processing disorder, A.D.H.D. and learning disabilities. Although she has worked with all ages, she has devoted the past 26 years to children and their families.  After almost 30 years of communication work with families with autism, Rhonda wanted more than improved verbal communication for her clients.  The verbal language was of little value without strong connections and relationships with others. Becoming certified in R.D.I. has provided that missing piece for Rhonda and her families.  You may contact Rhonda at careservicesaugusta.com.

Rhonda Lane M.A.C.C.C.S.L.P.

R.D.I Program Certified Consultant

Pediatric N.D.T. Certified

Rhonda Lane shares an amazing journey about how RDI helps all kinds of families, not only those affected by autism.

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Recently, I have had the privilege of working with families of medically fragile children who have begun the R.D.I. process.  I hope that sharing my observations and experiences will encourage others to use R.D.I with this population as well.

 The usefulness of RDI with the medically fragile community has been compelling in every aspect of its use.  I work in a day treatment facility for medically fragile preschoolers from infancy through 5 years of age.  A child has one or more of the following medical conditions at our center:  a tracheostomy which is a breathing tube in the neck for children who cannot obtain enough oxygen by breathing through their upper airway, various types of feeding tubes for children who cannot eat by mouth, and/or  oxygen tubes for children who cannot obtain enough oxygen by breathing on their own.  Other children may need a protected environment until injured body part(s) have healed, such as multiple wounds, burns or body parts that require artificial means to keep them open (i.e. external tubes to keep a burned esophagus open until it is healed). Some children have suffered a sudden trauma such as an animal mauling or endured a gas explosion or swallowed poisons.  Other children have been medically fragile since birth due to extreme prematurity of birth or traumatic births.  The three families with whom I currently partner in the use of R.D.I are clients who have been medically fragile since birth.  

One child/family was a product of an extreme premature birth of 23 weeks. This, now 7 year-old child, was not expected to survive.  Her skin was under-developed to the extent that when anyone touched her skin it tore and peeled away.  This led to permanent scars on her skin.  Her doctors had to place a tube down her throat so many times that scarring occurred to her vocal cords, and resulted in permanent hoarseness.  She was so small when born that she was could fit into the hand of her grandfather. She has undergone multiple surgeries to correct crossing eyes, and worn patches over one eye over the course of a couple of years in order to develop the muscles of the other eye. Her visual scanning continues to be a challenge, and she wears glasses in order to see as clearly as lens correction will allow.  She was fed by a tube in her stomach until the age of 4 and a half when she attained total feeding by mouth.  As with all severe premature infants, her respiratory system was particularly compromised. This resulted in recurrent asthma attacks, bronchitis and pneumonias.  The immaturity of her neurological system at birth resulted in moderate motor planning problems, and muscle tone weakness.  These movement challenges have made gross and fine motor tasks difficult for her, which have negatively affected her play, self-help, speech and expressive language skills.  She has also been diagnosed with a word-finding problem.  This challenge has been evident when she uses incorrect words in conversational speech and repeats words that she has just heard herself or someone else say. As if these challenges were not enough, she has also demonstrated a significant response delay in any motor task (including speech).  As the world moves on to the next interaction, she is just responding to the first one and before you know it, she is left behind in the on-going evolution of interactions that make up our everyday lives. 

Initially her grandparents, who are now her adopted parents, responded as most individuals would in a life or death situation such as this, by doing everything in their power to keep her alive.  When she finally came home after 5 months from the Neonatal Intensive Care Unit, it was necessary for the medical care to remain diligent.  She became their little “Miracle”.  The parents’ main objective was to keep her alive and healthy, tending to her every need. Protecting her from illness, physical, mental and emotional stress was of primary importance.  One can see that in a survival situation such as this, it would be easy to lose the guided participation relationship.  Instead of a GPR, the Parent-Child relationship developed into a Servant-Master relationship.  Every need of the child became the focus of the parents.  Keeping her the least sick, the least stressed, the least frustrated, the least upset, meant keeping her protected from disease, and situations that would cause her stress, frustration and unhappiness.  Subsequently, a pattern developed to the point that little “Miracle” saw that the world was there to serve her every need and desire.  This was what she expected and deserved.  She knew nothing else.  As she aged, this resulted in more and more severe negative behaviors. Some examples of these inappropriate behaviors were:  frequent and severe temper tantrums when she did not receive what she desired, throwing objects or hitting and kicking peers and adults to get what she wanted, not cooperating in apprenticeship with adults, which subsequently blocked new learning, decreased facial expressions, decreased referencing of peers and adults.  She was especially difficult with her father, as he particularly allowed her to do whatever she wanted.  This made life much more challenging for her mother and for “Miracle” as well. 

R.D.I. has given the parents the knowledge, i.e. the who, what, when, where and why, and the permission to be the Guides.  For the first time, they were educated about their child’s deep and desperate need for them to be her guides.  They were released from the bonds of protectionism, which enabled her to depend on them more and more for her every need and whim.  They are learning the tools of empowerment which allow the child to become a young girl who is finding her way toward independence, through experiences supported by her parents in such a way to allow her to feel competent. They have been able to visualize a new future for their child.  Not one of sickness and dependence, but one of abilities, confidence, pleasure in learning, being an apprentice and being in cooperative, co-regulated interactions with the two people closest to her…her parents.  This story is not finished for little “Miracle”.  The journey has just begun.  But her future looks the most optimistic, joyful, meaningful and the most connected with others than it has ever been in her 7 year-old life. Thank you, R.D.I., for vastly improving the quality of life for this “Miracle” and her parents!

Rhonda Lane M.A.C.C.C.S.L.P.

R.D.I Program Certified Consultant

Pediatric N.D.T. Certified

Rhonda Lane is a speech-language pathologist of 31 years with an emphasis in autism, auditory processing disorder, A.D.H.D. and learning disabilities. Although she has worked with all ages, she has devoted the past 26 years to children and their families.  After almost 30 years of communication work with families with autism, Rhonda wanted more than improved verbal communication for her clients.  The verbal language was of little value without strong connections and relationships with others. Becoming certified in R.D.I. has provided that missing piece for Rhonda and her families.  You may contact Rhonda at careservicesaugusta.com.