Evidence supporting the use of the Relationship Development Assessment in clinical practice
By Esther Tell
A team of researchers at the University College in Dublin, Ireland and University College, London conducted a study to assess patterns of parent-child interaction using a research version of the Relationship Development Assessment. The aim was to establish whether the processes targeted by the approach of RDI – joint engagement and co-regulation – could be coded reliably, and whether a) these processes had validity, and b) might be clinically-useful evaluation tools. The coding scheme was developed in consultation with Dr. Gutstein at the RDIConnect, and the study was partially-funded by the Foundation for Autism Research and Remediation.
The researchers assessed 20 parent-child dyads with a verbally able school-age child diagnosed with autism, and 20 parent-child dyads without autism in a mixed comparison group. Each dyad participated in a 30-minute, semi-structured play-based interaction which was video recorded and later coded by raters naïve to the study details. The coding was designed to assess global quality of guiding engagements, as well as proportion of time spent in states of experience-sharing, and contingent interaction. The researchers coded the parent-child pair as a system – rather than rating the behavior of one or the other member.
Despite good ability to coordinate attention in this relatively high-functioning sample, parent-child dyads containing a child with autism showed difficulties with fixed/rigid patterns of interaction and the tendency to try to control each-others actions rather than share experiences. These difficulties were associated with autism severity, as measured by the Autism Diagnostic Observation Schedule (ADOS).
Patterns of parent-child interaction can either hinder or promote development for any child, and may be specifically compromised by the difficulties of children with autism. Interventions which seek to empower parents to engage with their children in more interactive and contingent ways, may hold promise for autism remediation. The RDA may be a useful clinical tool for assessing difficulties and monitoring change over time in families participating in treatment. According to Dr. Jessica Hobson (one of the study authors), “This study illustrates how quality of parent-child interaction is a valid construct which can be reliably assessed using the RDA. This is not only an important area for the focus of treatment, but also important for our ability to measure meaningful development.”
*A special thanks to Dr. Jessica Hobson for reviewing and editing this article.