Autism remediation is a radical concept and a lot of parents wonder if it is even possible. Join Dr. Steven Gutstein, autism researcher and the founder of the RDI Model for remediating autism in a discussion on autism remediation and the RDI Model.
Kat Lee: Welcome back to ASD: A New Perspective, the podcast show where we help you understand what is going on in the mind of your child and we encourage you that growth for your child is possible. I’m Kat Lee, and in this podcast, Dr. Gutstein talks to us about remediation.
Dr. Gutstein: The idea that we can remediate these things is still very radical in the autism world. As I said, I haven’t found one paper written, and I’ve read everything, that talks about the potential for remediation of these areas: of neural remediation, of psychosocial remediation. Not one. It’s all about can we teach people other ways of functioning, or just neglecting it completely and not even thinking about it. Again, it’s back to that idea of people who choose other paths often really don’t understand autism from the way we’re understanding it, and the way I think modern researchers are understanding it, although some are. There’s just been a couple of articles lately that are starting to … They’re not using word remediation, but they’re starting to address the issue of do we have to accept this as the end point. Do we have to accept the fact that they’re just working on compensation, or they just don’t know what they’re working on? They don’t know what their end point is.
Dr. Gutstein: One of the things that I will say to you, when you talk about RDI, I talk about remediation rather than RDI first. I’m saying look, before we worry about names like RDI, QBC, let’s think about what you would like to be able to do. What’s your goal in seeking intervention here? I go back to this, which here’s what happens when people don’t have the benefit of this mind-guiding relationship. Their brain does not develop in a way that allows them to function in the real, complex dynamic world. The mind-guiding relationship is what allows that to happen. You’re gonna be able to have a mind-guiding relationship with your child. If you don’t have it, what can we expect to happen for this child? How are they gonna learn to use their mind? Who’s gonna help them learn to use their mind, to be able to conduct their own time traveling, to be able to think about alternatives, to be able to look at both points of view and perspectives, to be able to do that online monitoring, updating, functioning, reacting, adapting? Where are they gonna learn that?
Dr. Gutstein: I would have questions that I would ask people when they’re seeking intervention, which is before we talk about what, which is, how important are these things for you? Part of that is people who may have already accepted that, that won’t happen. These things are potentially possible for people with this diagnosis because this diagnosis is a pathogenetic diagnosis, and people still don’t understand that. They don’t understand that it’s about vulnerabilities resulting in the loss of opportunities for development, for neural and psychosocial development. They don’t understand that. Therefore, yes, and there could be other things. It could be brain damage and epilepsy and all kinds of … We’re talking about them. We’re talking about autism now. Autism is a pathogenetic disorder, and the research is very clear on that because in six months, you can’t tell the kids apart … At least the researcher can’t. I might be able to. They can’t. On terms of any major developmental issues, you can’t tell them apart from who’s not gonna be autistic.
Dr. Gutstein: By 18 months, you can, pretty much, almost everyone. 24 months, certainly. What we see in that second year is a detachment from the relationship, is the lack of parents to be able to guide and develop a mind-guiding relationship and very clearly document. That continues on. It doesn’t any better. It gets worse. What you have to think about, then, is if you’ve got families, they have to understand what autism is before you talk about treatment. People throw treatments at them without explaining what the disorder is. I go back to that, which is what do you think this is? Well, every parent would want the same thing for their autistic child as they do for their child who doesn’t have autism or any other child. We want them to be able to function in the world and to be successful in the world.
Dr. Gutstein: Well, what do you need to be successful in the world? You need dynamic intelligence. You need the ability to learn from your past experience to project yourself into the future, to conduct self dialogues with yourself, to be able to create and look at things from multiple different ways, to be able to shift the mental and be flexible. You need mental flexibility and shift sets when what you’re doing is no longer working. You need to know when to step back and reflect on what’s happening. You need to know how to make plans, knowing that you’re gonna have to adapt them and change them. We need to learn how to make sense of things that don’t make sense. We call it sense making. You need to be able to develop the ability, when things are confusing to you or they didn’t work as you expected, to try to make sense of those things, so that you can learn from them.
Dr. Gutstein: You need to be able to have situational awareness. You need to be able to understand how to develop a mental archive of situations so that you can match new situations to, that have partial matches to the situations that you’ve already experienced, so that you can say aha, that’s similar. I don’t have to approach every situation as if it’s the first time. You need to have situational awareness. That’s what I think we have to be able to explain to them, which is if you’re going to have a life, then this is what has to occur. Everybody agrees on that, that this is what people need to be able to function in the world.
Dr. Gutstein: Well, is that your goal for this child, to have that type of life? If so, let’s be a consumer and think about how are you going to obtain that for your child. It’s not gonna be in school. It’s very clear. Those things are not part of curriculum in the school. They’re not gonna be part of ABA or speech therapy or occupational therapy and not in school and not any of those things. They’re not just part of what they do. So,where is that going to happen? Where does it happen for any child? It’s family, it’s parents, through their guiding relationships, through their mind-guiding. It’s mental processing. It’s learning these mental processes, how to use your mind as an effective tool when you’re in real world situations. When you parent them, playing with them, learning from them, and engaging in the midst of them.
Dr. Gutstein: Do you want to be a parent for this child like you would for your other children? Do you wanna have the same influence for your child? What you wanna talk about is what autism is and isn’t. It’s not even things like epilepsy. It’s doesn’t have that permanence attached to it, although again, that’s the assumption that there’s a permanence attached to autism. When there’s a permanence that attaches to it, everybody has some vulnerabilities and clearly there is some organism of limitations that we all have in our genes, in our upbringing. There are some things. I’m not suggesting that everybody can be a quarterback for a football team or baseball player, championship dancer or in the Olympics or an art person. No, there are limitations that we all have.
Dr. Gutstein: Autism doesn’t address that. The word autism, it doesn’t address what your vulnerabilities, your limitations, are. All it addresses is that because of those early vulnerabilities, you’ve lost access to this critical relationship, this critical learning environment, call it that rather than relationship. [inaudible 00:09:05] relation with this critical learning environment, this critical mental and neural embedded development, growth environment. You’ve lost access to that. Because you’ve lost access, right, you then don’t develop neurally, mentally, what you need to be successful to be in our world.
Dr. Gutstein: If we can restore access and then give you opportunities to use that in a relationship, which almost means throwing down all those expectations out in the world for a while, not worrying so much about grade levels and throwing your kids at peer opportunities, but give them one-step-ahead challenges, which is how we know children develop. Good mind guides, good parenting mind guides, try to make sure their kids are not overwhelmed. They’re not in environments that are too difficult for them, impossible for them to be competent in and master, right. Not that they’re always successful, but they try. They know that they need to do that, and they very carefully try to gauge that. If we give them that opportunity, we establish the relationship and then give them the chance to be competent and challenge in environments that are just a little bit ahead, then remediations are possible.
Kat Lee: Thanks for joining us for ASD: A New Perspective, the podcast show where we help you understand what is going on in the mind of your child and we encourage you that growth for your child is possible. I’m Kat Lee. See ya next time!