so, exactly how much are we talking?

You'll notice that I put off writing this for a good week or so. The emails are still trickling into my inbox -- how much does an RDI Program Certified Consultant actually cost? Exactly how much money are we talking? It's not an answer I'm anxious (or qualified!) to provide, as I am NOT a consultant. But, here goes anyway.

Consultants' fees all vary, depending on the area of the country they live in, the facility they are associated with, the number of clients they have time to take on, whether or not they are actually accepting new clients, and how much their new vacation home in the Bahamas is going to cost them. (I AM JUST KIDDING ABOUT THAT LAST ONE!!! I don't know ANYONE living in luxury thanks to providing RDI services.) Some consultants work faster than other. Some are more thorough than others. Some take an entire week to perform an RDA (Relationship Development Assessment) and spend 4 hours with each tape review. Some do the RDA in a handful of hours and work with the clients for about half an hour a week.

So, it's sort of impossible to say exactly what this is going to cost the average Joe Parent out there shopping for RDI services for their kid.

What I can tell you is that because YOU, the parent, are providing the actual services to your child, it is VASTLY cheaper than ABA or any other "autism program" that employs outside therapists to do the work. All you are paying for is a consultant to evaluate and help chart your path, keep you on the right road, and provide support. So obviously, in terms of money spent, you get way more bang for your buck in RDI.

What I can also tell you is that a little logical math can give you a pretty good idea of the kinds of money we're talking. Professional Therapists in this field make anywhere from $100 to $175 per hour, depending on their specific specialty (obviously a liscenced Psyhotherapist makes more money than a PT), and the area of the country they are providing services in. The RDA takes anywhere from 12 to 20 or so hours to administer, evaluate, present results and a game plan to parents, and train parents in how to go about it. A 30 minute tape review takes at least 1 hour to complete, more if communication with the client involves emails or other written evaluations. The general RDI schedule involves an RDA every 6 months and bi-weekly tape reviews. A relaxed schedule that some consultants offer includes an RDA once yearly and monthly tape reviews. And of course there are a whole array of variations between the two.

So, do the math. Then call some Consultants to get an exact figure of how much they charge. Right now the bigger problem might be finding a Consultant that is still accepting new clients, so you need to keep that in mind too. Most Consultants are either not accepting new families (since an RDI program takes many years, the Consultants work with the same families for quite some time, and there are only so many hours in the day), or have long waiting lists for available time to administer the RDA.

A list of RDI Program Certified Consultants can be found at the Connections Center website at http://www.rdiconnect.com . 

why hire a consultant?

I wrote an entry about finding a Consultant and then lost it earlier today, and I'm sort of glad. Gives me a chance to do it better this time. The first time I just told the story of us finding an RDI Program Certified Consultant. But the more interesting topic to write about is WHY you would want to find one. I mean, professionals are expensive, and there's plenty of free information on the Connections Center website, http://www.rdiconnect/com, plus all the free Yahoo RDI e-groups, blogs, etc, as well as a couple of books written on the topic. Certainly it's possible to make progress on your own?

Well, yeah, it's possible. In fact, probable. We did it -- we had mastered stage 1 by the time we went to our RDA (Relationship Development Assessment), about 6 months after starting RDI on our own, and had already seen AMAZING progress. But it wasn't until we started working with our consultant that our program really kicked into high gear. Would we have kept making progress if we never started with a consultant? Probably. But I don't think the quality of our program would have been as deep or effective, nor would our progress have been as "fast" as it has been. It's one thing to read about how to "do" RDI, it's quite another to watch someone well-versed in it interacting with your child. My understanding of the process jumped exponentially during our RDA, and the support, advice, and having someone that HAS to listen to you (because you're paying them -- I'm only half-joking with this!) has made it worth every penny.

Ok, so why would an otherwise intelligent person (that's me, by the way, and probably a lot of you reading this too -- the rest of you are probably already working with a consultant!) need to hire a professional RDI Consultant?

1. To administer the RDA, so that you know what has been mastered and what still needs to be worked on. In the beginning, maybe this isn't as vital -- pretty much everyone starts at Stage One (and I'll talk more about the stages in an upcoming post). But once you start to get rolling, it's easy to get lost as to where exactly you are in the RDI program and what needs to be worked on before moving along to the next Stage. Having those basic building blocks in place and mastered certainly leads to a smoother road. Without it, potholes crop up and you end up having to stop and fix them at some point before being able to regain momentum again. The whole thing just runs much smoother under the experienced guidance of a Consultant.

2. So that someone emotionally outside of your family can look at what you're working on and tell you where you're screwing up. They'll tell you where you're doing good, too, but you probably already know THAT. It's the screwups being pointed out that help you learn and are the nudge you need to push you back onto the travel lane when you've drifted off into the shoulder of the road. And the Consultant prevents you from coasting, too, which will happen if you're not providing enough challenge, by telling you to increase the challenges you present. They also check your speed to make sure you're not going to swerve out of control and cause a wreck by providing too much challenge all at one. It may seem like a pretty "duh" moment when they point something as simple as "that was too challenging for him, try scaffolding a bit more" while viewing a video tape of your wild screaming child, but without the reminder, you just may keep kareening down the road with the pedal to the metal.

3. To act as a personal sounding board when you are frustrated, or feel like you just can't go on, or that you're not making enough progress, or that the whole thing is just too overwhelming. They help calm you, they keep you focused on the important goals, they remind you of what you've already accomplished. They provide support that nobody in your family or circle of friends can, because they truly understand. And they have a clientel full of other people on the same journey that they can hook you up with for real-life moral support. Many consultants host support groups for their clients.

4. To interpret all of Dr Gutstein's professional-ese babbling. Don't sell this function short. Dr. Gutstein has a totally brilliant mind, but I sometimes think that we mere mortals need a formal interpreter to understand the extent of the content he's trying to provide to us. There's been more than one email to our Consultant that has started by saying "What the heck did Dr. G mean when he said ..... on Tuesdays' chat?"

5. Related to #4, the Consultants are required to keep up with all of the latest RDI information. Because this is such a "new" and constantly evolving therapy, and because it's kept on the cutting edge of Autism research, it seemingly shifts on a daily basis. A Consultant can keep you abrest of all the lastest information and RDI news.

6. It's an AMAZING bargain compared to the vast majority of other therapies available, all of which are less effective at actually remediating Autism. I'm not going to lie, it ain't cheap. But it's less expensive than all of the other options I've run across. And the dollar spent per benefit gained ratio doesn't even compare. I like a bargain.

7. By working with a Consultant, you get access to the Annual Parent's Conference (which I posted about previously), which is an amazing opportunity to commune with hundreds of other fellow RDI-ers in person, not to mention the chance to attend workshops and lectures with some of the key people in RDI and Autism Remediation, on the cutting edge of progress. It's just too cool.

8. I left this one for last, because it's the most controversial. With the new RDI operating system, which will be launched at some point during 2007, you will need to be working with a Consultant in order to have access to the system. There are a couple of reasons for this -- first is because this form of detailed computerized tracking allows the Consultant to pick and choose the objectives you are working on (choosing the most appropriate, ignoring the rest), rather than you sitting there with all 1600 RDI Program objectives in front of you wondering where to go from here. The system will increase the effectiveness and efficiency of Consultant/Client communication, but you NEED this relationship with a professional in order for it to work. The other reason is simple Quality Control -- this is a way for the Connections Center to make sure their Consultants are practicing up to their high standards -- in other words, that they are truly representing the RDI program, and not some modified or water-downed version of it. There are bound to be "professionals" that call themselves "RDI Consultants" who work with clients in an RDI-type fashion of some sort, and no doubt some of them will have some amount of success. But I as a consumer would like a way to make sure that I'm really getting what I pay for, and I think this is a great way to ensure that.

Some people will argue that the Connections Center and Dr. Gutstein are trying to shut out people who can not afford to hire a Consultant, but I just don't believe that's the motivation behind this move. I think that Dr. Gutstein is very concerned that RDI is available to everyone that wants to use it. Certainly, people will continue to "do" RDI on their own and will continue to see results, just like they are now. But for those that want "something more", there are RDI Program Certified Consultants to help. 

productive uncertainty

I'm not even sure they are still using the term "Productive Uncertainty" at Connections Center anymore, but I like it, so I'm going to write about it. I like it because Uncertainty -- not knowing what's coming next -- is pretty self-explanatory, and Productive means that there is an opposite called Unprodcutive, and the difference is very clear in terms of which one is beneficial and what happens if you're not successful.

Uncertainty is that "C" in the R-C-R cycle, the Challenge, the moment when your child is pushed beyond their capabilities ever so slightly. This Uncertainty is Productive when they are successful and develop a new regulation, and they develop the competence that allows those ever-important neurons in the brain to grow. It's like a subtle little switch in the brain gets flipped into the correct position. When the child is NOT successful, then the uncertainy was UNproductive, and they become dysregulated and express that in whatever manner is usual for them (melt-downs, tantrums, shutting down, striking out). It's pretty clear to you, as a parent, when your child's uncertainty has been unproductive!

The best way to keep the Uncertainty productive is by scaffolding the activities to ensure that the child is able to be successful in the challenge. (It's also extremely important that the challenge be very slight, as too much challenge will not be successful/productive either -- so framing appropriately is the first step.) (For definitions of Scaffolding and Framing, see my previous two posts!)

Here's an example from our RDI program. Jacob has some pretty huge food issues, even with looking and and touching foods. So when we do anything having to do with baking, etc, I have to scaffold the heck out of it to ensure success. But I love doing these activities with him because it is SUCH a challenge to him, that I can be assured I'll get a lot of "bang for my buck" so to speak -- every accomplishment he has with an activity like this is a huge opportunity for brain development.

So, let's see how I scaffolded baking cookies. First, I knew that he could not handle the actual preparation of dough and all the millions of steps that go into it. So I bought the pre-made cookie dough, already cut into shapes. The first time we did this, I had him sit in front of a cookie sheet, and I handed him the cookie dough, and instructed him (non-verbally, just by indicating with body language) to place the dough on the cookie sheet. He really didn't want to take that cookie dough from me, but eventually he did, and was successful it transfering it to the cookie sheet (though I think I needed to physically guide his hand the first couple of times). We repeated until the cookie sheet was full. By the last cookie, he was getting pretty good at taking that cookie from me and placing it down on the sheet. So there was no uncertainty (challenge) anymore. So the next time we baked cookies, I used the same type of cookies, but this time, after handing him the first cookie (so he could see that it was the same activity), I just held out the cookie dough tray to him (uncertainty/challenge) and HE had to pull the cookie dough off the tray and transfer it to the cookie sheet. He had gotten pretty competent at that by the end of that cookie baking session. So the next time I used a different kind of cookie. Even though he'd been competent at that level with the original type of cookie, he was not able to bring himself to lift the new kind of cookie dough off the tray, and we ended up with tears and a lot of protesting. There was too much uncertainty with touching an unknown type of cookie dough. So I went back to handing him the cookie dough again, and that was enough scaffolding to allow him to be successful, even though he was still pretty distressed about it being a different kind of cookie than what he was expecting it to be. So we had tears, but he was successful. Next time we made that kind of cookie, we had no tears and didn't need the extra scaffolding. And the same held true when I switched up the type of cookie again, added dipping it in sugar or sprinkling it with sprinkles, etc. So long as I kept the scaffolding where it needed to be to keep enough (but not too much!) uncertainty, it was very productive. Fast forward a year or so, and I've got a kid who can mix up cookie dough pretty much on his own (under my supervision), and get his hands right in there to form the shapes, even if it's not a type of cookie he's going to want to eat.

The really cool think about this concept is that while Productive Uncertainty is where the child does his actual development, the UNproductive times are not slogging you deeper in the muck -- all you need to do is to increase your scaffolding slightly until you find that point at which your child is challenged just enough to make it productive, but not so much that it's unproductive.

As you get to know your child's strengths and weaknesses better through RDI, it gets easier to guess at how much scaffolding to use when first starting out on a new activity. But you always need to adjust to keep the uncertainty productive -- a little more here because they are already competent and need a challenge, a little less there because they are showing signs of it becoming unproductive. 

scaffolding

The second part of setting up a successful RDI activity is Scaffolding. Scaffolding is what we do to help the child feel competent in the role that he is taking in the activity. The idea is to scaffold (modify his participation in the activity) just enough so that he successfully participates, but not so much that there's no challenge for him. And as the child becomes more competent in that role, you reduce the scaffolding until he's actually performing his role completely on his own.

Going back to my cat feeding example, here's how I would scaffold it: initially I would set it up so that the bin was open and full of cat food, the scoop was in it, and the bowls were lined up nearby. I would hand Jacob the scoop, and put my hand over his to help him scoop the cat food out, then I would hold a bowl out towards him and help him pour the food into it. When he started getting competent at scooping and pouring, I let him do that on his own, handing him a bowl to pour into. Eventually, I stopped handing him the bowl and he had to reach for it on his own. Then I stopped removing the lid of the bin, so that he had to get it off himself. Then I started not including the scoop, so he had to run to the place that I stored it to get it before he could start scooping. Then I stopped bringing the bowls in and he had to go gather them from the hallway where they were left the last time the cats were fed. then I started letting the cat food run low so that occassionally he had to solve the dilemna of not having enough food. This reducation in scaffolding didn't happen overnight, it was over the course of months. But as his competence with the activity grew, I kept withdrawing more of the scaffolding.

Now, that might sound all well and fine, but it's tough figuring out exactly where to draw that scaffolding line. I'm a pretty infamous over-scaffolder -- I tend to not push him as hard as I could, and I actually think we'd be further along in our RDI program if I pushed him more. So I probably remove scaffolding at a much slower rate than I need to -- I like to see him be successful. But I think there's a greater danger in withdrawing the scaffolding too quickly (or not scaffolding enough intially, which I'm guilty of myself), in that if the child feels incompetent with the activity, they may refuse to participate, or may become so dysregulated that they have a big unproductive meltdown, which isn't pleasant for anyone. And it erodes their trust with you. So my feeling is, better to over-scaffold and make slower progress than to under-scaffold and meet failure at every turn for the poor kid. But too much of a good thing is not beneficial, so you've got to constantly be monitoring whether or not your child feels challenged, as without challenge there is no learning/progress. 

framing

In case you were wondering where it went, there WAS a post here entitled "framing and scaffolding", but I wrote it when I was in a hurry, and decided later to replace it with a more in-depth series of 2 posts, splitting the topics.

We were about two months into our RDI journey, spending most of September and part of October reading and learning as much as we could about RDI, had gotten pretty good at using mostly Declarative Epxerience-Sharing language intsead of Imperitive language, and had reduced a lot of our verbal garbage and was relying much more on non-verbal language to communicate with Jacob and each other. We had spent the better part of November working on Regulation and the R-C-R cycle with Jacob. We were ready to start looking at the Stage One (Emotion Sharing) objectives.

The first step was to frame our activity. Framing is setting up an activity so that your objectives can be acheived. In Jacob's case, this included re-decorating (or rather, UNdecorating) our living room, as just about everything distracted him, especially anything with writing on it or any surface that he could see his reflection in. We removed all reading materials and toys from the room, took out all the chairs other than one sofa that was pushed up against the wall, covered the TV and fireplace doors with sheets, and pulled the curtains shut whenever we worked with Jacob. These modifications to the environment left him more available to attend to us, increasing our chances of successfully eliciting Emotion Sharing from him. Not all kids are going to require this barren type of environment (which used to be refered to as RDI Lab Time), some kids can jump right into RDI activities in the home in general. Jacob wasn't one of those kids.

Another important aspect of framing is to recognize that there are 4 basic ways (frameworks) to do any activity. You can do the same thing at the same time (parallel simultaneous); you can do different things that are related at the same time (complimentary simultaneous); you can take turns doing the same thing (parallel sequential); and you can take turns doing different things that are related to each other (complimentary sequential).

I'll use feeding the cats, one of our earliest RDI activities, as an example of how it might be framed. First of all, I would bring the cat bowls, cat food bin, and scoops into the non-distracting living room. From there, I could frame the activity in a parallel simultaneous manner by us both scooping and pouring the cat food at the same time (each with our own scoops). Or I could frame it in a complimentary simultaneous manner by my scooping while he held the bin, or me pouring while he held the bowl. I could frame it in a parallel sequential manner by taking turns scooping and pouring -- first I scoop, then he scoops, then I pour, then he pours. Or I could frame it in a complimentary sequential manner by my scooping the food, then handing the loaded scoop to him, and then he pours it into the bowls.

Each of these framworks can be used to set up the overall RDI Framework, which is Variations on a Theme. So we would want to change it up quite freqently -- some days I would scoop and he would pour, other days he'd scoop while I held the bowl, etc.

And then there is scaffolding, which is another tool in the RDI toolbox, that I'll talk about next.