Monday 4 June 2012

Example of an RDI assignment: working on 'Planning for imperfection and mistakes' with a child

A fellow RDI Consultant, Libby, came up with this great idea of sharing an example of the kind of assignments we work on in RDI so that people can see how RDI is put into practice in real life family situations. Libby was kind enough to agree to share some of her assignments on my blog (big thanks Libby).

Please note that this is being shared to show how parents can become empowered through working with a highly trained consultant when take the Consultant’s guidance and apply it on their own without waiting for next therapy appointment, social skills class, etc.  
It is not recommended that parents who want to try RDI dive in with this objective as there may be many foundations that would need to be mastered before a child could work at this level as well as many objectives that parents would need to work on in order to be able to competently guide their child at this level.
For those who are interested in working directly with a consultant to create an individualized plan based on a rigorous assessment of the parent-child guiding relationship, please visit www.rdiconnect.com

Sample Parent Assignment

By Libby Majewski, RDI® Program Certified Consultant

As posted on Facebook (www.facebook/kidsahead.com) 6/3/12

Dynamic Intelligence Objective: Planning for Imperfection and Mistakes

Here is an example of an assignment I recently wrote to a parent who was working alongside and guiding her son as they planned a big lemonade sale at their church. This was a project that took several weeks of planning and preparation and the mom shared every step of the way with me (I'm very lucky). I, in turn, guided her with assignments and feedback. Below, I am guiding her to make sure she works with her son on "When Things Go Wrong" as they always do in any big project. Please note that all names and personal information have been changed - the purpose of sharing this is to give the community an idea as to how a developmental/cognitive approach can empower parents.

Please share thoughts or questions.

Hi J,

Here is your next assignment as you continue on with the lemonade sale project. I'd like to explore with D his expectations for the sale and also the theme of ‘Mistakes or When Things Go Wrong’. Although he is practicing a lot at home and is working hard and preparing, the sale, in fact, is probably going to be VERY different than the times he's been practicing. With that in mind, I'd like to work a little on planning for imperfection and having realistic expectations (that mistakes will happen, that it's going to be hectic maybe, that he may run out of certain things that he is selling, etc).

Here is some info from Dr. Gutstein's new dynamic intelligence curriculum that equates to where D is at this point:

- Constructs realistic expectations for mistakes.

- Does not routinely predict perfect performance and is not surprised or upset when he makes mistakes.

- Understands that there is no reason to get upset when you make a mistake, because everyone makes mistakes. Communicates about mistakes as a normal part of life

- Willing and able to co-participate with Guides to productively evaluate mistakes and learn from them

(by Dr. Steve Gutstein, rdiconnect.com)

Work Product: Please show me 1-2 clips of film footage where you and D are discussing (you can make a list if you want) about how the sale will be great especially because you prepared and planned so well and that D took on so much responsibility and made great decisions. In addition to all the positives, show me how you guide D through a discussion about potential things that could go wrong such as if he makes a mistake, or if things get too hectic, too confusing, etc.

Here are things you could/should cover as you discuss the upcoming sale:

Does D expect the sale to go exactly as you and he have practiced and planned? If not (you may have to lead him to the fact that it will be different), how does he predict it will be different? Try to list (just discuss or make a list) some possible differences that D anticipates (with your help).

Does D think it will be busy at the table and crowded? If so, does he think it will be crowded and busy the whole time? If he thinks it's going to be super busy, how will he (just one boy) handle it? Does he have a back-up plan to ask someone for help?

What if someone (D, you, etc.) makes a mistake? Will it be a big deal or not? Will he be surprised if someone makes a mistake? If not, why not (because we all make mistakes!)
What if he runs out of certain things that people want to buy? What will he do? These are all good questions to explore with him (you are free to dig around these questions with him as much or as little as you want – you do not have to ask all these or pose all these situations to him at once).

Keep in Mind: this can be a fluid conversation with D just sitting together or you can make it like a worksheet where you and he are thinking and answering questions together. You could each do your own sheet and give your own answers privately (not collaborating) and then compare your answers.

Due Date: next Wed

Let me know if you have any questions,

Libby

For a child to have got to this stage, two things have happened. The parent has become a competent guide – so she is using pausing, pacing, scaffolding, limit-setting, spotlighting, framing, modeling, declarative language and non-verbal communication to enable the child to reference for information and emotion-sharing, to initiate and respond to joint attention, to co-regulate and self-regulate and to increasingly productively manage uncertainty.

The child has mastered developmental foundations that will include: taking increasing responsibility for co-regulation, initiating and responding to joint attention, not automatically withdrawing from uncertainty, being motivated as an active apprentice, communicating for experience-sharing purposes, comparing reactions to the guide’s reactions, anticipating partner’s reactions (and many more).

So hopefully you can see why it’s not a good idea to jump into working on this objective without first making sure that the underpinning developmental competencies are in place. It would be setting the child up to fail – like expecting them to do calculus without first having learned to add up.For me this is the beauty of RDI and of working with a trained Consultant. 


It’s all about enabling your child to be competent and to have experiences of success, making sure (via the Consultant’s supervision and support) that everything that needs to be in place for that to happen is in place. So the Consultant ensures that parents are competent as guides and that the underpinning developmental foundations are in place for the child and then empowers parents to be as creative as they like in using RDI as an integral part of their everyday lives to promote their child’s dynamic intelligence. 

Questions and comments welcome!





Sunday 3 June 2012

'Best interest' decisions and people with autism/LD - getting the family's voice heard

A facebook friend recently asked for help regarding issues relating to her daughter's mental capacity.  I was able to refer her on for guyidance from Irwin Mitchell Solicitors.  As a result of this exchange, I discovered this new resource and thought I would share it with you:

Ambitious about Autism, Mencap and the Challenging Behaviour Foundation, in partnership with Irwin Mitchell Solicitors, have developed a new resource for parents who feel that they are not being appropriately consulted about the welfare of their loved ones to ensure families are involved in best interest decisions.
The new tool was produced after concerns were raised that many professionals are failing to appropriately consult with families, as required under the Mental Capacity Act 2005. In its latest report into deaths of people with a learning disability in NHS care, Mencap found that many health professionals are failing to abide by the Act and ignoring crucial advice from families.

The leaflet which can be downloaded here, contains two template letters which are intended to help family members who have not been involved, or are concerned that they will not be involved, in the best interests decision-making process. The letters have been written by Alex Rook from Irwin Mitchell’s Public Law Department, who specialises in cases involving the Mental Capacity Act.
Alex says: "If an individual lacks the mental capacity to make a decision for themselves that decision must then be made in their best interests in accordance with the requirements of the Mental Capacity Act 2005.
"The Act requires all professionals, including those from local authorities and the NHS, to consult with family members when an adult lacks the mental capacity to make the relevant decisions themselves. The law on this is clear. We want families to know their rights."
Template letter 1 is intended to be used when family members are concerned that they may not, in the future, be involved in best interests decisions in relation to their loved ones. It clearly sets out the legal requirement to involve them.
Template letter 2 is intended to be used when decisions have already been taken without family members’ involvement. All the text in square brackets should be replaced with individual details.

It should however be noted that this leaflet and the template letters are a general guide and do not replace the need for legal advice on a specific case.

David Congdon, Head of Campaigns and Policy at Mencap says
: “We know from our campaigning work how serious the consequences can be when families of people with severe learning disabilities are not listened to. They often have invaluable knowledge about their son or daughter, for example, they understand the subtle ways in which they communicate or express that they are in pain.

“It is crucial that professionals listen to family carers and use their knowledge to inform decisions being made. This applies to all decisions – those about medical treatment and social care as well as any other decision which affects the person’s life. This is not just good practice it is the law. It is important families understand this and feel able to challenge when they are not being involved.”

You can download a copy of the leaflet here.

Saturday 2 June 2012

Reflex stimulation and inhibition, sensory integration and RDI - what goes where?

Here is the response from Claire to the questions raised recently by Debbie and Nick. I've taken Claire's response out of the comments section and added it here so that it can form part of our ongoing discussions.

Gosh – not sure where to start! Think your questions pretty much embrace motor, sensory, cognitive, social and emotional development. And, of course, they are all intimately interwoven so it is always hard to unravel them to try and make sense of them developmentally. Will try and explain the bits I understand from my perspective as someone who has trained to provide a reflex stimulation and inhibition progamme (INPP) and also as the mum of a son who is autistic who had a sensory integration programme when he was younger. Others please chip in.

As you say if you were to put SIT, a reflex programme and RDI in developmental order – you would start with reflexes then sensory therapy then RDI. Of course this is overly simplistic. Failure of primitive reflexes to be stimulated and inhibitied and postural reflexes to be established will result in sensory integration problems (as well as other stuff, like emotional problems, postural problems, behavioural difficulties, gross and fine motor issues etc). Though sensory integration problems may be caused by issues other than reflexes, eg damage to developing brain.

What I was taught at INPP was that if you use sensory integration therapies (which complement reflex programmes) before addressing problems with early primitive reflexes – moro, ATNR, TLR particularly – the child doesn’t hold on to gains made during sensory integration therapy. This was certainly my experience with my son and left me wondering what comes before sensory development as it was clear we were working in the right area for him. I think if a person has problems only with the emergence of postural reflexes (which are developmentally later) sensory integration programmes have been successful and gains do hold.

And it is actually movement that proceeds sensory development. Movement that initially occurs automatically through reflexes. If a child can’t use movement to explore its world (going right back in utero as the fetus explores its body within the womb) it can’t create an physical image of either its own body, the world it can reach out and touch, and later the world it can see beyond the reach of its hand. An early crude experiment with 2 new born kittens illustrate this point. The kittens were kept together but only 1 was allowed to move its legs, the other was not. The second kitten did not develop vision. Deprived of its ability to touch the world it was impossible for its brain to make sense of the images of light that its intact retinas passed to its brain.

RDI addresses issues further on developmentally (though you can actually see the problems from the moment a baby is born sometimes). Clearly if an infant is unable to build up an image of its own physical self (eg where my body ends and the rest of the world starts/ my hand is attached to my arm etc) he/she is not going to be able to co-regulate with an adult as he/she will not have fully grasped the concept of them being 2 separate physical entities.

Thanks to Claire and everyone who has been participating in this discussion.  I've learned loads from it and hopefully it'll also have helped others :)