Case Study: Y
We first met Bimal in October 2007, when our son, Y, had just turned 5. By that time we had already been studying autism for more than one year. Due to limited information and resources as well as almost zero services for autistic kids in our country, all we knew about autism interventions was a little bit about ABA. During a 1-hour consultation with Bimal we heard about very important point – “quality of life”. Bimal explained to us what were the core deficits of autism. We could look deeper into the deficits rather than just seeing signs and symptoms. Bimal’s talk sounded very reasonable and we decided to attend the parents’ training on RDI®, which was going to be held in Singapore a few months later. The training contained a lot of new information and understanding, and it was a bit overwhelming. However we got more confident in our decision to follow RDI®. What we liked about RDI® first was that it was parent-based. We liked the idea not only because in our country there was no single teacher or therapist who knew autism, but also we wanted to develop our kid ourselves, not relying on others. The second thing we liked about RDI® was that we could contact our Consultant from a distance. And the most important thing was that RDI® was about changing ourselves, not the child. It was about changing our communication style and bringing RDI®into lifestyle.
Before RDI® Y had not been engaged in conversations, though he was verbal. We had to pull answers from his mouth, and his voice was monotone and high-pitched. Also, we were asking too many questions to make him talk. After introducing RDI® he got more and more involved in back and forth conversations, and those talks started to be more natural, and his eye-contact increased much based on that.
He had been having problems with shifting between activities and changing environments. This situation improved fast as he became more aware of people around and surroundings, and was more interested in them.
Y’s attention and referencing improved a lot also. He got much more attentive to people’s reactions and actions as well learnt that he could find information from people’s faces, gestures and voices. He started to look into our faces and seek for our expressions.
Over time, Y became more cooperative and accepting of limits. When we started to do things together he started to understand that he should wait for his turn, he should listen to others, and he should follow the rules.
He was not anymore on his own, he always wanted to be with people and he started to share his thoughts, feelings, interests and many other things.
We are still struggling with regulating his rigid thinking and other issues. But we were lucky to have had Bimal as our Consultant for 10 years, guiding us through to a better future for our son.
Y’s ability to accept limits set by his parents was noticed to be inconsistent, and even when boundaries were implemented, he was seen to not adhere to some of his parents’ attempts at limit setting. Y’s interaction with his parents was specifically based on his own terms and agenda, and if allowed, he was very self-directed in that he dictated the interaction. His ability to manage and shift attention was noted to be emerging but Y did not use it specifically for feedback or to seek information from his parents. He was seen to not initiate any activities with his parents. Y’s communication was noted to be primarily instrumental and questioning in the way he interacted with his parents. While there were the occasional statements that were experience sharing, this was rare and his verbal communication was observed to be mostly factual and statement based. Very little emotion sharing was seen with his parents and in his interaction with his parents, he was also seen to not use any of the alternative modes of communication (e.g. gestures, pointing, head shakes, head nod etc).
Initial Goals for Y
Forming the Master-Apprentice Relationship
The initial plan for Y was to establish the apprenticeship with his parents. This was especially important seeing how it is that they were pursuing the RDI® program from a distance and it was critical that the parents see that they can support Y’s growth through the online sessions which were conducted on a fortnightly basis.
Lifestyle activities were planned for the family which involved the key RDI® principles of slowing down, keeping the zone of connection close while the parents worked on Y’s non-verbal skills; his ability to reference his parents; and appraise their social communication bandwidth. Together with parental input about their life in the country they lived, certain tasks were planned which was very specific to their way of life and this became the basis of their activities. This involved going for long walks with the parents, chores that needed to be done around the house and very specific activities that were planned when the family was away on holiday during the summer vacation.
In addition, a flexibility program was implemented with Y which required the family to introduce targeted changes in the environment where moments of uncertainty were introduced requiring Y to be able to navigate these uncertain variations to his normal day to day functioning. The family was guided on changing their communication style which is reflective of RDI® principles where they were less manipulative in their verbal communication (eg. directive, prompts, questions and instructions) and the parents were required to take on a more experience sharing mode of communication with Y (eg. sharing of thoughts, ideas and perspectives).
Y has matured into a fine young adult. He has represented the Autism Association of his country in numerous events/functions and is an accomplished pianist. His family’s journey has inspired many other families in his country who see Y as proof that a certain quality of life can be achieved through the RDI® programme under Bimal’s guidance.