Tuesday, December 14, 2010

Aggression in Autism - Solutions through the Guided Participation Relationship

Do you have a child with autism who displays aggression? Are you bruised, stressed and feeling hopeless, after being subjected to years of being the target of your child’s frustration? Do you desperately want to help your child learn to manage his anger so that, when he grows to be a teen or an adult, he can handle his frustration in socially acceptable ways, and you can feel comfortable about your safety and the safety of others?

I remember well my own experience with my son, diagnosed with autistic disorder at age 2, with confirming diagnoses at ages 3 and 4. I had to cut my hair short to curb his tendency to pull my hair. I was pinched, bitten, and head-butted regularly. We had holes in our sheetrock walls from his head banging. He knocked out part of his two front baby teeth banging his face on the tile floor.

I tried to predict what would set him off, and make adjustments accordingly; but this proved impossible. The littlest things would set off a tantrum, aggression and self-injury.

When Matt was five, we found a solution to the aggression and his other core issues: the RDI® program. It was not a quick fix, but over time, we saw results. So I thought I would explain here the basics of the program and how it can improve a person’s ability to regulate emotion and manage anger.

The RDI® program is not what some people think it is. It is not a program that teaches “social skills.” It is not a program that teaches rote cooperation in meaningless tasks. Neither is it meant to place the entire task of “recovering” the child on the parents, a burden that, quite understandably, is overwhelming to many parents.

The core purpose of the RDI® program is to develop what we call the “Guided Participation Relationship” (GPR) between parents and child. If there is one concept that underpins the GPR, it is “trust.” If a child trusts you, the parent, the child will use you as a reference point in resolving any situation he comes upon in life, in which he experiences uncertainty. The child will not only look to you for help to get his needs met (opening a jar, getting a snack, etc.) but will also be interested in your mental perspective in a situation, and use that perspective to shape his OWN mental perspective.

Think of how typical children look to their parents to assess the safety of a new situation, such as being approached by a large dog or a stranger. Based on the parent’s feedback to them (through face, voice and actions) the child experiences the new situation as safe or threatening. The child’s mind is being shaped by what is in his PARENT’S mind. Typical children who have a strong GPR with their parents will also seek out their parents for sharing purposes. Children do this for one central purpose: They are interested in integrating their parent’s mental perspective with their own. They are motivated to improve their mind, to expand their knowledge of the world, by “borrowing” the perspectives of their parents and, later, other adults and peers.

ASD persons usually have difficulty with using others as reference points to resolve uncertainty. Why? Because of a predisposition toward favoring “things” over social feedback, ASD infants do not develop the normal nonverbal back-and-forth social interplay that characterizes typical parent-infant communication. It is this early fluid social “dance” between typically developing children and parents that sets the groundwork for the child’s establishment of the parent as the central reference point for both social reinforcement and for resolving uncertainty. Through continual feedback from the typical child, the parent becomes adept at presenting the child with the amount of challenge that is "just right" for the child in most situations. Parents adjust the level of challenge they present to the child in many ways - such as how the parent communicates with the child (pace, amount of language, type of language, prosody, body position, etc.), in what types of tasks to present to the child, and in how much assistance to give to the child in any task or exchange.

Through the early emotion-based communication exchanges between parents and very young children, the social milestones of social referencing, joint attention, and emotional attunement develop. The child learns how to use the parent as a guide to shape his emotional responses to stimuli – both the types of response and the magnitude of the response. The child also learns to use the parent as a guide to control his emotional responses. He learns how to mitigate outbursts, control his temper, and use socially acceptable means of expressing anger. The process happens gradually, over a period of years. By about age 5, the typical child has a good amount of emotional self-control, thanks to the regulating influence of his parents, whom he learned to use early on to guide him in this process.

In situations of autism, in which the child is not predisposed toward favoring social feedback, such as facial communication, the child is not as readily available emotionally to receive parent's social bids. The child does not provide parents with a reliable feedback mechanism to promote continued social exchanges. The ASD child, instead, will often avoid social exchanges, even with parents. His failure to develop this fluid reciprocal social-emotional feedback loop with parents has profound and debiliating effects on his future social and emotional competence. His long-term quality of life is dramatically compromised through the failure of the development of this early parent-child identification relationship. Parents are left unsure of how to communicate and interact with their child in ways that will build his trust in interacting with and learning from others. Often there is a sense of failure and hopelessness.

Autism involves challenges in communication as well as with emotional regulation. The communication challenges are especially pronounced with nonverbal or preverbal children. However, even children with significant communication challenges can improve their emotional regulation and reduce aggressive tendencies through the RDI® program and similar programs that target building the trusting and guiding relationship between parents and child. In the RDI® program, parents are systematically trained in how to interact and communicate with their child, even if their child is nonverbal, in ways that build the GPR, reduce the child’s and parents’ general stress level, and improve the family’s overall quality of life. Often when parents change their own communication style with their child and change their expectations of how the child should respond, there is a positive affect on aggression and emotional regulation. In addition, the RDI® program contains developmental child objectives related to emotional regulation and self-control. The consultant assigns these objectives sequentially for the parents to work on in their lifestyle with their child. In the RDI® Program, parents are also guided in how to be better parents to all their children, ASD or typical.

Parents who have aggressive ASD children would do well to investigate the RDI® Program or a similar program focused on building trusting parent-child relationships. The cost of the program is low, compared with common intensive therapist-delivered programs; the empowerment and peace of mind parents could gain is priceless.

In my family, we have largely overcome the aggression issue. I am no longer my son’s whipping post. I have a child who has developed empathy, kindness, and an interest in what others are thinking. The progress has been gradual over a period of years, and things are not yet perfect, but people who meet my son are impressed with how courteous and well-regulated he is.

There are currently about 250 certified RDI® consultants worldwide who can help you get started in reclaiming your relationship with your ASD child. See www.rdiconnect.com for more information on the RDI® Program.


  1. Hi there Laura
    Can you post this to facebook so that I can share???

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