Relationship Development InterventionJanuary 25, 2013
This week's "Got Questions?" answer comes from Lauren Elder, PhD, former Autism Speaks assistant director of dissemination science.
When my granddaughter was diagnosed with autism at age 5, she ignored other people. After Relationship Development Intervention (RDI), she’s a different person – seeking interaction and initiating conversation. Why don’t we hear more about this intervention?
RDI is one of several behavioral interventions for autism that we describe in our website’s treatment section. It focuses on treating autism’s core symptoms – with a special emphasis on developing social relationships.
Many parents, grandparents and other caregivers have described how RDI has helped their children. However, this intervention remains little studied. In other words, it hasn’t undergone the kind of rigorous testing needed to clearly determine its effectiveness and identify which individuals are most likely to benefit from it.
I think that this lack of scientific support is the reason why you don’t hear more about RDI. Health and science journalists, for example, typically report on autism treatments when studies about them appear in leading scientific journals.
Certainly, isolated stories of success are compelling. But it takes high-quality research to determine whether an intervention is broadly effective. The most dependable findings come out of studies conducted in ways that minimize bias. If a researcher is already convinced that a particular intervention is effective, he or she may tend to unconsciously inflate its benefits. So how do we control for bias in studies?
For starters, it’s important to have a control group. The participants in this group receive a comparison treatment. They should be similar in age, behavior and other aspects to the “active treatment” group. This group receives the treatment being studied.
Avoiding bias (intentional or not) also requires study “blinding.” This means that the experts evaluating each participant’s progress don’t know who was in which group (active treatment or control).
This type of “gold standard” research hasn’t yet been done with RDI. However, we do see preliminary positive results from a few small “pilot” studies. We need studies that enroll more individuals – and a wider variety of individuals – to know more about who may benefit from RDI might and how it compares to other, better-studied treatments. These more thoroughly studied treatments include Discrete Trial Training, the Early Start Denver Model and Pivotal Response Training. RDI may be just as effective as some or all of these treatments. We simply don’t know yet.
Unfortunately, the scientific literature can’t always tell us what intervention will work best for a particular child, even if it produces great results with many other children on the autism spectrum.
Got more questions about autism treatments and research? Send them to GotQuestions@autismspeaks.org.