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The Evidence Supporting RDI

RDI was created, and continues to evolve, based on the latest research into the causes and most effective treatments 

of Autism Spectrum Disorders.  Additionally, current research conducted on Relationship Development Intervention, itself, is revealing that RDI can produce comparable behavioral outcomes, but with longer-lasting, more meaningful results than other treatments.  Please find a compilation of research supporting the underpinnings and efficacy of RDI, created by my colleagues, below: 


Relationship Development Intervention (RDI™)

Evidence Based Practice for Remediating Symptoms of Autism Spectrum Disorder


Relationship Development Intervention (RDI™) is a cost-effective research-guided intervention approach

for remediating autism spectrum disorders. The program uses a parent-training model to help children

learn skills like joint attention, social referencing, theory of mind, social reciprocity, and communication

for experience sharing purposes. It is an evidence-based practice approach that makes use of a

combination of the best available research and clinical expertise in treatment decisions (TwachtmanCullen,

2009). The following are peer-reviewed published articles document evidence of its efficacy for

children with ASD.


• Gutstein, S. E., Burgess, A. F., & Montfort, K. (2007). Evaluation of the relationship

development intervention program. Autism, 11(5), 397-411.

• Gutstein, S. E. (2009). Empowering families through relationship development intervention: an

important part of the biopsychosocial management of autism spectrum disorders. Ann Clin

Psychiatry, 21(3), 174-182.

• Beurkens, N. M., Hobson, J. A., & Hobson, R. P. (2013). Autism severity and qualities of parent–

child relations. Journal Of Autism And Developmental Disorders, 43(1), 168-178.

• Larkin, F., Guerin, S., Hobson, J. A., & Gutstein, S. E. (2013). The Relationship Development

Assessment–Research Version: Preliminary validation of a clinical tool and coding schemes to

measure parent-child interaction in autism. Clinical Child Psychology And Psychiatry,

1359104513514065.

• Hobson, J. A., Tarver, L., Beurkens, N., & Hobson, R. P. (2015). The Relation between Severity

of Autism and Caregiver-Child Interaction: A Study in the Context of Relationship Development

Intervention. Journal Of Abnormal Child Psychology, 1-11.


A broader examination of the literature demonstrates a growing body of empirical research evidence and

best practice recommendations supporting the practices embedded in RDI™. Specifically, RDI™ is a

family-centered, intensive, objective driven, individualized intervention targeting the components of

social-emotional development in the context of the parent-child relationship. The articles listed below

document the peer-reviewed published evidence supporting the core components of RDI™ for treating

autism spectrum disorders.


SUPPORT FOR RDI™ – remediating the core deficits of autism in a developmental progression


Aldred C, Green J, and Adams C. (2004). A new social communication intervention for children with

autism: pilot randomized controlled treatment study suggesting effectiveness. Journal of Child

Psychology & Psychiatry, 45(8), 1420-1430.


Hobson, J. A., Hobson, P., Gutstein, S., Ballarani, A., Bargiota, K. (2008). Caregiver-child relatedness in

autism, what changes with intervention? Poster presented at the meeting of the International Meeting For

Autism Research (IMFAR), April 2008, London, UK.


Howlin, P. (2008). Can children with autism spectrum disorders be helped to acquire a “theory of mind”?

Revista de Logopediay Audiologia, Vol. 28(7), 74-89.


Jones E. A., Carr E. G., Feeley K. M. (2006). Multiple effects of joint attention intervention for children

with autism. Behavior Modification. Nov. 30(6):782-834.


Kasari C, Freeman S, Paparella T. (2006). Joint attention and symbolic play in young children with

autism: a randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47(6)

611-20.


Keen D, Rodger S, Doussin K, Braithwaite M. (2007) Pilot study of the effects of a social-pragmatic

intervention on the communication and symbolic play of children with autism. Autism, 11(1), 63-71.


Mahoney, G., and F. Perales (2005). Relationship-focused early intervention with children with pervasive

developmental disorders and other disabilities: a comparative study. Journal of Developmental &

Behavioral Pediatrics, 26(2), 77-85.


Schertz, H. H., Odom, S. L. (2007). Promoting joint attention in toddlers with autism: a parent-mediated

developmental model. Journal of Autism and Developmental Disorders. Sept., 37(8) pp. 1562-1575.


Siller, M. & Sigman, M. (2008). Modeling longitudinal change in the language abilities of children with

autism: parent behaviors and child characteristics as predictors of change. Developmental Psychology,

44(6), 1691-1704.


Solomon, R., Necheles, J., Ferch, C. & Bruckman, D. (2007). Pilot study of a parent training program for

young children with autism: The P.L.A.Y. Project Home Consultation program.  Autism, 11, no.3, 205-

224.


Tannock, R., Girolametto, L. & Siegal, L. (1992) Language intervention with children who have

developmental delays: Effects of an interactive approach. American Journal on Mental Retardation, 97,

145-160.


Whalen, C. and Schreibman, L. (2003). Joint attention training for children with autism using behavior

modification procedures. Journal of Child Psychology and Psychiatry, 44(3) 456-468.


SUPPORT FOR RDI™ – improving overall functioning (per special education placement, ADOS

diagnostic category, and other normed valid measures of ASD symptoms like flexibility and joint

attention)

Gutstein, S., (2005) Relationship Development Intervention: Developing a Treatment Program to Address

the Unique Social and Emotional Deficits in Autism Spectrum Disorder.  Autism Spectrum Quarterly,

Winter, 8-12.


Gutstein, S., Burgess, A. & Montfort, K. (2007). Evaluation of the Relationship Development

Intervention Program. Autism, 11, 397-411.


Hobson, J. A., Hobson, P., Gutstein, S., Ballarani, A., Bargiota, K. (2008) Caregiver-child relatedness in

autism, what changes with intervention? Poster presented at the meeting of the International Meeting for

Autism Research.


SUPPORT FOR RDI™ – training parents through ongoing consultation and using the parent-child

relationship as a natural context for child learning and growth


Aldred, C., Green, J., and Adams, C. (2004). A new social communication intervention for children with

autism: pilot randomized controlled treatment study suggesting effectiveness. Journal of Child

Psychology & Psychiatry, 45(8), 1420-30.


Beurkens, N.M., Hobson, J.A., Hobson, R.P. (2013). Autism severity and qualities of parent-child

relations. J Autism Dev Disord., 43(1), 168-78. doi: 10.1007/s10803-012-1562-4.


Casenhiser, D., Shanker, S.G., & Stieben, J. (2011). Learning Through Social Interactions in Children

with Autism: Preliminary Data from a Social-Communications-Based Intervention. Autism, 26, Sept: 1-

22.


Center on the Developing Child at Harvard University. (2015). Supportive Relationships and Active SkillBuilding

Strengthen the Foundations of Resilience: Working Paper

13. www.developingchild.harvard.edu.


Dawson, G., Rogers, S., et al. (2010). RCT of an Intervention for Toddlers with Autism: The Early Start

Denver Model. Pediatrics, 125(1).


Drew, A., G. Baird, S. Baron-Cohen, A. Cox, V. Slonim, S. Wheelwright, J. Swettenham, B. Berry, and

T. Charman. (2002). A pilot randomized control trial of parent training intervention for pre-school

children with autism. European Child & Adolescent Psychiatry, 11, 266-272.


Green, J., Charman, T., McConachie, H., et al. (2010). Parent-mediated communication-focused treatment

in children with autism (PACT): A randomized controlled trial. Lancet Online, May 21.


Greenspan, S.I., & Wieder, S. (1997). Developmental Patterns and Outcomes in Infants and Children with

Disorders in Relating and Communication: A Chart Review of 200 Cases of Children with Autistic

Spectrum Disorders. The Journal of Developmental and Learning Disorders, 1(1), 87-141.


Gutstein, S. (2004). The effectiveness of Relationship Development Intervention in remediating core

deficits of autism-spectrum children, Journal of Developmental and Behavioral Pediatrics, 25(5), 375.


Gutstein, S. E., Burgess, A. F., & Montfort, K. (2007). Evaluation of the relationship development

intervention program, Autism, 11(5), 397-411.


Ingersoll, B., Dvortcsak, A., Whalen, C. & Sikora, D. (2005). The Effects of a Developmental, SocialPragmatic

Language Intervention on Rate of Expressive Language Production in Young Children With

Autistic Spectrum Disorders, Focus of Autism and Other Developmental Disorders, 20(4), 213-222.


Jones E. A., Carr E. G., Feeley K. M. (2006). Multiple effects of joint attention intervention for children

with autism. Behavior Modification. Nov. 30(6):782-834.


Kasari, C., Gulsrud, A.C., Wong, C., Kwon, S. & Locke, J. (2010). Randomized controlled caregiver

mediated joint engagement intervention for toddlers with autism, Journal of Autism and Developmental

Disorders, 40(9): 1045–1056.


Kasari, C., Paparella, T., Freeman, S., & Jahromi, L.B. (2008). Language outcome in autism: randomized

comparison of joint attention and play interventions, Journal of Consulting and Clinical Psychology,

76(1), 125-137.


Landa, R.J., Holman, K.C., O’Neill, A.H., & Stuart, E.A. (2011). Intervention targeting development of

socially synchronous engagement in toddlers with autism spectrum disorder: A randomized controlled

trial, Journal of Child Psychology and Psychiatry, 52(1), 13-21.


Krebs Seida, J., Ospina, M., Karkhaneh, M., Hartling, L., Smith, V. & Clark, B. (2009). Systemic reviews

of psychosocial interventions for autism: An umbrella review, Developmental Medicine & Child

Neurology, 51, 95-104.


Mahoney, G. & Perales, F. (2003). Using relationship-focused intervention to enhance the social

emotional functioning of young children with autism spectrum disorders. Topics in Early Childhood

Special Education, 23(2), 74–86.


Mahoney, G., & Perales, F. (2005). Relationship-focused early intervention with children with pervasive

developmental disorders and other disabilities: a comparative study, Journal of Developmental &

Behavioral Pediatrics, 26(2), 77-85.


McConachie H., Diggle T. (2007), Parent implemented early intervention for young children with autism

spectrum disorder: a systematic review. Journal of Evaluation in Clinical Practice. Feb, 13(1), 120-9.


McConachie, H., Randle, V., Hammal, D., & Le Couteur, A. (2005). A controlled trial of a training

course for parents of children with suspected autism spectrum disorder. Journal of Pediatrics, 147(3),

335-340.


Ospina, M., Krebs Seida, J., Clark, B., Karkhaneh, M., Hartling, L., Tjosvold, L., Vandermeer, B. &

Smith, V. (2008). Behavioural and Developmental Interventions for Autism Spectrum Disorder: A

Clinical Systematic Review, PLoS ONE, 3(11), e3755. doi:10.1371/journal.pone.0003755.


Pajareya, K. & Nopmaneejumruslers, K. (2011). A pilot RCT of DIR/Floortime parent training

intervention for pre-school children with ASD, Autism, 15(2), 1-15.


Prizant, B.M. & Wetherby, A.M. (1998). Understanding the continuum of “discrete-trial traditional

behavioral” to “social-pragmatic developmental” approaches to communication enhancement for young

children with autism/PDD, Seminars in Speech and Language, 19, 329–353.


Reichow, B., Volkmar, & Cicchetti, (2008). Development of the Evaluative Method for Evaluating and

Determining Evidence-Based Practices in Autism, J. Autism Dev. Disord., 38, 1311.


Schertz, H. H., Odom, S. L. (2007). Promoting joint attention in toddlers with autism: a parent-mediated

developmental model. Journal of Autism and Developmental Disorders. Sept. 37(8) pp. 1562-1575.


Siller, M. & Sigman M. (2002). The behaviors of parents of children with autism predict the subsequent

development of their children’s communication. Journal of Autism and Developmental Disorders, 32(2),

77-89.


Solomon, R., Necheles, J., Ferch, C., & Bruckman, D. (2007). Pilot study of a parent training program for

young children with autism: The P.L.A.Y. Project Home Consultation program, Autism, 11(3), 205-224.


SUPPORT FOR RDI™ – incorporating intervention into daily routines while accounting for

caregiver needs and child functioning


Aldred, C., Green, J., and Adams, C. (2004). A new social communication intervention for children with

autism: pilot randomized controlled treatment study suggesting effectiveness. Journal of Child

Psychology & Psychiatry 45(8), 1420-1430.


Prizant, B. (2008). Treatment Options and Parent Choice: An Individualized Approach to Intervention,

Autism Spectrum Quarterly, Winter, 34-37.


Prizant, B. (2009). Creating a culture of family-centered practice for the autism community, Autism

Spectrum Quarterly, Summer, 30-33.


Deborah Berrang, Amy Leventhal, Melissa Rascovitch, Blair Armstrong, and Sarah Wayland contributed

to this list.