Evidence Based Practice for Relationship Development Intervention (RDI™)

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

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

 Gutstein, Burgess, & Montfort (2007) report on the 3-year follow-up of 16 children who met 'gold standard' criteria (ADOS/ADIR) for autism, Asperger’s syndrome or autism spectrum disorder prior to treatment with RDI.  Marked clinical improvements after RDI were reported; for example, whereas prior to treatment 10 had ADOS scores corresponding with the diagnosis of autism, none did so at follow-up, at which point five were classified as ‘autism spectrum’ and five as ‘non-autism’. There were especially marked improvements in the children’s capacity to share experiences with others.  Semi-structured interviews with parents revealed that the children’s flexibility had significantly improved. Moreover, there had been positive changes in the children’s educational placements.  In this study there was not a treatment-as-usual control group (a previous pilot study had included such a control group who did not show the gains of the RDI-treated group). Having said this, the magnitude and breadth of this response to RDI renders it very unlikely that the effects were non-specific.  

• 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.

 Aldred, Green, & Adams (2004) report a randomized control trial of an intervention for autism that has close affinity with RDI in its attempt to foster developmentally effective parental input through a focus upon the children’s social deficits. The approach ‘educated parents and trained them in adapted communication tailored to their child’s individual competencies’.  
The study reported significantly greater improvements in the treated vs. untreated group of children with autism, on a range of outcome measures:  total scores on the Autism Diagnostic Observation Schedule, expressive language, parent-child interaction, and the children’s initiation of communication.  The authors concluded:
'this study suggests that a specific intervention that addresses bi-directional adult/child communication breakdown, joint attention, and is tailored to the specific needs of the cases can improve autistic symptoms across severity and age groups in terms of quality reciprocal communication and expressive language'.

Like RDI, this treatment approach provided specialized structured interventions that scaffold social interaction.  The uniqueness of RDI lies in its sharper focus on links between social relatedness and the capacity to engage in flexible thinking and coping through the guided-participation relationship.

• 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,


• 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.

 In a series of recent (and ongoing) studies, J. A. Hobson and colleagues (Hobson et al., 2008; Hobson & Hobson, 2008; Hobson, 2009; Hobson et al., 2009; Hobson & Gutstein, 2010), have followed children/adolescents with autism and their families (participating in RDI programs) over time. On the basis of prospective study and retrospective chart review, preliminary results of the above studies (note: research is ongoing) suggest that this approach may yield significant changes in global clinical/psycho-social functioning as well as in improving qualities of parent-child interaction and social communication.


Aldred, C., Green, J., & Adams, C. (2004).  A new social communication intervention for children with autism: pilot randomized controlled treatment study suggesting effectiveness.  Journal of Child Psychology and Psychiatry, 45, 1420-1430.
Gutstein, S.E., Burgess, A.F., & Montfort, K. (2007).  Evaluation of the Relationship Development Intervention Program.  Autism, 11, 397-411.
Hobson, J. A., Hobson, R. P., Gutstein, S., Ballarani, A., & Bargiota, K.  (2008). Caregiver-child relatedness in autism: What changes with intervention? Presentation at 2nd International Conference: Communication – the Key to Success. Pontville School and Edge Hill University, May.
Hobson, J. A., Hobson, R. P., Gutstein, S., Ballarani, A., & Bargiota, K.  (2008). Caregiver-child relatedness in autism: What changes with intervention? Poster presented at the International Meeting for Autism Research, London, UK, May.
Hobson, R.P., & Hobson, J.A. (2008).  Interpersonal engagement: A focus for understanding and intervention in autism.  In symposium on The understanding and treatment of autism: A revolution in the making? Organized by R.P. Hobson, Annual Meeting of the Royal College of Psychiatrists, July.
Hobson, J. A. (2009). The guided participation relationship as a focus for change in children with autism and their parents. Presentation at the biennial meeting of the Society for Research in Child Development, Denver, CO USA, April.
Hobson, R.P., Hobson, J.A., Gutstein, S., (2009).  Parent-child interaction and global assessment of functioning:  measuring change and outcome in adolescents with autism. Presentation at International Meeting for Autism Research (IMFAR), Chicago, USA, May.
Hobson, J. A., & Gutstein, S. E. (2010) The Guided Participation Relationship as a vehicle for change in autism. Manuscript under review.
Hobson, R.P. (2002).  The Cradle of Thought. London: Macmillan.


Dr Jessica Hobson, PhD
Senior Research Fellow
Institute of Child Health, UCL and
Tavistock Clinic, London


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