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The DIR®/Floortime model originated in the 1980s from the work of Dr. Stanley Greenspan and Serena Wieder, Ph.D. From their early studies of high risk children and families, they created a systematic developmental intervention approach which integrates psychodynamic and cognitive learning principles. DIR® is a comprehensive framework, and Floortime play-based intervention, is a major component of this approach. Over the past 30+ years, research has validated the critical role of developmental principles in treatment, including the importance of affective experience, parent-child relationships, and understanding and responding to the individual differences of each child. While discrete behavioral methods, based on learning theory, continue to be used, there is increasing recognition of the importance of affective relationship-based intervention strategies for the treatment of autism, and other developmental and emotional challenges. The DIR®/Floortime approach places a priority on all interactions being within a systematic comprehensive developmental framework. This approach addresses the core areas of challenge in autism: social engagement, social communication, and broadening interests. Recent research specific to this approach includes a current research study by Casenhiser, Stieben and Shanker1 at York University, which documents its effectiveness. DIR®/Floortime is now used around the world for children and adults with autism and other developmental challenges.
1 Casenhiser, D (2011) Learning through interaction in children with autism: Preliminary data from a social-communication-based intervention Autism Sept 2011
DIR®/Floortime is based on the idea that emotional experience leads the way in development, and by mastering functional emotional developmental milestones, a child develops the capacity to be a warm, caring individual, who is flexible and adaptable and a creative problem solver.
The goals of DIR®/Floortime intervention correspond to the 6 sequential developmental milestones (The “D” of DIR®). These broad goals are:
Over the course of intervention, and depending on the level of challenges for the individual, some individuals begin working on higher level capacities (while continuing to strengthen the initial capacities), including these three additional goal areas related to reflective thinking:
The “I” of DIR® stands for Individualized: this means that in the DIR®/Floortime approach, the activities and the strategies are individualized for each child. It is important to recognize each child's particular interests, as well as sensory responses, motor skills, gestural and verbal communication skills, visual-spatial abilities, and cognitive and executive functioning skills so that a treatment is tailored to that child. This often calls for comprehensive interventions including speech and language therapy, occupational therapy, physical therapy, visual-spatial cognitive therapies, and other semi-structured activities.
The “R” of DIR® stands for Relationships: In the DIR® Floortime approach, all activities involve interactions between people. Interactions may be between parents, caregivers, teachers, therapists and child, or child and peers. Learning takes place through these affective interactions and the relationships that are formed. Therapists and special educators do actively engage the person and develop relationships; however their primary aim is to support and enhance the child’s relationships with family, friends, teachers, and others in the child's natural environment.
The term ‘Floortime’ refers literally to being on the floor to play with a child, and also represents the idea of joining another person, in any circumstance, through emotional attunement to their experience, and engaging in a back and forth flow of interaction that supports that person's capacities to relate, communicate, problem solve, and learn. DIR®/Floortime utilizes Floortime play as well as semi-structured activities, and specific therapies to promote specific developmental goals. The basic principles of Floortime are to:
The unique features of the DIR®/Floortime approach are:
The DIR® Floortime approach is a positive approach that credits every individual with the internal motivation to share warm relationships and to learn, and which does not place any limits on the capacities of an individual to achieve higher functional emotional developmental milestones.
Evidence-Based research on DIR®/ Floortime:
Other Developmental Approach Research: