Ricki Robinson, MD, M.PH

Clinical Professor of Pediatrics, USC and author of Autism Solutions

Well, in my developmental approach, I’ve adopted the DIR Floortime method for working with the kids and helping empower and...In this method, we empower parents, other family members, therapists to really work with the child based on their understanding of how the child learns from the world. And then trying to woo the child to work together with us so we can help move him up the developmental ladder. And it’s been...it’s a very powerful methodology. But Floortime is a technique that we use where we’re on the floor paying, but it’s also a philosophy, which is how we approach the kids 24/7. And how we interact with them no matter where we are, whether we’re in the car, going to school, we’re in the bathtub, it's mealtime, or it's homework time. So it's an engagement that we have with the children where we are helping them become internally motivated so that they want to go out there and interact and do certain things. So you can imagine when an approach is so broad-based, that it’s a little bit harder to study than a program that has a very specific curriculum where you can tease apart different elements of that program. So this is why it’s been so difficult to get broad-based comparisons of, say, Floortime to something like a more behavioral approach. Having said that, we are now at a phase where we do have lots of research that has been able to tease apart elements of the DIR methodology. So, for example, Connie Kasari out of UCLA has done fabulous clinical trials where she has looked at the elements of joint attention and symbolic play, which are crucial to a developmental approach. And what happens when you have programs specifically designed to support joint attention and symbolic play is that when you compare it to a group that doesn’t have this program, you have much more language at the end gate. And so she has really brought to the forefront the need for these elements in a program. (03:11:21:12) And, fortunately, we now are getting the first randomized control trials using Floortime. And what we are finding, one is out of York, another out of England, is that indeed what we say is happening is happening, and that we’re able to improve social communication. According to our theory, and our theory is very well founded — it comes out of Piaget and Erickson and Barry Brazelton, and all of the studies that come before this about how social emotional development occurs in children — that with these newer studies that we’ll be able to see that the actual technique that we use actually supports what we say. And, in this theory, what we know is that when children develop these social abilities that language comes and thinking comes and creativity comes. And this is just so crucial to being a whole human. And so it has to be included as part of any child’s program. In my world, it’s the foundational part. We never leave from it, but we’re continually adding to it what else is necessary.