DIR Floortime Model

Great video and guide to DIR Floortime, one of the only autism therapies focused on helping a child progress through the six basic developmental milestones.

caregiver engaged in DIR Floortime technique

DIR, which stands for Developmental, Individual difference, Relationship based Model, is a guide for parents and educators to create appropriate interventions for children on the spectrum centered on their current developmental level.

Floortime therapy is a specific technique used involving activities based on the DIR Model. This treatment method may also include therapies such as speech therapy, occupational therapy and problem solving exercises. It is intended to focus more on social, emotional and intellectual capacities rather than a specific skill or behavior. Originally started by Dr Stanley Greenspan during the 1980’s, each part helps to build on the child’s existing strengths.

Developmental: By understanding where a child is developmentally, the clinician is able to better plan an appropriate treatment program for the child. The six steps on the developmental ladder Greenspan describes include:

  1. Self regulation and interest in the world
  2. Intimacy or a special love for the world of human relations
  3. Two-way communication
  4. Complex Communication
  5. Emotional ideas
  6. Emotional thinking

Individual Differences

All children on the spectrum tend to interpret and perceive sensory information in their own unique way. Many children have difficulties with sensory processing resulting in over-reactivity or under-reactivity to sensory stimuli, such as sound and touch. They may have problems with motor planning and sequencing. By learning what those individual differences are, a therapist can better learn how to implement a treatment plan to be more effective within the DIR Floortime Model.

Relationship Based

This refers to the relationships a child has within his/her environment including parents, teachers, peers, and caregivers who modify their interactions to be based on the child’s current developmental level and individual differences.

The primary goal of DIR is to help the child achieve emotional milestones that were previously not obtained during early development and that are crucial to learning. Through Floortime, a treatment component of the DIR Floortime model individuals in the child's life work to help the children accomplish each milestone on the developmental ladder.

Despite not being as well known or utilized as Applied Behavior Analysis (ABA), I think it would be great to incorporate the strengths of the two interventions as a way to help a child progress developmentally. This would involve doing activities based on the child’s social, emotional, and intellectual capacities as determined by the DIR Model, while still using the benefits of repetition and reinforcement that ABA provides.

The following is a video illustrating this method of treatment:

Although the video is long, I found it to not only illustrate a DIR Floortime session, but it actually shows the relevant child at 7 months old, 18 months old, 2 years old, and 3 years old. During these scenes you can clearly see his signs of autism. Then the video shows him after six months of Floortime therapy. Honestly, the difference is very profound and inspiring.

There have also been some articles to demonstrate how successful this approach can be for children.

  1. Learning Through Interaction in Children With Autism: Preliminary Data From a Social-Communication-Based Intervention

  2. A pilot randomized controlled trial of DIR Floortime parent training intervention for preschool children with autistic spectrum disorders

For more information about Floortime go to www.icdl.com or checkout the following:

Return to Autism Treatments page

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1. What’s DIR/Floortime?. The Interdisciplinary Counsel on Developmental and Learning Disabilities. http://www.icdl.com/dirFloortime/overview/index.shtml. 10-6-11.
2. History of Floortime http://www.icdl.com/dirFloortime/overview/index.shtml. 10-6-11.
3. Treatments for Autism. Autism Speaks. www.autismspeaks.org. 11-22-09.

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