Tuesday, June 5, 2012

Overview of Greenspan's DIR/Floortime Model

There are many treatment methods available to support learning, appropriate behaviors, social and emotional growth, and relationships with children on the autistic spectrum. Many of these techniques are behaviorally based, which can provide some structure and containment for children. However, to fully develop a child's long-term capacity to interact in the world, relate to others, problem solve, tolerate frustrations, and enjoy engaging, relationally based approaches to treatment are the way to go.

In the 1980s, Stanley Greenspan developed a model for working with children with deficits in relating and communicating. This model became known as the "Developmental Individual Difference Relationship Model" or DIR. "Floortime" is a specific therapeutic technique within this model. All children learn via relationships; relationships are necessary in order for learning to occur. Floortime is built on this premise and informed by research, theory, and practice from a variety of disciplines, including infant mental health, psychoanalysis, developmental psychology, neurobiology, etc.

Floortime therapy is commonly associated with children with autistic spectrum disorders but it is also useful for connecting with and expanding the learning and emotional growth of children with social and behavioral problems, in general.

Below is an overview of the basic goals, steps, and strategies of floortime training.

Goals of Floortime

To help the child --
  1. Become more alert
  2. Take more initiative
  3. Become more flexible
  4. Tolerate frustration
  5. Sequence longer actions - plan and execute them
  6. Mediate process of finding solutions
  7. Communicate verbally and with gestures
  8. Take pleasure in learning
Step in Floortime
  1. Observe the child's actions
  2. Open circles of communication by building on whatever the child's current interest is in the moment (e.g., playing with a toy, flapping, turning switches on and off)
  3. Follow the child's lead (e.g., copy the child's behavior)
  4. Extend and expand the child's play by encouraging the child to build on the play narrative (e.g., do something that builds on the child's behavior, ask questions)
  5. Close circles of communication - circles are closed when the child builds upon a comment or makes a gesture of his/her own that expands the play and lead to the beginning of another circle
Intervention Strategies
  1. Follow child's lead and join him/her - it does not matter what they do as long as they initiate the move
  2. Be persistent
  3. Treat what the child does as intentional and purposeful - give new meanings to the actions
  4. Help child do what he/she wants to do
  5. Position self in front of the child; the parent should be the "toy" (what the child is focused on)
  6. Invest in whatever the child initiates or imitates
  7. Join perseverative play
  8. Do not treat avoidance or "no"as rejection
  9. Be patient and wait for the child to initiate then expand on that idea
  10. Be dramatic in voice tone and gestures to demonstrate understanding and model affect
  11. Expand, expand, expand - keep going, play dumb - but not too dumb, do wrong moves, do as told, interfere, etc.
  12. Do not interrupt or change the subject as long as it is interactive
  13. Insist on a response
  14. Do not turn the session into a structured teaching experience
All human learning begins within the context of a relationship. Floortime is designed to use these relationships to help children with autistic like behaviors develop the skills to regulate emotions, tolerate upset, connect and interact with others, communicate, reason, think logically, and solve problems. Using the relationship to start where the child is and join him/her in the action then expand on themes is key to helping a child with autistic like behaviors grow and develop to his/her full potential.

Adapted from article entitled, "The Greenspan Floortime Model." www.cms-kids.com

DIR/Floortime resources:
The Greenspan Floortime Approach
Interdisciplinary Counsel on Developmental and Learning Disorders/Floortime.org 
Floortime videos:
Dr. Stanley Greenspan Founder of Floortime Speaks
The Greenspan Foortime Approach 
Floortime services in Chicagoland:
Beth Osten and Associates
Cawn-Krantz and Associates