Megan Romanczyk, MS CCC-SLP
DIR is an evidence-based developmental, individual-differences, and relationships based model. This model was created by psychologist Dr. Stanley Greenspan, who theorized that strong, affectively-charged relationships are the avenue through which positive developmental growth takes place. In other words, DIR Floortime is based on the theory that growth takes place in the context of meaningful relationships in which the caregiver or therapist takes time to understand the strengths and individual differences of a child. This theory has since been supported by decades of research. It is now widely used across therapeutic and educational fields. It is important to note that, at the BAC, we combine the principles of DIR Floortime with our knowledge of neurodiversity affirming care. Our ultimate goal is to support growth in a manner that honors and celebrates diversity in thought, learning, processing, and interacting with the world.
The “D” in DIR represents the ‘Functional, Emotional, Developmental Capacities’ that individuals move through across their lives. There are 16 total levels. These include:
Regulation and Interest in the World (Emerges birth-3 months)
Engaging and Relating (Emerges 2-7 months)
Purposeful Two-Way Communication (Emerges 3-10 months)
Complex Communication and Shared Problem Solving (Emerges 9-18 months)
Using Symbols and Creating Emotional Ideas (Emerges 9-18 months)
Logical Thinking and Building Bridges Between Ideas (Emerges 3-4 ½ years)
Multiple Perspectives (Emerges 4-6 years)
Gray Area Thinking (Emerges 6-10 years)
Internal Standard of Self (Emerges around 9 years)
Every child moves at their own developmental pace. While some of these skills emerge early on in childhood, children may benefit from support to strengthen their capacities at each level.
The “I” in DIR represents the ‘Individual Differences’ that influence how a child perceives and interacts with the world. These include:
Auditory Processing/Receptive Language
Expressive Language
Praxis/Motor Planning
Vestibular Processing
Proprioceptive Processing
Visual Spatial Processing
Arousal Level
Olfactory, Gustatory, Visual, Auditory, and Tactile Processing
Through understanding a child’s individual differences, we can better understand what supports they need to help them to grow and develop. Further, we can draw on a child’s strengths and preferred learning styles when planning our intervention.
The “R” in DIR represents the power of relationships in promoting developmental growth. Through strengthening and lengthening our interactions with a child and demonstrating genuine interest in their preferences, we help them to develop skills in a supportive, authentic, and meaningful manner.
DIR Floortime is the application of the DIR model into practice. It is a play-centered and relationship driven approach. Through DIR Floortime, we follow the child’s lead and challenge the child to achieve their goals. DIR Floortime can be used in the context of structured therapy sessions, but these principles and strategies can also be applied to day-to-day interactions to strengthen developmental skills.
Floortime strategies that you can implement at home include:
Setting up the environment:
Consider a child’s individual differences. Do they benefit from open space for movement breaks, or do they prefer a cozy corner to focus their attention? Would alternative forms of communication (pictures, gestures) assist their language comprehension? Is this space visually distracting? By setting up the environment to accommodate for individual learning and processing differences, we help our child best access opportunities for growth.
Following the child’s lead:
Follow your child’s interests and seek to understand what it is that makes that toy or activity interesting to them. Before joining into the play, watch to see how your child plays independently and wonder what they find motivating about that play. When you do join in, first do so with no demand. Before expanding on your child’s play, take time to just be with your child in the playful interaction. The initial step in DIR Floortime is to show the child “What you are doing is interesting to me, and I’m looking forward to spending time doing it with you.”
Adding complexity:
When you know that your child is regulated and engaged in the interaction, you can then add complexity. A good rule of thumb is to imitate and add one expansion. For example, if your child is lining up blocks in a row, you can line up blocks too and then take a car and drive it across. If your child imitates, see if they will then initiate a next step. If they don’t, return to lining up blocks. If your child does show that they are ready for a challenge, continue to add small expansions to your play and language and see what your child does. For example, if you’re rolling a ball back and forth you can:
Expand: Bounce the ball, throw the ball, or spin the ball.
‘Playfully obstruct’: Put the ball on your head or behind your back to see if your child will giggle, reach, or in any spoken or non-verbal way indicate that they want the interaction to keep going. You can also pause in an interaction with a big smile to see what your child will do to let you know “This was fun! I want to keep this going!”
It’s important to remember that the goal is not to change the way your child is playing or interacting with the world. Instead, our goal is to create learning opportunities to help a child reach their unique goals, whether that be the development of language, motor planning, or so on. When adding complexity, it’s important to ensure that this is specifically targeting a goal in a way that still honors a child’s unique way of engaging.
If you have any questions about how DIR Floortime can be used to support your child’s development, our clinicians are happy to help!
References:
Pajareya, K, Sutchritpongsa, S, Kongkasuwan, R. (2019) DIR/Floortime® Parent Training Intervention for Children with Developmental Disabilities: a Randomized Controlled Trial. Siriraj Medical Journal. 2019. 71(5), 331-338.
Binns, A. and Cardy, J.0. (2019), Developmental social pragmatic interventions for preschoolers with autism spectrum disorder: A systematic review. Autism and Developmental Language Impairments. 2019 Jan; Vol 4(1), 1-18,
Solomon, R., Van Egeren, L., Mahoney, G., Quon Huber, M., Zimmerman, P. (2014). PLAY Project Home Consultation Intervention Program for Young Children With Autism Spectrum Disorders: A Randomized Controlled Trial. Journal of Developmental and Behavioral Pediatrics, 35(8), 475-485. http://www.playproject.org/assets/PLAY_Project_Home_Consultation_Intervention.1.pdf
Casenhiser D.M., Shanker, S., Stieben J. Learning Through Interaction in Children with Autism: Preliminary Data from a Social-Communication-Based Intervention. Autism, published online September 26, 2011.
Pajareya K, Kopmaneejumruslers K. A pilot randomized controlled trial of DIR/Floortime parent training intervention for pre-school children with autistic spectrum disorders. Autism, published online before print, June 13, 2011.
Dionne M, Martini R. Floor Time play with a child with autism: A single-subject study. Revue canadienne d'ergotherapie, juin 2011, 78(3)
Casenhiser DM, Binns A, McGill F, Morderer O, Shanker SG. (2015). Measuring and supportinglanguage function for children with autism: evidence from a randomized controltrial of a social-interaction-based therapy. Journal of Autism and Developmental Disorders, 2015 Mar; 45(3):846-57
Sealy, J. and Glovinsky, I. P. (2016), Strengthening the Reflective Functioning Capacitiesof Parents Who have a Child with a Neurodevelopmental Disability through a Brief,Relationship-Focused Intervention. Infant Mental Health Journal. Doi: 10.1002/imhj.21557.
Christian, G (2011). A Person-Centered Approach to Problem Behavior: Using DIR®/Floortime with Adults Who Have Severe Developmental Delays. The NADD Bulletin, 2011, March/April, 14(2), 21-31.
Mok, J.W.S. and Chung, K.H. (2014). Application ofDIR/Floortime Model in the Psychiatric Service for Very Young Children with Autism in Hong Kong. Hong Kong Journal of Mental Health. 2014, 40(1), 23-30.
Binns, A, Hutchinson, L, and Oram Cardy, J (2018). The speech-language pathologist;s role in supporting thedevelopment of self-regulation: A review and tutorial. Journal of Communication Disorders (2018) 78, 1-17
Guiot, G, Meini, C, and Sindelar, M.T. (2012). Autismo e musica: il modello Floortime nei disturbi della comunicazione e della relazione. Difficoltà di apprendimento. 17(3), 103-113.
Sandbank, M., Bottema-Beutel, K., Crowley, S., Cassidy, M., Dunham, K., Feldman, J. I., Crank, J., Albarran, S. A., Raj, S., Mahbub, P., & Woynaroski, T. G. (2020). Project AIM: Autism intervention meta-analysis for studies of young children. Psychological Bulletin, 146(1), 1–29. https://doi.org/10.1037/bul0000215
