The journey to finding the right therapy for a child with autism spectrum disorders (ASD) can be stressful. Many therapies claim to offer benefits such as social and communication development, but it’s difficult choosing which therapies autistic children should receive to assist them in the long run to become fully independent.
It’s important to look at the bigger picture and choose an intervention that assists in areas such as social-emotional development, as well as the ability to understand and perceive the world. Many parents are looking for options which expose autistic children to the power of emotional and relationship connections and teach those who struggle in these areas in a proactive form of therapy. One such approach growing in popularity is DIR Floortime therapy.
DIR Floortime therapy is said to be effective for autistic children in a variety of ways. This article will overview how the therapy works and the potential benefits of implementing this form of therapy for autistic children.
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What is DIR Floortime?
DIR Floortime stands for the Developmental Individual-difference Relationship-based model Floortime and was developed by the late Dr. Stanley Greenspan to help children with autism spectrum disorder (ASD) connect while using their interests and passions to develop engagement skills, symbolic thinking, increase logical thinking, and improve interaction.
During DIR Floortime, children lead an activity with their clinician or caregiver joining in and encouraging skill development within the world and parameters the child has created. Dr. Greenspan’s approach stresses the importance of including the child’s senses, emotions, and motor skills to create a holistic approach to support the child’s development. This can be adapted to the child’s age and developmental level. As a child becomes older, DIR Floortime becomes more conversation-based and focuses on creative thinking and exploring the child’s interests and ideas.
The highly adaptive nature of this therapy makes it a valuable option for children at all points of the autism spectrum. Dr. Greenspan encouraged parents to observe the kind of play their child engages in best (such as sensory, object, symbolic, or a combination) and determine whether the child is sensitive sensory seeking, under-reactive, or passive.
Is DIR Floortime therapy right for my child?
Many believe DIR Floortime’s benefits largely outweigh its challenges. When Dr. Gil Tippy PsyD, clinical director and founder of the Rebecca School in New York, spoke with the University of Vermont’s publication OutReach in 2015, he said the following about Floortime’s drawbacks and challenges:
“The primary struggle with DIR/Floortime is that somehow the general public, and those who make funding decisions, have been tricked into believing that DIR is not scientific. Nothing could be further from the truth. DIR/Floortime, and child development, in general, have been so well documented and researched that it meets criteria now to be seen as an ‘evidence-based practice…The confusing charts and graphs of applied behavior analysis look like what people believe science should look like, but it’s a trick. I would say that is DIR’s greatest challenge”
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Additionally, The Autism Resource Foundation notes that parents who practice Floortime with their children require “a lot of patience, imagination, and stamina”. They go on to say that “since there is very little in the way of a specific direction (each child is different) it can be hard to know if you’re doing it right”.
However, the benefits can potentially be life-changing, especially when practiced by a clinician. During Floortime, a child has the opportunity to communicate and connect on their own terms. It’s suggested that, by meeting children where they are, they are more likely to pick up language skills, express their needs and desires, and connect with their Floortime partner.
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Difference between DIR Floortime and ABA therapy
DIR Floortime is quite different from ABA. Unlike ABA therapy, floortime centers on emotional connection and development rather than behavior. Another difference is that Floortime is focused on play and having the child take the lead on activities. In addition, DIR Floortime always takes place on the floor, following the child’s lead and using whatever tools or objects they are drawn to.
Is Floortime therapy evidence-based?
Evidence-based research has been found to support Floortime. According to a study by K. Pajareya, MD, and K. Nopmaneejumrulers, MD of Mahidol University in Bangkok, Thailand, Floortime is an effective treatment strategy for children with autism. In this study, parents conducted an average of 15.2 hours/week at home Floortime for three months.
Floortime was used in conjunction with the child’s existing behavioral treatment. The group of children who participated is said to have made significant gains.
Pajareya and Nopmaneejumruslers noted that the children who did not show a favorable outcome in this study were affected by their families’ need for better intervention coaching and modeling to change their communication styles and encourage them to relate to the child better. The children whose parents were well trained and able to spend more time with their children made significantly better progress (Pajareya & Nopmaneejumruslers, 2012).
Other anecdotal evidence was recorded in Physical and Occupational Therapy in Pediatrics. This study noted that Floortime conducted at home improved parent-child interaction in preschool-aged children with autism.
The families in this study completed a 10-week Floortime program averaging 109.7 hours of intervention. These children improved their emotional functioning, communication, and daily living skills. These findings were supported by the mothers of these children noticing improved parent-child interactions. (Liao, et al., 2014)
How to conduct play therapy techniques at home
Affecting Autism, a group dedicated to “educating, empowering, and supporting parents of children with developmental challenges” published a guide that breaks down the basics of conducting Floortime at home based on Dr. Greenspan and Dr. Tippy’s research. The guide suggests that autism caregivers do the following:
Determine your child’s sensory need
The first step outlined is to create a comfortable environment for your child based on their sensory needs and preferences. As mentioned above, Dr. Greenspan’s website offers a downloadable manual to determine your child’s sensory profile. Any teachers, therapists, or other doctors in your child’s life may be able to help you determine your child’s profile
Observe and play with sensory toys
The next step is to observe your child’s play and join in. This is referred to as “meeting your child where they are” or “following the child’s lead”. By doing this, parents can understand their child’s rhythm and preferences before joining them in play
Let your child with autism know you want to play
Parents need to make sure their child knows someone is interested in playing with them. Parents must be supportive and engaged in their child’s chosen activity and show interest in all the moving parts of the play. Children who feel that the world they have created is valued and acknowledged will likely be motivated to stay engaged longer
Participate in play therapy technique
Be sure to include yourself in the child’s play. This may look like posing a challenge to the child and putting yourself into their play world. Entice your child to include you in their play. Then, use some effect to engage the child. This may take the form of any of the five senses. For example, adding sound effects or making a silly face could be engaging. If your child is comfortable with touch, this could be a useful addition to play (i.e., running a Matchbox car up their arm)
Keep the play routine fresh by changing sensory toys
Finally, parents need to change or add an element to the play. This will extend the play and keep the child from falling into repetitive behaviors or patterns. (Key Take-Aways The nuts and bolts of the Floortime session, 2015)
Talk to a child therapist about adding Floortime
Finding a specialist is imperative to the success of Floortime therapy. Whether you choose to conduct Floortime at home or see a specialist practice it with your child, a child therapist may help provide metrics to measure your child’s success and solutions to roadblocks you may hit along the way. It is important to note that for optimal success in Floortime, families commit to practicing it regularly for a prolonged period.
If you think this could be a helpful addition to your child’s behavioral therapies, speak to your child’s pediatrician, occupational therapist, or psychiatrist for a referral to a psychologist who specializes in DIR Floortime. Additionally, it may be helpful to include sessions in your child’s school day. Many schools will accommodate this request through an Individualized Education Plan.
Occupational therapists or other professionals are often open to drafting exercises that parents can do with their children at home. Don’t be shy to ask!
As compared to typically developing children, children with autism or special needs often require the right individualized form of therapy to assist their development. DIR Floortime is a proven form of therapy believed to assist in the holistic development of various faculties to help autistic children thrive throughout their lifespan.
With the right training and in conjunction with a therapist’s recommendation, parents can implement the strategies of DIR Floortime at home. It’s important to ensure your autistic child is able to apply what they learn in therapy at home. Just remember, every child is unique and different therapy approaches will work best for different children.