DIR® /Floortime™ Model

Last updated Tuesday, April 05, 2011   |   comments

DIR ® /Floortime ™ stands for Developmental, Individual Difference, Relationship-based and is the model program commonly referred to as Floortime™.  Developed by Stanley Greenspan MD and Serena Wieder PhD, this therapeutic approach has been proven effective in helping young children and infants with disabilities progress through developmental milestones.  While used to treat varying disabilities, DIR®/Floortime™  is often associated with treating autism and autism spectrum disorders, since this model focuses on dynamics, such as socialization, emotional regulation and intellectual abilities, which are common challenges for children with autism. 

According to Greenspan and Wieder’s publication, DIR® /Floortime™ Model, “Central to the DIR® / Floortime™ Model is the role of the child’s natural emotions and interests which has been shown essential for learning interactions that enable the different parts of the mind and brain to work together and to build successively higher levels of social, emotional, and intellectual capacities” (2008).  This central belief transcends all activities, interactions and is the cornerstone of program development.

The development portion of the model focuses on laying the foundation for children to progress through the developmental milestones which, according to The Interdisciplinary Council on Developmental and Learning Disorders (ICDL) are the, “foundation for all our learning and development” (2009).  The Individual differences portion of the model focuses on sensory regulation and perception of the environment, while the Relationship based portion of the model focuses on individual relationships with therapists, caregivers and others.

The Floortime™ portion of this comprehensive intervention refers to the technique therapists and caregivers use to enhance a child’s social, emotional and intellectual abilities.  Trained adults will use Floortime™ strategies to extend the length and quality of conversations and interactions using the child’s interests and activities as a guide. If the child is lining up cars then the adult will line up cars and cause an interaction; if the child is chanting a phrase then the adult joins in and creates reciprocal conversation and a social interaction. These interactions are the building block of Floortime™ and take place throughout the day in twenty minute segments.  They are also a premium example of using a child’s interests and lead to teach.

Since Floortime™ is child directed therapeutic opportunities present during times of play and often take place on the floor. While conducted primarily at home, certified professionals conduct the assessment, develop the program and train those working with the child; related professionals, such as speech and occupational therapists complete the interdisciplinary team approach that’s critical to this therapy.

Greenspan and Wieder founded the ICDL, which provides DIR ®/ Floortime™ training and certification to professionals across disciplines. Certification requirements vary by level but require professionals to have advanced academic degrees and substantial clinical experience using the model.  The most recent certification requirements, a database of certified professionals and information on building an interdisciplinary team are available on the ICDL website.

It’s not surprising so many caregivers and clinicians are utilizing the DIR ®/ Floortime™ model as research supports its long-term effectiveness.  In 2005 Greenspan and Wieder conducted a ten to fifteen year follow up study of 16 children treated with the DIR®/Floortime™ Model that showed, “some children with ASD can master the core deficits and reach levels of development formerly thought unattainable with a family-oriented approach that focuses on the building blocks of relating, communicating, and thinking.” (2005 p.39). Other research shows evidence to support this model as a treatment but notes the lack of proven “relationships between any particular intervention and children’s progress” (p.5).  More clinical research is needed and currently taking place as the use of this modality continues to grow.

To begin a DIR ®/ Floortime™ program interested persons arrange for a certified professional to conduct an initial assessment. The practitioner will then develop a program that includes, Floortime™ sessions done in the home and/or clinic, problem solving sessions, activities to address motor and sensory needs and promote peer interaction.  Additional and individual therapies are common; speech, physical, occupational, mental health, nutritional.  Educational and community programs are also developed.

To implement and maintain a home-based DIR ®/Floortime™ program the interdisciplinary team, including caregivers, receive training and ongoing support. The materials needed for DIR®/ Floortime are minimal, as therapy takes place in the child’s environment and uses the child’s everyday interests and activities as a platform for therapy.  The most integral materials will be those designed to help parents better understand and apply the principles of the DIR®/Floortime™ model. 

Greenspan has authored or co-authored over twenty books and over one hundred articles on child development and related issues. Many books are written for caregivers interested in or currently using DIR®/Floortime™; a complete list of publications is available on Greenspan’s personal website: http://www.stanleygreenspan.com

The DIR®/Floortime™ intervention model has changed the course of treatment for children with varying needs and disabilities. Greenspan and Wieder have given parents and clinicians a technique and model to build healthy social, emotional and intellectual abilities by identifying and working with the child’s individual differences and interests.  This also created a new professional field of clinical specialty and these are the professionals needed to implement a home-based program.  To find a certified provider new you, visit the Butterfly Effects Directory.

References

Greenspan, S.I. and Wieder, S. (2008) DIR® / Floortime™ Model. Available at http://www.icdl.com/dirFloortime/overview/index.shtml

Interdisciplinary Council on Developmental and Learning Disorders. (2009) Six Developmental Milestones. Available at
http://www.icdl.com/dirFloortime/overview/SixDevelopmentalMilestones.shtml

Greenspan, S.I. and Wieder, S. (2005) Can Children with Autism Master the Core Deficits and Become Empathetic, Creative and Reflective? A Ten to Fifteen Year Follow-up of a Subgroup of Children with Autism Spectrum Disorders (ASD) Who Received a Comprehensive Developmental, Individual-Difference, Relationship-Based (DIR) Approach. The Journal of Developmental and Learning Disorders 9. National Research Council Division of Behavioral and Social Sciences and Education. (2001). Committee on Educational Interventions for Children with Autism. NATIONAL ACADEMY PRESS: Washington, DC . Available at: http://books.nap.edu/openbook.php?record_id=10017&page=R1

 
 
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