by Leon Cheong
For most parents of young children with disabilities, their top priority is finding the developmental program that is best for their child. The Developmental, Individual Difference, Relationship-based (DIR) and Floortime Model is a program developed by the late Dr. Stanley Greenspan, who was a Clinical Professor of Psychiatry and Pediatrics at the University of George Washington University Medical School, and an eminent researcher and pioneer in the field of developmental disorders. DIR refers to the fundamental principles behind creating a treatment program that fosters an optimal ability to grow, learn, and build relationships. The model follows a set of milestones that allow the parent or mentor to evaluate how a child makes developmental progress. Floortime refers to the application of DIR during interactive sessions with a child.
Bay Area parent Usha Arun is the mother of a 12-year-old boy with Asperger’s Syndrome, and has used the DIR/Floortime Model ever since her son was three. Arun, who has used the technique extensively, says that the most notable trait of DIR/Floortime Model is its flexibility and ability to attend to the specific needs of a child. “The way you use it greatly depends on your child’s needs and interests,” Arun said.
The first step of the model involves pinpointing intrinsic behaviors in the child. “You have to ask yourself, how does the child connect with the world?” Arun said. “Is he stimulated by touch or sound? How does he communicate? What is he obsessed with?”
After determining the child’s interests, a parent can build the program off of that knowledge. For example, Arun’s son had an initial fascination with doors. “My son would always run from one doorknob to another and look at his reflection, over and over again.” Arun said, “But I was able to take his fascination with door knobs and use it to expand his interactions of the world beyond that. These interactions allowed me to help him develop joint attention, then turn taking, and finally engagement!” (See inset to understand how this floortime session was carried out.)
The next step involves building trust between the parent and the child. For Arun, this meant making sure her son was comfortable doing whatever he wanted to, in front of her. After a connection has been made between the parents and their child, an intimate relationship can occur and the child loses a sense of self-absorption. “Building engagement and emotional connection with a child is crucial,” Arun said, “This gives the child an interest in the world other than just obsessions. This lets the parents know what the child’s other natural inclinations are, which can be expanded upon.”
Communication is the crucial milestone that follows. “Once we built trust, we began communicating. We used words and gestures to let him know what certain words meant,” Arun said. “During Floortime, at first, my son would learn how to use language to express things he wanted or things he was thinking about. Gradually, two-way communication became normal, and Floortime was happening everywhere, like having conversations in the car. As my son became older, our conversations got more sophisticated because now he had the language to communicate not only his immediate needs but also to be involved in my world. So, while riding in the car for instance, we would talk about where we were going. If it happened to be the grocery store, then my son would write out the grocery list. He would bring the shopping cart, we would shop together and he would pick out the items listed. At home we would set up a grocery store and play this game.”
DIR/Floortime can also teach the child how to cope with real-life social situations. Arun employed Floortime to simulate scenarios that her son would normally have difficulty with. “For example, my son used to be very overwhelmed at airport security checks,” Arun said. “There was always a lot going on around him at the airport, and we needed to teach him how to handle it. At the time, my son was very interested in Sesame Street, so we set up a play-simulation with Sesame Street toys where he would go through the airport scanners and the whole process. When we brought a certain real life situation into play, it just clarified that experience more for him, so that he no longer felt anxious and scared.” Through these play scenarios, her son explored and understood the real world in a safer way and was able to find coping strategies.
Floortime has helped Arun’s son make important strides in many areas of development. “It has changed how [my son] perceives the world,” Arun said. Her son has come a long way from being absorbed in his own interests. He now actively interacts with the people around him. “The biggest improvements have been in the areas of language and the ability to reason and strategize. He has an amazing capacity to delve into certain subjects and take them to another level,” Arun said
When asked what her son’s current interests are, Arun responded, “As of now, he is very intrigued with freeway design, and is constantly studying maps and remarking on how traffic efficiency can be improved. We have had him meet with freeway engineers so that he can learn more. Ultimately, it is about what he wants.”