Floortime/DIR (Developmental, Individual differences, Relationship-based) approach is a developmental intervention for children experiencing developmental delays due to autism, Asperger syndrome, or other developmental disorders. Floortime involves meeting a child at his or her current developmental level, and building upon a particular set of strengths. Floortime is child-focused—the parent or therapist follows the child’s lead, with playful positive attention and tuning in to the child’s interests. Proponents of Floortime claim that by entering into a child’s world, support can be given to climb the ‘developmental ladder’.
The DIR model is based on the idea that due to individual processing differences children with ASD do not master the early developmental milestones that are the foundations of learning. DIR outlines six core developmental stages that children with ASD have often missed or not mastered:
- Stage One: Regulation and Interest in the World: Being calm and feeling well enough to attend to a caregiver and surroundings. Have shared attention.
- Stage Two: Engagement and Relating: Interest in another person and in the world, developing a special bond with preferred caregivers. Distinguishing inanimate objects from people.
- Stage Three: Two way intentional communication: Simple back and forth interactions between child and caregiver. Smiles, tickles, anticipatory play.
- Stage Four: Social Problem solving: Using gestures, interaction, babble to indicate needs, wants, pleasure, upset. Get a caregiver to help with a problem. Using pre-language skills to show intention.
- Stage Five: Symbolic Play: Using words, pictures, symbols to communicate an intention, idea. Communicate ideas and thoughts, not just wants and needs.
- Stage Six: Bridging Ideas: This stage is the foundation of logic, reasoning, emotional thinking and a sense of reality.
Most typically developing children have mastered these stages by age 5 years. However, children with ASD struggle with or have missed some of these vital developmental stages. When these foundational abilities are strengthened through the child’s lead and through meaningful play with a caregiver, children begin to climb up the developmental ladder. An introduction to DIR/Floortime can be found in the book – Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate, and Think. By Stanley Greenspan, M.D. and Serena Wieder, PhD.
While interventions such as Applied Behavior Analysis (ABA) and the Lovaas technique have proved effective as interventions for autism spectrum disorders, new types of developmental interventions such as Floortime have emerged in response to criticisms that the rote learning involved with behavioral interventions may not result in generalized learning.