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DIR/Floor Time

The Developmental, Individual-Difference, Relationship-Based (DIR) intervention model, also known as Floor Time™, is designed to help children work around processing difficulties to reestablish effective contact with caregivers or play partners and begin to master developmentally appropriate skills. It is designed to increase socialization, improve language, and decrease repetitive behaviors.

Description

Children with autism (AU) often lack the most basic foundation for interpersonal experiences. Greenspan and Wieder (1997a) suggested, “The child’s interactions in relationships and family patterns are the primary vehicle for mobilizing development and growth” (p. 5). Greenspan and colleagues developed the Developmental, Individual-Difference, Relationship-Based (DIR) intervention model, also known as the Floor Time™ approach, to facilitate understanding of children and their families by identifying, systemizing, and integrating the essential functional developmental capacities (Greenspan & Wieder, 1999; 2000).

Floor Time™ was created (Greenspan & Wieder, 1997a) to increase socialization, improve language, and decrease repetitive behaviors (Greenspan & Wieder, 1997b). Its name is derived from Greenspan’s philosophy of the importance of adults “getting down on the floor” to interact with the child.

Joint attention and the promotion of contingent interaction form the methodological core of the model (Kasari, 2002; Siller & Sigman, 2002). Specifically, the primary goal of this intervention is “to enable children to form a sense of themselves as intentional, interactive individuals and to develop cognitive language and social capacities from this basic sense of intentionality” (Greenspan & Wieder, 2000, p. 289), and to progress through the six functional emotional developmental milestones.

These milestones are the ability to (a) self-calm and process environmental information, (b) engage in relationships, (c) engage in two-way communication, (d) create complex gestures and connect a series of actions into an elaborate and deliberate problem-solving sequence, (e) create ideas, and (f) build bridges between ideas so that they become reality-based and logical (Greenspan, Wieder, & Simon, 1998). Furthermore, Greenspan et al. proposed four specific goals corresponding to these six milestones:

  • Attention and intimacy
  • Two-way communication
  • Expression and use of feelings and ideas
  • Logical thought

Floor Time™ is a play-based interactive intervention in which affect and interactive relationships are the primary components. It emphasizes individual differences, child-centered interests, and affective interactions between a child and a caregiver or play partner. During Floor Time™ sessions, the caregiver or play partner takes an active role in spontaneous and fun activities that are directed by the child’s interests and actions. The intervention can be used in nearly any setting and at any time. In addition, it may be used as a component of other comprehensive therapy programs (Greenspan et al., 1998).

Elements of Floor Time™ are shared by other methods, including Pivotal Response Training or PRT (Koegel & Koegel, 1995). Greenspan suggests implementing 6 to 10 sessions per day, each lasting 20 to 30 minutes, particularly for children with severe challenges (Greenspan et al., 1998).

Research Summary

Ages (yrs) Skills Settings Outcome
0-22 Social, communication, joint attention, behavior, play, cognitive, school readiness, self-regulation, motor, adaptive Home, school, community

Outcomes:     Evidence-based     Emerging     No evidence     Comprehensive

Steps for Implementation

 

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