A Review of the DIRFloortime Model for Autism Treatment

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A Review of the DIR/Floortime Model for Autism
Treatment

• Jessica Seeman
• Jennifer Connelly
• Caldwell College Graduate Program in Applied
  Behavior Analysis

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The DIR/Floortime Model What Is It?

• DIR- Developmental, Individual-Difference,
  Relationship-Based Model
• Developmental- Six Levels
• Individual-Difference- Unique way in which a
  child processes information
• Relationship-Based- Learning Relationships
  necessary for a child to progress in his
  development

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The History of DIR/Floortime

• Developed approximately 30 years ago
• Based on cognitive and developmental psychology
• Started with a six-year study based on typically
  developing infants
• Look at how typical development can be derailed
• Not only Greenspan

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History of DIR/Floortime

• Used model to treat autism, and additionally
  focused on sensory/motor components
• In 1990 began training in assessment and
  treatment of autism using model
• In 1996 Greenspan and colleagues Formed
  Interdisciplinary Council on Developmental and
  Learning Disorders

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History of DIR/Floortime

• Published own diagnostic manual, assessment
  intervention tools (measures), and videotaped
  training models
• Formed the Journal of Developmental Processes
• In 1999 began a DIR institute certificate program
• In 2003 the Floortime Foundation was founded

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The Theory Behind DIR

• Language, cognition, social skills, and emotions
  are learned through meaningful relationships
• Underlying sensory processes determines how
  learners interpret and learn from their
  environment
• Progress in all areas of development is
  interrelated
• The theory is based on the understanding of
  autism as unique biologies of individual
  learners

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DIR/Floortime Treatment Claims

• Relate to adults and peers with warmth and
  intimacy
• Communicate meaningfully with gestures and words
• Think using abstract reasoning and empathy
• Integrates emotional, social, intellectual,
  educational goals

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FEDCs

• FEDC- Functional emotional developmental
  capacities
• Stage 1 Regulation and Interest in the World
• Stage 2 Engaging and Relating
• Stage 3 Intentionality and Two-Way Communication
• Stage 4 Social Problem-Solving, Mood Regulation,
  and Formation of Sense of Self

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FEDCs

• Stage 5 Creating Symbols and Using Words and
  Ideas
• Stage 6 Emotional Thinking, Logic, and Sense of
  Reality

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DIR Approach to Evaluation and Intervention
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DIR Components

• Floortime
• Semistructured Problem-Solving Activities
• Speech Therapy
• Occupational Therapy
• Peer Play Opportunities
• Educational Programs
• Biochemical Interventions

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What Is Floortime?

• Floortime is only one component of the DIR-
  based intervention program, but is the heart of
  the home program
• Floortime is a family approach
• Two main goals of Floortime
• 1. Follow the childs lead
• 2. Bring the child into a shared world

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Floortime How to Implement It

• Not about doing the right or wrong thing-only
  learning together
• Think of yourself as a player
• Parents coaching each other in order to analyze
  floortime sessions

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Floortime How to Implement It

• Voice (intonation) is the most powerful tool
• Meet on current developmental level, instead of
  expectations
• Giving things symbolic meaning
• No rush in floortime, moving at the childs
  preferred pace

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Floortime One Example

• http//www.youtube.com/watch?vvQW4TncfP7g

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Floortime Checklist

• Involves following the childs lead and pulling
  him into your world.Is he
• Engaging with toys/objects or me?
• Reacting or initiating interactions?
• Opening/Closing a few circles of communication?
• Labeling/Creating own new ideas in play
  conversation?
• Marching to his own drummer/responding to my
  ideas as well as his own?

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Floortime Creating Learning Environments

• With siblings/peers
• Across settings
• Everyday activities
• At school

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Creating a Comprehensive Intervention through
Additional Components DIR Intervention Pyramid
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DIR Views on Sensory Processing and
Self-Stimulatory Behavior

• Sensory Processing- learners being overreactive
  or underreactive to sensory information
• Why learners engage in stereotypy, and how it is
  addressed through the DIR model

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DIR Approach to Problem Behavior

• Avoidant Behavior
• Repetitive Behavior/Perseveration

• Dangerous/Aggressive Behavior
• Self-Stimulation

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DIR Approach to Other Challenges

• Toilet Training
• Dressing
• Meal Time

• Social Skills
• Feelings
• Scripting
• Echolalia

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DIR/Floortime Research Support

• Developmental patterns and outcomes in infants
  and children with disorders in relating and
  communicating A chart review of 200 cases of
  children with autistic spectrum diagnoses.
• Stanley I. Greenspan Serena Wieder (1997)
• Can children with autism master the core
  deficits and become empathetic, creative, and
  reflective?
• Serena Wieder Stanley I. Greenspan (2005)

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DIR/Floortime Scientific Validity

• Internal Validity Functional Relationship
• Demonstrated no experimental control
• Measures biased
• Nothing operationally defined
• No explanation of data collection or reliability
  data
• DIR not only IV
• Behaviors were internal states (not measurable
  through observation)

• External Validity Replication
• Method not described
• Various confounding variables
• No demonstration of internal validity

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References

• Greenspan, S. I., Wieder, S. (1997).
  Developmental patterns and outcomes in infants
  and children with disorders in relating and
  communicating A chart review of 200 cases of
  children with autistic spectrum diagnoses. The
  Journal of Developmental and Learning Disorders,
  1, 1-38.
• Greenspan Wieder (2006). Engaging autism.
  Cambridge, MA Da Capo Press.
• Wieder, S., Greenspan, S. I. (2005). Can
  children with autism master the core deficits and
  become empathetic, creative, and reflective? The
  Journal of Developmental and Learning Disorders,
  9, 39-61.

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Questions Period