Students with disabilities falling on the Autism Spectrum Scale face many life challenges. One of the most difficult is appropriate social interaction. Initiating and sustaining social interaction, whether in a peer group setting (classroom) or individually with a teacher or family member, does not come naturally. Social interaction can be painful; many autistic students withdraw from social situations to avoid pain, and even with cognitive knowledge of how to interact with others, they prefer not to.
Teaching social interaction skills to students with autism spectrum disorders can be difficult, slow to yield positive results, and continual reinforcement of strategies taught is almost always necessary. Therapy results vary and progress is affected by severity of the disability, age of therapy intervention and many other factors.
The Developmental, Individual Difference, Relationship-based Model, also known as DIR/Floortime Model, is one program that has yielded positive results improving social interaction outcomes with students facing relationship challenges. The six step plan can be implemented across therapies, like art, music, and dance, that help students struggling with interpersonal relationships.
The approach was developed by Drs. Stanley Greenspan and Serena Wieder. The relationship-based approach focuses on using an intensive integrated intervention which is individualized to match the child’s level in the social-interaction development hierarchy. Relationship-based developmental experiences build skills in the core processes of relating, attending, communicating, and thinking.
Difficulties in relating and communicating are believed to be secondary to sensory and motor processing deficits. The ultimate goal of the intervention is to help the child develop appropriate affect and form a sense of self as an intentional and interactive individual.
The Model’s framework helps clinicians, parents and educators conduct a comprehensive assessment and develop an intervention program tailored to the unique challenges and strengths of children with Autism Spectrum Disorders (ASD) and other developmental challenges. The objectives of the DIR / Floortime Model are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors.
One can think of a developmental ladder that needs to be climbed one rung at a time. Children with autism may have difficulty climbing this ladder for many reasons related to their autism. DIR/Floortime involves the adults helping a child to move up this developmental ladder by following the child’s lead and building on what the child does in order to incorporate and encourage more interactions between child and adult. Through mutual shared engagement, the caregiver uses techniques to engage the child in increasingly complex interactions.
The six developmental milestones outlined are:
Stage One: Discovering your Child's Sensory and Motor Profile
Stage Two: Intimacy, engagement, & falling in love
Stage Three: Opening and closing circles of communication
Stage Four: Expanding the Circles of communications to Solve Problems
Stage Five: Creating Emotional Ideas; the child's ability to form ideas develops first in play.
Stage Six: Emotional Ideas & Logical Thinking
These skills scaffold, leading to higher level capacities to think in multicausal, grey area, and reflective ways. These developmental capacities are essential for spontaneous and empathic relationships as well as the mastery of academic skills.
The I (Individual differences) part of the Model describes the unique biologically-based ways each child takes in, regulates, responds to, and comprehends sensations such as sound, touch, and the planning and sequencing of actions and ideas. Biological Challenges describes the various processing issues that make up a child's individual differences and that may be interfering with his ability to grow and learn.
The R (Relationship-based) part of the Model describes the learning relationships with caregivers, educators, therapists, peers, and others who tailor their affect based interactions to the child's individual differences and developmental capacities to enable progress in mastering the essential foundations.
“Floortime” is a series of reciprocal child-directed interactions resulting in “communication circles.” The goal of “floortime” is to sustain interactions between the child and the adult by gradually increasing the circles of communication. These interactions become the basis for further play development.
During “floortime,” the adult joins in the child’s play to increase opportunities for pleasurable interaction and engagement. The child’s actions are considered intentional and purposeful. The adult follows the child’s lead to validate the child’s sense of self. Music, art, and dance therapies are often implemented during “floortime” as they are frequently pleasurable, self-directed activities that can be manipulated by therapists through introduction of new materials, exposure to new ideas and skills, and immediately reinforced to increase a student’s likelihood to repeat the activity.
Preferred objects and activities are used to motivate the child and facilitate persistence and patience. Higher level skills and concepts are taught through interactive play. “Floortime” also provides for peer experiences with typically-developing age-mates. Frequently, therapists include peers in small groups to encourage the targeted student to share experiences.
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