Floortime Strategies to Promote Development in Children and Teens

A User’s Guide to the DIR® Model

by Andrea Davis, Ph.D., Lahela Isaacson, M.S., and Michelle Harwell, M.S.

Contents

• About the Authors .ix
• Foreword—Serena Wieder.xi
• How to Use This Book xv
• Introduction xvii
• Acknowledgments xxiii
• Core Methods A. Basic Strategies to Promote Social-Emotional and Intellectual Development 1
  • A.1 Follow cues: Provide sensitive interactions by following cues .2
  • A.2 Be responsive: Always respond to all communication. 4
  • A.3 Build upward: Meet your child or teen at current developmental capacity .6
  • A.4 Use play: Use play and playfulness as primary means to engage and teach. 8
  • A.5 Use natural interests: Capitalize on natural interests to elicit higher skills .10
  • A.6 Use problems: Set up situations that invite child-initiated solutions .12
  • A.7 Pretend play: Create opportunities to use ideas in symbolic (pretend) play .14
  • A.8 Embrace feelings: Help embrace a wide range of feelings .16
  • A.9 Enrich ideas: Help enrich ideas or stories in play and conversation. 18
  • A.10 Self-reflect: Take a reflective stance toward yourself in interactions. 20

Introduction

Welcome to a journey of learning a new approach to helping children and teens reach their highest social-emotional and intellectual potential. DIR ® , or the Developmental, Individual Differences, Relationship-Based model, is a unique intervention approach developed by Drs. Stanley Greenspan and Serena Wieder as a way for families and professionals to understand and help children, especially those with developmental differences. Floortime is the application of DIR principles to intervene with children and adolescents, by using intentional methods of playing and interacting to help them achieve crucial capacities in personal development. This book is based on DIRFloortime ® as presented in The Child with Special Needs (S. Greenspan & S. Wieder, 1998; Da Capo Press).

What Is DIRFloortime?

The DIRFloortime Pyramid (see p. xix) is a graphic representation of Drs. Greenspan and Wieder’s model; at our center we use the pyramid with families to make the approach easier to visualize. To sum up the basic idea, we say social-emotional and cognitive growth happens in the following manner:

• Adults in Floortime attune, engage, respond, expand, pretend, challenge, and reflect.
• Children and teens in Floortime regulate, connect, reciprocate, communicate, create, think, and self-reflect.

Steps to Begin DIRFloortime Home Intervention

Assessment: Obtain a comprehensive developmental evaluation or assessment of your child or teen’s individual differences by a medical doctor, clinical psychologist, or multidisciplinary team specializing in developmental differences. The recommendations from the assessment report should help you begin to build an intervention team of the needed professionals and make a plan for school, clinic, and home intervention.

Focus: Ask the educational and therapeutic team to help you select which pages of this DIRFloortime book might be most appropriate for your situation.

Guidance: Schedule regular sessions with a local (or long-distance) professional who has extensive training and experience in DIR.

Update: Have a DIR professional implement the Floortime strategies alongside you or review home video clips to help you monitor ongoing progress.

Regulation and Attention

The D in DIR ® embraces and promotes the stages of human personal development, starting with Capacity 1, Regulation and Attention, or the ability to be calm and alert and to focus. A developmental approach helps children and adolescents attain a calm, alert state before expecting them to achieve further accomplishments in their general developmental trajectory and in any given moment.

Strategies Include:

1. Support regulation: Help your child or teen get regulated before expecting more.
2. Notice and adjust: Notice and adjust your intensity to support an optimal arousal level.
3. Calming choices: Offer choices for help in calming down.
4. Lengthen attention: Attend to and join interests to expand focus and attention.
5. Avoid flooding: Support regulation at early stages of upset to avoid emotional “flooding.”
6. Practice modulation: Practice modulation regularly in fun, playful ways.

Examples

• Preschool/elementary: You are hurrying to get yourself ready and trying to help your son attend to getting dressed for school.

• Middle school/high school: You need to remind your adolescent of a chore, but she is focused on the television screen with a glazed expression.