DIR®Floortime™ Model – An Overview
This week I have the privilege of working with a family friend, Virginia Speilman, in an Occupational Therapy Clinic (SPOT) in Hong Kong, so I thought I would share some of the new theories I have learned, starting with the DIR Floortime Model.
The DIR Model (which stands for Developmental, Individual Difference, and Relationship Based) basically gives clinicians a way to assess children, and then tailor make a program that will suit the child and the individual challenges they face in their day to day lives. It has been developed for children with Autism Spectrum Disorders (ASD) and other developments disorders, and aims to create more healthy foundations for the child’s emotional and intellectual development. This is opposed to most other models, which places more focus on their skills and the isolated behaviours associated with their particular developmental issue. You can find a more detailed overview of the model on the website by clicking this link.
The Developmental part of this model refers to the building blocks of this foundation. It is extremely important to understand where the child is in terms of development, and this will help towards creating a treatment program. You can find the Six Developmental Milestones here, which describe the stages each child must overcome for healthy development. Children with developmental disorders find it difficult to remain calm and to regulate their emotions, to relate to others and effectively engage with them, to use effective communication techniques including gestures, and many more social and emotional skills that healthy children possess (however, some symptoms are more suited to certain disorders than others). Overcoming these milestones and developing these skills are extremely important for children to form strong, empathetic and emotional bonds with other people, as well as aiding them academically.
The individual difference part of this model is very important, in my opinion, and is something a lot of clinicians can forget. EACH CHILD IS DIFFERENT! They take in, regulate, respond to and comprehend the world in uniques ways, and their therapy/treatment should reflect this. An example on the DIR site is that some children are extremely sensitive to touch and sound, however others may be under sensitive and actually seek them out. This kind of Biological Challenge could be one of many individual differences in a child, and this is what is believed to be interfering with their inability to grow and learn easily.
The relationship based component of this model refers to the child’s relationships with their caregivers, teachers, clinicians, peers, and other people they are in contact with. Relationships are a very important factor children during cognitive and social development, especially with their caregivers as they look towards them for social cues. Healthy relationships help a child to develop and master essential skills and foundations. (Don’t panic, no relationship is perfect, they just need to be healthy).
Floortime is a specific technique which follows the child’s emotional instincts, as well as challenging them to master social, emotional and intellectual skills. It incorporates occupational therapy, speech therapy, physical therapy, counseling for parents, as well as intensive home and school programmes, as well as Floortime.
The name Floortime comes from the Floor component of the therapy. It gives the clinician and the child a chance to get down on the floor in order to work on developmental challenges, but also a philosophy that defines all of the child’s interactions and relationships and the goals of these (which include interactions with OT’s and speech therapists). There are two ways in which parents and clinicians can use Floortime, and by keeping them in mind at all time they can help the child reach their developmental milestones. The first is to follow the child’s lead, and the second is to join their world and enter into a shared world to help them to master their Functional Emotional Developmental Capacities. (You can read about how to do this effectively here).
While with young children, interactions may remain on the floor and involve mainly play, as they grow they can include conversations and interactions in a wider variety of places. The DIR Floortime Model emphasizes the role of parents/caregivers and close family members as their emotional relationships with the child tend to be more important.
However, this model is a comprehensive framework, enabling clinicians and parents to create a treatment program that is tailor made for the child. It tackles their own unique challenges and strengths, as well as their developmental disorder. The central factor is the role of the child’s natural emotions and interests (which shows the importance of individual differences) as these have been shown to be essential for the child to engage in interactions that will enable the different brain areas to work together. This will then lead to higher levels of social, emotional and intellectual skills – this may involve problem solving exercises and team sessions in OT, speech therapy, educational programs, mental health intervention and augmentative and biomedical intervention alongside Floortime.
When I have had the opportunity to observe the DIR Floortime method, I will post more information about it, however if you feel you cannot wait you can follow this link and have a look at the website for yourself.
Written by Philippa Berry