Supporting the Rhythms of Relationships

Relationships are an important component to a healthy life; we experience life through shared experiences. But for children with autism, forming relationships can be challenging. The Developmental, Individual Differences, Relationship-Based Model (DIR®/Floortime™), developed by Stanley Greenspan, MD and Serena Weider, PhD, is a framework used to help children with developmental differences, including autism, work through these challenges.

The goal of the DIR®/Floortime™ Model is to build a foundation for social, emotional and intellectual growth rather than focusing on specific  behaviors, as many behavioral interventions do. The primary strategy for building such foundations is to teach adults to support the child in expanding “circles of communication”. This is achieved by meeting the child at his/her developmental level, following the child’s lead and building upon strengths. What this actually entails is incorporating intervention strategies into play-based interactions. The name Floortime™ literally comes from the primary focus on playing on the floor, especially when working with young children!

Six developmental milestones are emphasized in DIR®/Floortime™, as they are thought to make important contributions to emotional and intellectual growth. This is the “developmental” part of the model, or the “D” in DIR. These milestones include:

  1. Self-regulation and interest in the world
  2. Intimacy or a special love for the world of human relations
  3. Two-way communication
  4. Complex communication
  5. Emotional ideas
  6. Emotional thinking

These milestones are targeted when parents and caregivers are trained to implement the Floortime™ approach. Therapists (e.g., occupational and speech), psychologists, educators, and others may also use this approach in their work with children on the autism spectrum. The “I” in DIR stands for “individual differences”, which captures the biological uniqueness of each individual child. The emphasis in on biological differences because self-regulation, sensory processing and planning/sequencing of actions can vary widely among children with developmental delays. These biological differences are thought to have critical impact on how children think and learn.

The “R” in DIR stands for “relationship based”. This refers to the relationships with caregivers and other adults who are trained to tailor their emotional interactions to the child’s individual needs and capacity. Through these relationships progress toward the six developmental milestones is enabled.

In the DIR® model, parents are coached to develop rich interactions with their child based on their child’s interests and strengths. This will eventually lead to more complex interactions. For example, if your child likes stacking blocks, the adult is encouraged to join in this activity and follow the child’s lead.  This joining and following will eventually lead to a more elaborate game which will continue to build upon itself. Let your child take the lead and watch the games advance. In Floortime™, this is known as “opening and closing circles of communication”.

To clarify why this treatment model has two names (DIR® and Floortime™), Floortime™ is the specific technique of following the child’s lead, while challenging him/her to expand in the areas of social, emotional and intellectual capacity. DIR® is the comprehensive framework for this model that drives overall program development. A DIR® program includes Floortime™, as well as other exercises and therapies (e.g., speech, occupational, educational, mental health, biomedical, etc.).

For more information about this treatment model visit the following websites:  

Interdisciplinary Council on Developmental and Learning Disorders

Have you used Floortime™ or the principles of DIR® in your intervention program? How did it fit with your other program components? Share your Floortime stories with us!