what is dir / floortime?
TRANSCRIPT
What is DIR/Floorti
me?Rachel Emas, Kevin Le, Caitlin Lee, Taryn
Lozon
Rachel EmasB.A. in Communicative Disorders
M.S. in Occupational Therapy
Kevin LeB.A. in Liberal Studies
Minor in Mathematics
M.S. in Occupational Therapy
Caitlin LeeB.S. in Child and Adolescent Studies
M.S. in Occupational Therapy
Taryn LozonB.S. in Child and Adolescent Development
M.S. in Occupational Therapy
Objectives- The learner will become familiar with the DIR model and
understand who DIR is used for
- The learner will recognize the 6 different levels of DIR with the ability to discuss typical signs of a child at each stage
- The learner will understand the basics of sensory processing
AgendaPurpose of DIR
What is DIR/Floortime
Key Terms
Parent Education
Population DIR Addresses
ASD
Sensory Processing
6 Levels
Family Dynamics
Floortime Coaching
Siblings
Cultural Considerations
Questions?
Purpose of DIR/ Floortime- DIR is an approach that addresses the different developmental
milestones of a child.
- Floortime is an umbrella term used under DIR that is used as a technique to help support children’s emotional and social development
- DIR focuses to:- Encourage attention and intimacy
- Facilitate two way communication
- Encouraging feelings and logical thoughts
What is DIR/Floortime?D- “developmental” - the nine distinct levels and different tasks or goals that are accomplished
I- “Individual-difference”- how each child processes information different
R- “Relation-based”- relationships a child will foster a young age including parental and therapeutic
DIR/FloortimeFamily-first approach during intervention and at home
Built on the foundation of child and parental figures
Treatment is done in child’s naturalistic environment (home or school)
Parents should let child take initiative in activities
Parents should follow child’s lead to promote two way communication
Terms used by Greenspan and Wieder
1.Circle of Communicationa. Child→ adult→ child
2.Functional emotional developmental capacities (FEDC)a. 6 levels/stages/milestones
3.Affecta. Expressing emotions through facial expressions, gestures, and body language
4.Affective processinga. The ability to process and understand thoughts, feelings, and emotions of others
5.Regulationa. When the sensory information of the body is interpreted correctly by the brain
resulting in calmness and ability to tend to the environment
Importance of Parent Education
Parents and/or caregivers know the child best
Can provide ongoing, consistent intervention
Child may respond better to parents
Can help decrease treatment costs
Population DIR AddressesNormal developing children
DIR can be used to encourage the typical developmental milestone
Autism Spectrum Disorders (ASD)DIR is typically used with ASD because it addresses social deficits
Developmental Disabilities
ADHD
Intellectual Disability
Fragile X syndrome
Down syndrome
Autism Spectrum DisorderA developmental disorder that presents itself through deficits in social communication, forming relationships,
repetitive behaviors and function
ASD is considered a spectrum disorder
Symptoms/ behaviors of ASD
Social- emotional reciprocity
Nonverbal communication and behaviors in social interactions and personal relationships
Repetitive motor movements
Inflexibility and patterned behaviors
Fixations
Abnormal responses to sensory stimuli
Sensory ProcessingUnderstanding senses
How the body processes input How the body uses inputHow the body responds to input
Modulation- regulation of the intensity of the sensory input the body receives
Discrimination- being able to tell the difference between points
Single sensory sensitivities: Hyposensitive: low processing (no
discrimination)Hypersensitive: high processing
6 Levels1. Self-Regulation and Interest in the World
2. Intimacy, Engagement, and Falling in Love
3. Two-Way Communication
4. Complex Communication,
5. Emotional Ideas
6. Emotional and Logical Thinking
Level 1: Self Regulation & Interest in the WorldMastery age: 3 monthsTake interest in worldReceive input through smells, sights, textures, noises, and tastesRegulate feelings and senses
Translate input into state of calmness and self-regulation
Level 1: Do and Don’ts
Level 1: Goal➔ Become calm, attentive, and interested in the world➔ Regulate emotions
Level 2: Intimacy, Engagement, & Falling in Love
Mastery age: 5 monthsChild is reactive
Craves attentionResponds
CuriousAttentive
Level 2: How do you know?
Level 2: Goal➔ Emotional engagement and attachment
◆ Falling in love!
Level 3: Two-Way Communication
Mastery age: 9 monthsTake initiative
Power to make things happenGesture, eye contact, verbal
Open circle of communicationInteractions
Learning cause and effect
Level 3: Goal➔ Becoming a two-way communicator
◆ Opening and closing circles of communication◆ Initiation◆ Begin to understand affect
● Smile is happy; frown is sad◆ Begin to understand symbolism
● Stepping stone for verbalization
Level 4: Complex Communications
Mastery age: 12 months- 18 months
Stretching circles of communicationOpen and close
Complex circles:VocalizationsWordsGestures
Social cuesExpression and interpretationFeelings Shared problem solving Representative play
Level 4: Goal➔ Using a series of interactive emotional signals or gestures to
communicate◆ Approx: 10+ circles of communication◆ Growing patience with their current means of communication
● Specific gestures● Sounds and words● Able to initiate communication to deal and resolve distress
Level 5: Emotional IdeasMastery age: 24 months - 30months +
Expansion of vocabularyQuestions
Understanding and using symbols Pragmatic language Symbolic play
Isolated ideasNot connectedManipulation of ideas
Level 5: Goal➔ Using symbols or ideas to convey feelings or intentions
◆ Creates dramas and play ◆ Partakes in rule following
● Motor games◆ Expresses feelings, wishes, and intentions
● Words● Multiple gestures used● Touch● Recovery from distress
Level 6: Emotional and Logical Thinking
Mastery age: 34 months+ (approx. 3 years old)
Maintaining complex ideas and connections between conceptsExecutive functioningReality vs. fantasyRegulating impulsesDebate and negotiate
Logical thinkingSequences Imagination
Emotional expressionFeeling predictionImpact on othersEmotional problem solving
Level 6: Goal➔ Building bridges between ideas
◆ Even if illogical➔ Child can connect his/her ideas together
◆ Seeking opinions◆ Enlarging his/her pretend dramas
● Playing spatial games ● Building off real events● To recover from stressful situations
➔ Closes 2 or more verbal circles of communication
Family dynamics and DIR Family stress arises when raising a child with a developmental
disorderStress is shown through rigid and anxiety
Balance is achieved when looking at caregiver’s strengths and weakness
Family ChallengesHard day at work
Relationship troubles
Displacement (defense mechanism)Taking anger out on someone/something else
Floortime CoachingParents need to remain flexible and calm during DIR/Floortime
Children are able to sense tense and angry voices
Parents need toBe able to anticipate the child’s next move
Be flexible if the child does not do as expected
SiblingsMay feel jealous, anxious, or worried
May play a protective role or aggressive role
Sibling should be involved in family challengesAvoids exclusion
Can assist parents with DIR/Floortime
Parents can train the sibling in how to open and close the circles of communication
Cultural Considerations22.9% of US citizens report being a minority
Different beliefsPersonal space
Household responsibilities
Perceptions of authority
Parent Involvement
Language barrierDifficult understanding therapy and neuroscience jargon
ConclusionDIR according to Greenspan and Wieder
Developmental disorders
Parent Education
6 Levels
Family Dynamics
Cultural Consideration
Let’s See How Much You Learned!
ReferencesBastable, S., Gramet, P., Jacobs, K. & Sopczyk, D.L. (2011). Health Professionals as Educator: Teaching and Learning.
Boston, MA: Jones and Bartlett. IBSN 987-0763792787
Davies, A. (2006). [Connecting through play: A parent education workshop]. Unpublished raw data.
DeGangi, G. A., & Greenspan, S. I. (n.d.). Functional Emotional Assessment Scale. Retrieved
from http://www.icdl.com/research/functional-emotional-assessment-scale
Greenspan, S. I. & Wieder, S. (2006). Engaging autism. Philadelphia, PA: Da Capo Press.
U.S. Census Bureau (2015). Population estimates quick facts, United States summary. Washington, DC: Author.