The Developmental, Individual Difference, Relationship-based (DIR®/Floortime™) model is a framework that 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.
The D (Developmental) part of the Model describes the building blocks of this foundation. This includes helping children to develop capacities to attend and remain calm and regulated, engage and relate to others, initiate and respond to all types of communication beginning with emotional and social affect based gestures, engage in shared social problem-solving and intentional behavior involving a continuous flow of interactions in a row, use ideas to communicate needs and think and play creatively, and build bridges between ideas and logical ways which lead 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 and responds to, and comprehends sensations such as sound and touch, and plans and sequences actions and idea. Some children, for example, are very hyper responsive to touch and sounds, while others are under-reactive, and still others seeks out these sensations.
The R (Relationship-based) part of the Model describes the learning relationship 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.
What is the difference between DIR® and Floortime™ and how are they related?
Central to the DIR®/Floortime™ Model is the role of the child’s natural emotions and interests which has been shown to be essential for learning interactions that enable the different parts of the mind and brain to work together and to build successively higher levels of social, emotional, and intellectual capacities. Floortime™ is a specific technique to both follow the child’s natural emotional interests (lead) and at the same time challenge the child towards greater and greater mastery. With young children these playful interactions may occur on the “floor”, but go on to include conversations and interactions in other places. The DIR®/Floortime™ Model emphasizes the critical role of parents and other family members because of the importance of their emotional relationships with the child.
Assessment and Intervention Program using the DIR®/Floortime™ Model
As a comprehensive framework, the DIR®/Floortime™ Model typically involves an interdisciplinary team approach with speech therapy, occupational therapy, educational programs, a mental health professional (e.g., social worker, psychologist, child psychiatrist) and biomedical intervention.
After carefully observing the child’s functional developmental level, individual differences and relationships with caregivers and peers, the interdisciplinary team and parents develop an individualized functional profile that captures each child’s unique developmental features and serves as a basis for creating individually tailored intervention programs.
A comprehensive DIR®/Floortime™ intervention program includes consideration of the following components, tailored to the individual child’s profile:
Home-based, developmentally appropriate interactions and practices, including
Floortime™ sessions: Theses sessions focus on encouraging the child’s initiative and purposeful behavior, deepening engagement, lengthening mutual attention, and developing symbolic capacities through pretend play and conversations.
Semi-structured problem-solving: These sessions involve setting up challenges to be solved in order to teach a child something new. These challenges can be set up as selected learning activities that are meaningful and relevant to the child’s experiences.
Motor, sensory, sensory integration, visual-spatial, and perceptual motor activities: These activities are geared toward the child’s individual differences and regulatory patterns, build basic processing capacities and provide the support to help children become engaged, attentive, and regulated during interactions with others.
Peer play with one other child: This should be started once a child is fully engaged and interactive, with parents providing mediation to encourage engagement and interaction between the children.
Speech and oral motor therapy
Sensory motor and sensory integration based occupational therapy and/or physical therapy
Other therapies as required (e.g., Mental Health support and guidance)
For children who can interact and imitate gestures: Integrated, inclusive program or regular preschool program with additional teacher or aid if needed
For children not yet able to engage in preverbal problem solving or imitation: Special education program with a strong focus on engagement, preverbal purposeful gestural interaction
Transition educational-type programs with typical peers (e.g., gymnastics, creative drama)
When indicated other interventions include: Biomedical interventions, nutrition and diet, and technologies geared to improve processing abilities.