DIR®/Floortime™
The Developmental, Individual differences, and Relationship-based (DIR®) model is an interdisciplinary developmental framework
created by Stanley Greenspan, M.D. and Serena Wieder, PhD. It generally includes speech, occupational, and physical therapy, mental health professionals and educational programs. This team of professionals work together to promote social, emotional, and intellectual capacities by taking into account three important elements of a child’s growth: their developmental capacities, their individual processing differences, and relationships that promote learning.
Below is a thorough description of each of these three elements of DIR® taken directly from Engaging Autism by Stanley Greenspan, M.D. and Serena Wieder, PhD.
Development
The first element of DIR® is development. Created by Stanley Greenspan, M.D. and Serena Wieder, PhD, it refers to the six functional, emotional, developmental capacities (FEDC) that each child acquires throughout development. A simplified explanation of the six developmental capacities is seen below.
| Capacity | Description |
| Capacity 1: Shared Attention & Regulation
(begins at 0-3 months) |
Calm interest in and purposeful responses to sights, sounds, and touch (e.g. shows interest by responding to a person’s voice or touch through body language or vocalization) |
| Capacity 2: Engagement & Relating (begins at 2-5 months) | Show expressions of intimacy and relatedness (e.g., initiates and sustains an interaction with another person) |
| Capacity 3: Purposeful Emotional Interactions
(begins at 4-10 months) |
A range of back-and-forth interactions with emotional expressions, sounds, hand gestures, etc. used to convey interactions |
| Capacity 4: Behavioral Organization & Problem-Solving
(begins at 10-18 months) |
Many social and emotional interactions in a row used for problem-solving |
| Capacity 5: Creating Ideas
(begins at 18-30 months) |
Meaningful use of words or phrases and interactive pretend play with caregivers or peers |
| Capacity 6: Emotional & Logical Thinking
(begins at 30-42 months) |
Logical connections between meaningful ideas (e.g., “I want to go outside because I want to play.”) |
*Stanley Greenspan and Serena Wieder, Engaging Autism (Da Capo Press, 2006), 30.
Typically, each of these developmental capacities begins around a specific age and progresses naturally. At times though, some children skip a capacity or become stuck at a particular capacity. Since we learn through social and emotional interactions, this can affect the child’s social-emotional and cognitive growth. Therefore, a child may be seven years old but does not yet use eye gaze appropriately because, for various reasons, he/she did not become robust in the first few capacities of development. Therefore, in our therapies at Lakeside Center for Autism, we not only take a child’s age into account but their developmental capacity as well. Focusing only on age can cause problems as a child may not developmentally be at their chronological age yet. Identifying which capacity a child is at in their development allows us to support them appropriately.
Individual-Differences
The second element of DIR® is individual-differences. This involves understanding your child’s sensory profile, how he/she perceives and processes their world. Every child has different sensory experiences. Some may be extra sensitive to light or sound, plugging their ears or closing their eyes when they are overwhelmed by the stimuli in their environment. Other children crave more intense experiences. At times, these sensory differences can prevent the building of relationships and intellectual capacities. Understanding how your child responds to different stimuli allows us to create an individual plan that improves attention, problem-solving, and the creation of ideas.
Relationships
The last element of DIR®/Floortime™ refers to relationships. Relationships are important bonds that play a central role in human development. It is this emotional bond that creates the desire to learn, therefore, relationships are vital for the development of language, cognition, and emotional and social skills.
Floortime™
In order to support these three elements of DIR® as outlined in Engaging Autism it is recommended that, therapists use a specific technique in DIR® called Floortime™ with the following main goals: 1) follow the child’s lead/interests and 2) bring the child into a shared world. We follow the child’s lead because their interests are enjoyable and motivating for them. By allowing the child to explore his/her interests, the child learns to trust us since we respect, validate and participate in something they desire. Once the child allows us into their world, we slowly pull them into a shared world with the goal of inspiring an empathic, imaginative, and reflective individual.
Ultimately, DIR®/Floortime™ is different from other interventions for ASD in that DIR®/Floortime™ focuses on the underlying deficits (i.e., sensory processing concerns) that lead to symptoms of autism rather than focusing specifically on the child’s negative symptoms and behaviors. At Lakeside Center for Autism we value this interdisciplinary approach that focuses on emotions, relationships, and affect which in turn enables us to understand and alleviate the primary deficits that may be hindering a child with ASD.
