Floortime Strategies to Promote Development in Children and Teens

A User’s Guide to the DIR® Model

by Andrea Davis, Ph.D. Lahela Isaacson, M.S. and Michelle Harwell, M.S.

Contents

• About the Authors .ix
• Foreword—Serena Wieder.xi
• How to Use This Book xv
• Introduction xvii
• Acknowledgments xxiii

Core Methods A. Basic Strategies to Promote Social-Emotional and Intellectual Development. 1

A.1 Follow cues: Provide sensitive interactions by following cues .2
A.2 Be responsive: Always respond to all communication. 4
A.3 Build upward: Meet your child or teen at current developmental capacity .6
A.4 Use play: Use play and playfulness as primary means to engage and teach. 8
A.5 Use natural interests: Capitalize on natural interests to elicit higher skills .10
A.6 Use problems: Set up situations that invite child-initiated solutions .12
A.7 Pretend play: Create opportunities to use ideas in symbolic (pretend) play .14
A.8 Embrace feelings: Help embrace a wide range of feelings .16
A.9 Enrich ideas: Help enrich ideas or stories in play and conversation. 18
A.10 Self-reflect: Take a reflective stance toward yourself in interactions. 20

Core Methods B. Understanding and Addressing Individual Differences in Processing Profiles ... 23

B.1 Child's profile: Identify and understand your child's or teen's profile of strengths and weaknesses ... 26
B.2 Adult's profile: Consider your individual differences ... 30
B.3 Adapt yourself: Adapt your interactive style to your child's or teen's unique profile ... 32
B.4 Calm or energize: Provide motor or sensory inputs as needed to calm or energize ... 34
B.5 Home design: Set up the home environment to accommodate the unique sensory profile ... 36
B.6 Sensory connections: Provide daily sensory-motor relational experiences ... 38
B.7 Practice in play: Provide daily planned play activities to address processing challenges ... 40

About the Authors

Andrea Davis, Ph.D.

Director and Founder, Greenhouse Therapy Center, 685 East California Boulevard, Pasadena, California 91106
Andrea Davis received her B.A. in psychology from Swarthmore College, M.A. in theology from Fuller Theological Seminary, and Ph.D. in clinical psychology from Fuller Graduate School of Psychology. She completed her postdoctoral fellowship in infant mental health and early childhood disorders at Brown University Medical School.

Lahela Isaacson, M.S., LMFT

DIRFloortime Supervisor and Program Manager, Greenhouse Therapy Center
Lahela Isaacson has devoted her professional career to working with children with special needs using the DIRFloortime ® model.

Michelle Harwell, M.S., LMFT

Owner, Michelle Harwell Therapy, 2120 Colorado Boulevard, Suite 2, Los Angeles, California 90041
Michelle Harwell is an expert training leader and supervisor in DIRFloortime and an infant mental health and early intervention specialist.

How to Use This Book

This book is designed to help professionals and parents more easily grasp and practice basic DIRFloortime ® methods at home with children and teens. While the techniques are very useful for advancing the development of all children and adolescents, they are particularly relevant when there are developmental challenges including attention deficit disorder, sensory processing disorder, language delays, motor problems, trauma history, or autism spectrum disorder.

Introduction

Welcome to a journey of learning a new approach to helping children and teens reach their highest social-emotional and intellectual potential. DIR ® , or the Developmental, Individual Differences, Relationship-Based model, is a unique intervention approach developed by Drs. Stanley Greenspan and Serena Wieder.

What Is DIRFloortime?

The DIRFloortime Pyramid is a graphic representation of Drs. Greenspan and Wieder’s model; at our center we use the pyramid with families to make the approach easier to visualize. To sum up the basic idea, we say social-emotional and cognitive growth happens in the following manner:

• Adults in Floortime attune, engage, respond, expand, pretend, challenge, and reflect.
• Children and teens in Floortime regulate, connect, reciprocate, communicate, create, think, and self-reflect.

Steps to Begin DIRFloortime Home Intervention

1. Assessment: Obtain a comprehensive developmental evaluation or assessment of your child or teen’s individual differences.
2. Focus: Ask the educational and therapeutic team to help you select which pages of this DIRFloortime book might be most appropriate for your situation.
3. Guidance: Schedule regular sessions with a local professional who has extensive training and experience in DIR.
4. Update: Have a DIR professional implement the Floortime strategies alongside you or review home video clips to help you monitor ongoing progress.

Overview of the Book’s Structure

Core Methods A. Strategies to Promote Social-Emotional and Intellectual Development

Learning to attend to cues, determining and meeting the current stage of social-emotional capacity.

Core Methods B. Understanding and Addressing Individual Differences in Processing Profiles

Observing and using individual differences in sensory, motor, visual, auditory, and language processing capacities.

Capacity 1. Regulation and Attention

Attaining a Calm, Alert, Attentive State

1.1 Support regulation: Help your child or teen get regulated before expecting more. 1.2 Notice and adjust: Notice and adjust your intensity to support an optimal arousal level. 1.3 Calming choices: Offer choices for help in calming down. 1.4 Lengthen attention: Attend to and join interests to expand focus and attention. 1.5 Avoid flooding: Support regulation at early stages of upset. 1.6 Practice modulation: Practice modulation regularly in fun, playful ways.

Support Regulation

1.1 Help your child or teen get regulated before expecting more.
Why? Being in a calm, alert state is required before higher capacities can be expressed.
How do we get there? Notice and manage your own regulation states in order to be able to interact calmly.