What is Floortime Therapy?

Understanding Floortime Therapy

Floortime therapy, also known as the Greenspan Approach or DIR/Floortime, is a relationship-based therapy designed to support children with autism in their development and interaction through play. It was developed in the 1980s by Dr. Stanley Greenspan and Dr. Serena Wieder. The therapy is based on the Developmental Individual-difference Relationship-based model (DIR) and focuses on promoting emotional and intellectual growth in children with autism.

Origins of Floortime

Floortime therapy was created by child psychiatrists Dr. Stanley Greenspan and Dr. Serena Wieder in the 1980s. They developed the therapy based on the Developmental Individual-difference Relationship-based model (DIR). The primary idea behind the DIR/Floortime Model is that all children, including those with autism and other disabilities, need to reach specific milestones in their development to continue growing emotionally and intellectually. Floortime therapy provides intense, individualized support to help children reach these milestones.

Principles of Floortime

The principles of Floortime therapy revolve around engaging children in child-led, playful interactions to foster emotional and cognitive growth. The therapy emphasizes the following key principles:

Follow the child's lead: Floortime sessions are child-centered and follow the child's interests and preferences. The therapist joins the child on the floor, entering their world of play, and actively engages in activities that capture the child's attention.
Building a relationship: Floortime therapy focuses on building a strong and nurturing relationship between the child and therapist. This relationship forms the foundation for meaningful interactions and promotes the child's emotional development.
Meeting the child at their developmental level: The therapist meets the child at their current developmental level and supports them in moving forward. This approach ensures that the therapy is tailored to the child's specific needs and abilities.
Expanding circles of communication: Floortime therapy aims to expand the child's communication skills by encouraging back-and-forth interactions. The therapist follows the child's lead, acknowledges their nonverbal and verbal communication attempts, and helps them build on those skills.
Promoting problem-solving and thinking skills: Through play-based interactions, Floortime therapy encourages the child to problem-solve, think creatively, and use their imagination. This helps develop cognitive skills and enhances the child's ability to navigate their environment.

Floortime therapy provides a child-centered and individualized approach to autism intervention, focusing on fostering emotional development, enhancing communication skills, and promoting daily living skills. By understanding the origins and principles of Floortime therapy, parents and caregivers can gain insight into this innovative therapeutic approach and its potential benefits for children with autism.

Benefits of Floortime Therapy

Floortime therapy, also known as Developmental, Individual-difference, Relationship-based (DIR) Floortime therapy, has been shown to offer significant benefits for children with Autism Spectrum Disorder (ASD). This child-led approach focuses on emotional development, communication enhancements, and progress in daily living skills. Let's explore these benefits further.

Emotional Development Improvements

Floortime therapy prioritizes emotional development over isolated skills like speech, motor, or cognitive abilities. By engaging children at their level and following their lead, Floortime aims to help children expand their circles of communication and build on their strengths [2]. Research studies have shown that Floortime therapy is effective in building social communication skills and engagement among children with autism.

Communication Enhancements

Through Floortime therapy, children with autism have the opportunity to improve their communication skills. Therapy sessions involve engaging the child in various activities, following their lead, and encouraging back-and-forth play to enhance shared attention and problem-solving skills. The child's communication skills are nurtured, allowing for the development of meaningful connections and interactions with others [4].

Daily Living Skills Progress

Floortime therapy also focuses on progress in daily living skills. By participating in child-led activities, therapists and caregivers can help children with autism develop and improve their ability to perform essential daily tasks. These skills may include self-care routines, social interactions, and problem-solving abilities.

It's important to note that Floortime therapy sessions typically last from two to five hours a day, and the involvement of parents and caregivers is crucial in the therapy process. The therapy emphasizes building a strong relationship between the child and the caregiver, leading to progress in emotional development, communication, and daily living skills.

Floortime therapy has shown to be an evidence-based and cost-effective approach for engaging children with autism, providing substantial progress in different levels of functioning. While it may not be sufficient on its own for children with higher support needs, Floortime therapy can be a powerful tool for building skills, emotional connections, and enhancing the overall well-being of children with autism.

Contrasting Floortime with ABA Therapy

When it comes to interventions for children with autism, two commonly discussed approaches are Floortime therapy and Applied Behavior Analysis (ABA) therapy. While both aim to support children with autism, they differ in their approach to therapy and therapeutic focus.

Approach to Therapy

Floortime therapy, also known as the Greenspan Approach or DIR/Floortime, is a relationship-based therapy developed by Dr. Stanley Greenspan and Dr. Serena Wieder in the 1980s [1]. This therapy involves therapists and caregivers engaging with the child through play and activities that the child enjoys, typically on the floor. The focus of Floortime is on building a strong emotional connection and promoting the child's development and interaction through play.

On the other hand, ABA therapy, developed by O. Ivar Lovaas in the 1960s, is based on the science of learning and behavior. ABA therapy uses positive reinforcement techniques to encourage desired behaviors and teach new skills. It typically involves therapist-led sessions with specific skill targets, following a structured and scheduled approach.

Therapeutic Focus

Floortime therapy primarily focuses on emotional development and building relationships. It is child-led, allowing the child to take the lead in play and interaction. Through these interactions, therapists and caregivers aim to expand the child's circles of communication and build on their strengths. Floortime therapy emphasizes meeting the child at their level and engaging with them in a way that supports their individual needs and interests.

In contrast, ABA therapy focuses on teaching specific skills and behaviors, such as communication, social skills, and activities of daily living [1]. ABA therapy uses structured teaching methods and positive reinforcement to encourage the child to acquire and generalize these skills across various settings.

While both Floortime and ABA therapy aim to support children with autism, the key differences lie in their approach to therapy and therapeutic focus. Floortime therapy emphasizes building relationships and emotional development through child-led play and interaction. ABA therapy, on the other hand, focuses on teaching specific skills and behaviors through structured sessions and positive reinforcement. Each approach has its own merits, and the choice between them may depend on the individual needs and preferences of the child and their family.

Implementing Floortime Therapy

To effectively implement Floortime therapy for children with autism, therapy sessions and the involvement of parents and caregivers play vital roles.

Therapy Sessions

Floortime therapy sessions typically last from two to five hours a day. During these sessions, the parent, caregiver, or therapist engages with the child in play and activities that the child enjoys [1]. The sessions are usually conducted on the floor, as the name "Floortime" suggests, to create a comfortable and interactive environment.

The focus of Floortime is to follow the child's lead and participate in play or activities chosen by the child. This approach helps maintain the child's focus and encourages back-and-forth play, also known as "opening and closing circles of communication". By joining the child in their world of play, therapists and caregivers can establish a strong connection and promote emotional engagement.

Involvement of Parents and Caregivers

One of the unique aspects of Floortime therapy is the active involvement of parents and caregivers. Parents are encouraged to actively participate in therapy sessions and become co-therapists with the guidance of professionals. This involvement helps parents develop a deeper understanding of their child's strengths, challenges, and individual needs.

By participating in Floortime therapy sessions, parents and caregivers can learn how to engage with their child at their level, play, and interact based on the child's interests and actions. This approach allows the child to feel seen, heard, and valued, fostering a stronger sense of connection and trust within the therapeutic relationship.

In addition to participating in therapy sessions, parents and caregivers are encouraged to continue Floortime principles and techniques during everyday interactions with their child. By incorporating Floortime strategies into daily routines and activities, parents and caregivers can continue to support their child's emotional development, communication skills, and problem-solving abilities.

Overall, the active involvement of parents and caregivers in Floortime therapy is crucial for its successful implementation. Through their participation and dedication, they can provide ongoing support and create opportunities for their child's growth and development both inside and outside of therapy sessions.

Effectiveness of Floortime Therapy

Floortime therapy has gained recognition as an effective intervention for individuals with autism spectrum disorder (ASD). Extensive research and studies have been conducted to evaluate the efficacy of Floortime therapy in improving various aspects of autism. While the research supports the benefits of Floortime, there are also limitations and the need for further research in certain areas.

Research and Studies

Floortime therapy is evidence-based and supported by strong research. Studies have shown evidence supporting improvement in core issues in autism through Floortime or developmental interventions based on Floortime, as expressed by Stanley Greenspan, a pioneer in the field of Floortime.

A study published in the National Center for Biotechnology Information (NCBI) highlighted the effectiveness of Floortime therapy in engaging children with ASD and their parents. It showed substantial progress in different areas of functioning, including emotive functioning, communication, and daily living skills. Parent-child interactions also improved, as reported by mothers. Importantly, no adverse events were observed during Floortime sessions [5].

Additionally, research studies have demonstrated positive effects of DIR/Floortime therapy. It has been found to improve interactions between parents and children, enhance children's social and emotional development, and build social communication skills and engagement among autistic children.

In a 2003 study, Floortime therapy significantly improved emotional development and reduced core symptoms of autism in a child named Joey. The child engaged in six daily Floortime sessions over three years with his father, as concluded by Dr. Greenspan and Dr. Weider. Another pilot study conducted in 2007 further supported the effectiveness of Floortime in enhancing emotional development [2].

Limitations and Future Research

While the existing research provides support for the effectiveness of Floortime therapy, there are limitations and areas that require further investigation. Some studies have highlighted the need for more high-quality research to assess the impact of Floortime therapy on children's communication and adaptive skills.

It is essential to recognize that each child's progress and experience with Floortime therapy may vary due to the uniqueness of their individual needs and characteristics. Therefore, measuring success and outcomes can be challenging. Future research should aim to address these limitations, explore the long-term effects of Floortime therapy, and further investigate its impact on various aspects of autism.

In conclusion, research and studies provide evidence supporting the effectiveness of Floortime therapy in improving emotional development, communication, and daily living skills in children with autism. However, more research is needed to comprehensively assess its impact on communication and adaptive skills. Floortime therapy continues to be a valuable intervention for individuals with autism, and ongoing research will further contribute to its development and refinement.

Getting Started with Floortime

If you are considering implementing Floortime therapy for a child with autism or other developmental disorders, it's important to understand the training and certification involved, as well as the role of professionals in the therapy process.

Training and Certification

Floortime therapy requires specialized training and certification to ensure that professionals have the necessary skills and knowledge to effectively implement the therapy. Professionals who oversee the program and provide guidance for home implementation must have training from the Interdisciplinary Council on Development and Learning (ICDL), which certifies them in the DIR/Floortime Model. This certification ensures that professionals are equipped with the expertise to tailor the therapy to the unique needs of each child.

Parents and caregivers can also participate in training programs to learn how to implement Floortime techniques at home. These programs allow parents to become actively involved in the therapy process and create a supportive environment for their child's development. While parents may not require formal certification, training programs can provide valuable insights and strategies for effectively engaging with their child and promoting progress.

Role of Professionals

In addition to DIR/Floortime certified professionals, other professionals may also be involved in delivering Floortime therapy. These professionals can include psychologists, speech pathologists, occupational therapists, teachers, and aides [3]. Their expertise and specialized knowledge complement the Floortime approach, allowing for a comprehensive and individualized therapy program.

Each professional brings a unique perspective and skill set to the therapy process. Psychologists can provide psychological assessments and help address any underlying emotional or behavioral issues. Speech pathologists focus on improving communication skills, while occupational therapists assist with sensory integration and daily living skills. Teachers and aides can support the child's educational and social development within a Floortime framework.

Collaboration and communication among professionals, parents, and caregivers are essential for the success of Floortime therapy. By working together as a team, these individuals can provide the necessary support and guidance to help the child progress in their emotional and cognitive development.

It's important to note that while Floortime therapy can be a valuable tool for building skills and emotional connections, it may not be sufficient on its own for children with higher support needs. Additionally, the availability of Floortime therapy may vary, as it is not widely implemented in schools, and it may not be covered by insurance, potentially making it a costly option. However, for those who choose Floortime as a therapeutic approach, the commitment of trained professionals and the active involvement of parents and caregivers can make a significant difference in the child's developmental journey.