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Julie McIsaac
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April 27, 2022

What is DIR Floortime? Is it right for my autistic child?

Many families are drawn to Floortime because they want to understand why their Autistic child behaves a certain way. Here is my experience as a child therapist.

Image shows a Black floortime [capitalize?] therapist smiling, seated crossed legged playing with paper boats on the floor with a 6 year old boy. The therapist has black twists and is wearing a blue shirt and grey pants with black ankle socks. The b…

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I’m a parent of three children with varying needs. I know how hard it is to know which therapy is the best fit to support your child. I’m also a child development therapist trained in Floortime. My training has influenced my work and my relationships.

In the area where I live, ABA (applied behavioral analysis) is the most common intervention for Autism. I am sharing my perspective to help inform parents that it is not the only option.

When it comes to understanding human development, I’ve always been drawn to models that value relationships. When it comes to disability, I’ve looked for strength-based models. And when it comes to cognitive development, or developing thinking skills, I’ve learned we cannot underestimate the power of play.

The way we relate to one another and the way in which we interact with the world form a foundation for learning and emotional health.

Floortime (also known as DIRFloortime) is an intervention that is used to promote an individual’s development through a respectful, playful, joyful, and engaging process. It uses the power of relationships and human connections to promote the development of the capacities for self-regulation, engagement, communication, shared social problem solving, and creative, organized, and reflective thinking and reasoning. (icdl.com)

Many families are drawn to Floortime because they want to understand why their Autistic child behaves a certain way (why do things have to be a certain way all the time? Why must the pez containers be lined up in that way? Why won’t he look at me?). Floortime falls into the category of developmental approaches to thinking about behavior. In other words, this perspective views the child’s behavior through the lens of the cognitive, social, emotional and sensory systems. In this model, the behavior is not addressed directly, but the child’s overall development is supported. The behavior provides the clues to help us understand how to do that.

Although it is usually associated with Autism, Floortime is a way of thinking about a child’s development and is not diagnosis specific.

Floortime is an intervention that reaches across disciplines. It is provided by speech and language pathologists, physical therapists, occupational therapists, mental health providers, medical doctors, educators or child developmental specialists. Usually through parent or caregiver coaching, the therapist uses a developmental framework to join a child where they are and builds upon their strengths and interests. When done well, it looks easy and seamless. This is deceiving. This work requires a solid understanding of child development; our brains, our emotions and our senses.

So, what does Floortime look like? That’s the fun part.

Floortime looks like a child swinging on a platform, laying on his belly, with headphones on, while interacting with a therapist working on speech goals.

Floortime looks like playing a videogame together while the therapist is challenging the child to expand their shared problem-solving abilities or flexible thinking.

Floortime looks like a conversation with my husband when I realize that I can’t ask him to problem-solve with me until he’s calm, regulated, and engaged again. (Yes! You can use floortime with your spouse too!)

Floortime looks different for different people in different settings. Which is exactly why it makes sense to me.

To help you decide if it’s right for your family, I’ll share what I’ve learned over the years:

  1. Get comfortable feeling uncomfortable. This is easier said than done. I learned early on that while you can have an agenda for a session (as a therapist) or an expectation for playing with your child (as a parent), you need to be able to let go of the structure of what you thought you were going to do depending on what child walks through the door. You don’t always know what happened at school that day, or how they slept last night. But following the child’s lead means listening, observing, and showing respect for what comes in the room with that child. Feeling uncomfortable is ok. Listen to it.

  2. The phrase “Following the child’s lead” is misleading. ‘Following the child’s lead’ is commonly associated with Floortime. But it does not mean you need to do only what the child wants to do. It means joining the child where they are developmentally. If a child is sitting by herself playing with trains and is not interested in engaging with you, play with trains beside her. Gently try to join your train on her caboose. Does she let you or does she turn her back to you? Either way, she is communicating, and you’ve learned something that can guide future interactions.

  3. Make assumptions. Assume the non-speaking child in front of you has a lot to say. Assume the child who stiffens up when hugged is searching for connection in a different way. Presume competence in your child—it is respectful, inclusive and the way we all want to be treated.

  4. Don’t make assumptions. I can be the most empathetic person you’ve met, but at the end of the day my experience is my experience. I can imagine what someone else’s experience may be but I cannot assume I know. We all have stories and experiences that shape our behavior. If we react to a behavior based on our own experiences, we are likely to miss something. This applies to our gender, race, experience being a parent, our experiences in school, etc. I once worked with a child whose long hair was always in his face and it brought back memories of my own hair getting in my line of vision or bothering me as a child— I assumed this was irritating to him and was an easy fix–cut the hair. But I made assumptions. There were reasons, deep emotionally embedded reasons, why this child’s hair was long and that played into the dynamic of the relationship in the family. Knowing this informed my work with them.

  5. Be gentle with yourself. You can’t be 100 percent “on” 100 percent of the time. And guess what, it’s not even the ideal! Rupture and repair — the process of making a mistake and then apologizing or healing the relationship – is important for development. We all make mistakes. But it’s what we do with it that is the magic. Model respect and reflection. You are human. Just like your child. Talk about it.

  6. My training in Floortime has taught me that Floortime is not the answer. As parents, we often want to find the answer. But I encourage you to go back to your question. Instead of looking for a solution to a problem, Floortime can help you reframe your question; “how can I better understand my child? What can I do to help them get what they need?” Floortime strategies will give you tools to create the opportunity to learn from and with your child.

  7. And finally, the most recent and most important part of my learning journey–listen and be humble. Seek out Autistic adults or self-advocates, online or in-person, and learn from them. As parents, we turn to other parents walking in our shoes because we have shared experiences. It helps. But when it comes to understanding the experience of our kids, let’s turn to others walking in their shoes. If we choose to accept autism, we choose to listen to others’ experiences and respect differences of opinions. That is part of embracing our humanity and neurodiversity. We can only understand one another when we listen to one another. 

Play, wonder, be curious.

Floortime Resources:

Icdl.com (use this directory to find a provider near you: https://www.dirdirectory.com/home)

Profectum.org 

Affectautism.com

And for a few professionals working with and writing about a developmental model:

https://www.joshuafedermd.com

https://monadelahooke.com

https://www.mindsightinstitute.com

  • Julie McIsaac, Ph.D.

    Child Development and Disability Advisor

    Julie specializes in working with children and families with diverse developmental profiles She uses reflective practice, emotion-coaching, play and a relationship-based framework to support skill building in the areas of emotional-regulation and problem-solving. Julie consults with families, schools and community organizations. As a parent, she understands the need to have a cohesive team supporting a child and family.

    Profile Photo of Julie McIsaac
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