DIR / Floortime You Can Do At Home
By Dr. Anna Ho
The DIR model was developed with a pool of research and expertise in child psychiatry, developmental psychology, brain science, speech language pathology and occupational therapy. There are three key elements: “D” represents the developmental milestones that each child has to master in order to mature, from being able to remain calm while maintaining attention, to being engaged with another person, communicating back-and-forth, and then using symbols to problem-solve logically; “I” represents the individual differences in the child’s sensory reception and motor response to the world, which must be addressed specifically in order for us to engage them; “R” represents the emphasis in parentchild relationship which will be enhanced with specific techniques.
DIR model is also called the “Floortime Model” as Floortime is the core approach designed by the DIR developers to achieve a child’s social emotional goals. However, this model does not exclude other treatment methods such as ABA, TEACCH, etc. The idea is that these methods are helpful in teaching the child how to perform important life skills, while the Floortime techniques enhance the emotional motivation behind these skills, so that the child would want to do them.
While some families use DIR as a supplement to the more traditional treatment methods, others have used it as the key or guiding model in their children’s treatment. Some research studies suggested that comparing to traditional behavioral treatment, DIR may be more effective with children who are non-verbal and showing more severe autistic symptoms. With verbal and higher-functioning children, practitioners and families have found DIR useful in helping these children become more spontaneous and socially appropriate while interacting with others.
Since each child is different, the activities used in DIR may also differ across children as they are tailored to their individual needs. However, according to guidelines informed by this model, here are some activities that are usually helpful to children at each developmental level:
Stage 1 (the goal is to help your child be calm and alert) – “Cradle time”: depending on the size and interests of your child, you may cradle him/her in your arms, in a blanket, or in a comfortable rocking chair. Help them feel secure and comfortable by observing their expressions. Adjust the speed of movement, stop and go again according to the signals from your child. E.g., when you are not moving, if they look at you and/or move your hand to signal “more”, you move them again.
Stage 2 (the goal is to engage your child into emotional closeness) – “Copycat”: copy what your child loves to do in the moment when he/she is doing it. It could be something you don’t think is fun, such as spinning an object on the table. Look for your child’s expression. Go for a sense of pleasure or amusement. When he/she starts looking at you or your action, he/she is somewhat engaged. Then try to expand that by doing it in a slightly different way – to lengthen their pleasure and attention on you.
Stages 3 & 4 (the goal is to entice your child to initiate and respond in communication) – “Undoing”: entice your child to respond to you by building something for him/her to take apart, e.g., a block tower. Make a tall one and your child may come right up to tear it down. Then you build it again, and again. Then pause, put a block in your child’s hand. He/she may start putting two blocks together, so as to take them apart. That way you may pull your child into multiple give-and-take communication cycles, which would become building blocks for speech.
Stages 5 & 6 (the goal is to help your child express ideas and connect them in emotionally meaningful ways): “Character Play” – pretend play as your child’s favorite character. Speak and express feelings through the character’s voice and position. Instead of telling your child, “Give Barney a cookie”, speak as Barney, “I’m hungry!” with a begging voice while making Barney sniff around the cookies. Negotiate and resolve problems as characters with your child. They will be inspired to do the same.
Dr. Anna Ho is a Doctor of Clinical Psychology in Dallas, TX.