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Monday, May 23, 2016
Therapies for Autism - What is DIR? (RDI Floortime Greenspan Method P.L.A.Y.)
What is DIR Floortime?
From wiki and more links below.
The Developmental, Individual-differences, Relationship-based (DIR) model is a developmental model for assessing and understanding any child's strengths and weaknesses. It has become particularly effective at identifying the unique developmental profiles and developing programs for children experiencing developmental delays due to autism, autism spectrum disorders, or other developmental disorders. This Model was developed by Dr. Stanley Greenspan and first outlined in 1979 in his book Intelligence and Adaptation. However, it has been listed by the National Autism Center in their National Standards Project Phase 2 as having an "unestablished level of evidence." "The Play Project" - a version of DIR which was developed by Richard Solomon, established evidence-based status for their approach through a 3-year study by NIMH which was published last year.
The Developmental, Individual-difference, Relationship-based (DIR) model is the formal name for a new, comprehensive, individualized approach to assess, understand, and treat children who have developmental delays (including Autism Spectrum Disorder). Focusing on the building blocks of healthy development, this approach is also referred to as the "Floortime" or "DIRFloortime" approach. However, Floortime is actually a strategy within the DIR model that emphasizes the creation of emotionally meaningful learning exchanges that encourage developmental abilities.
The goal of treatment within the DIR model is to build foundations for healthy development rather than to work only on the surface of symptoms and behaviors. Here, children learn to master critical abilities that may have been missed along their developmental track. For example, Autism Spectrum Disorder (ASD) has three core/primary problems: (1) establishing closeness, (2) using emerging words or symbols with emotional intent, and (3) exchanging emotional gestures in a continuous way. Secondary symptoms (perseveration, sensory-processing problems, etc.) may also exist. Thus, treatment options are based on particular underlying assumptions. The DIR model is based on the assumption that the core developmental foundations for thinking, relating, and communicating can be favorably influenced by work with children’s emotions and their effects.
The DIR model was developed to tailor to each child and to involve families much more intensively than approaches have in the past. Through the DIR model, cognition, language, and social and emotional skills are learned through relationships that involve emotionally meaningful exchanges. Likewise, the model views children as being individuals who are very different and who vary in their underlying sensory processing and motor capacities. As such, all areas of child development are interconnected and work together beneficially.
The Interdisciplinary Council on Development and Learning (ICDL) holds registered trademarks in the United States and/or other countries for DIR, DIRFloortime, and Floortime.
The DIR model is broken down into milestones (AKA capacities) (i.e., stages of development) that are gauged in normally developing children (versus children who have developmental delays).
In babies from 0 to 2 months, Milestone One involves self-control/self-regulation and interest in the world. The focus here is shared attention, which involves learning and interacting socially. Children need to learn to stay calm, to focus, and to actively take in information from their experiences with others.
Milestone Two occurs in ages 2 to 6 months. It involves relating and engagement whereby babies learn to recognize patterns, such as patterns of language in the flow of conversation. From there, they can internalize and process those patterns into something meaningful; for example, they understand cognitively that they can use language to obtain a desire.
Milestone Three involves intentional two-way communication and occurs by 6 months, when babies begin to convert emotions into signals for communication. But in order for this to happen, primary caregivers must read and respond to babies’ signals while also challenging the babies to read and respond to theirs.
Milestone Four involves social problem-solving, formation of a sense of self, and mood regulation, which occurs between 9 and 18 months. Babies use two-way communication to solve problems by employing patterns that involve a few steps to achieve a desired goal. For example, the baby can engage a parent and use eye gaze to get a desired goal or can grab a caregiver’s hand and pull toward his/her plate to indicate the desire for more food. Later, this process helps children to put words together into a sentence. Progress here is built on emotional interactions that increasingly become more complex.
Milestone Five occurs around age one, involving the creation of symbols and the use of words/ideas. "Using ideas" is defined as the meaningful use of pictures, words, or symbols to communicate something (in contrast to scripting or repeating).
Milestone Six, which occurs in toddlers around two years of age, regards emotional thinking, a sense of reality, and logic. Here, to create a new understanding of reality, one must logically connect his/her own idea to someone else’s. Emotional investment in relationships helps children to recognize the differences between their own and others’ ideas and behaviors.
Milestone 7 presents multi-causal and triangular thinking in which a child between ages 5 and 7 begins to recognize and process multiple causes for emotions and events.
During Milestone 8, between ages 7 and 10, emotionally differentiated thinking and gray-area thinking occur. Here, the child begins to understand the varying degrees or relative influences of events, feelings, or phenomena (e.g., "I’m only a little sad").
Last, Milestone 9, which arrives between puberty and early adolescence, involves a growing sense of self and reflection on an internal standard. This means that more-complex emotional interactions are helping the adolescent to progress into thinking in relation to an internal standard of an expanding self (e.g., "I was more angry than usual").
These nine functional emotional-developmental capacities continue to develop throughout life, but they need to happen sequentially, building upon the prior capacity, in order for the child to adapt and develop healthily.