The DIR Model is an assessment and treatment framework that was created by child psychiatrist, Stanley Greenspan, M.D., and clinical psychologist, Serena Wieder, Ph.D., for children with autism spectrum disorder (ASD) and other developmental conditions. Floortime is the treatment approach used by clinicians, teachers, and parents to implement the DIR Model with the goal of promoting the development of social, emotional, and cognitive skills.
What is the DIR Model?
The DIR model stands for: Developmental, Individual differences and Relationship-based model. Under the DIR model, each child has a unique developmental profile that is made up of their functional emotional developmental levels (9 milestones), individual differences, and important relationships (including the caregiver/child relationship) that facilitate learning.
What are the 9 functional emotional developmental milestones?
The first component of the DIR Model is the functional emotional developmental milestones that the child progresses through.
- Shared Attention: This milestone includes the child’s ability to self-regulate (behavior and attention), the development of an interest in the world including sensations in the environment (i.e., sights, sounds, smells, and movements), and the ability to share attention with another person. Shared attention typically emerges from 0-3 months old.
- Engagement: This milestone involves the ability to engage and relate with others to form relationships which typically emerges from 2 to 7 months old.
- Intentional Communication: This milestone involves the child’s ability to communicate and interact in a purposeful way (two-way communication) and typically emerges from 3-10 months old.
- Complex Communication: This milestone involves the child’s ability to communicate in a more complex way (including facial expressions, body language, gestures, and words (if verbal communication has developed)), problem solve with others, development of a sense of self. This milestone typically emerges from 9 to 18 months old.
- Creative Use of Ideas and Symbols: This milestone involves the child’s ability to think symbolically and creatively, express him or herself using emotional language, and engage in pretend play. This milestone typically emerges from 5 to 4 years old.
- Logical Thinking: This milestone involves the child’s ability to form mental connections between ideas. This milestone typically emerges from 3 to 4.5 years old.
- Comparative Thinking: This milestone involves the child’s development of more complex reasoning including understanding that there are multiple causes for an effect and the ability to compare and contrast. Comparative thinking typically emerges from 6 to 10 years old.
- Gray Area Thinking: This milestone involves the child’s ability to understand different “levels” of an emotion, understand the consequences of behaviors, and develop more complex problem-solving skills. This milestone emerges from 6 to 10 years old.
- Reflective Thinking: This milestone involves the child’s development of a more complex sense of self including the development of personal values. The child is also able to reflect on their thoughts and feelings in connection to their sense of self. This milestone typically emerges at around 9 years old.
What are individual differences in the DIR Model?
The second component of the DIR Model is the understanding that each child has individual strengths and weaknesses. The individual differences describe each child’s level of motor development (fine and gross motor skills, motor planning, sequencing, balance and coordination), auditory and language processing (expressive and receptive language), visual-spatial processing (tracking and scanning, visual thinking), and sensory modulation and processing (unique sensory profile – including over or under reactivity to the senses, vestibular, and proprioceptive systems).
What is the relationship component of the DIR Model?
The third component of the DIR Model is the child’s important relationships including the child’s relationship and interactions with their caregiver(s), teacher(s), and therapist(s). These relationships are crucial to the child’s growth and development helping the child progress through the 9 functional emotional milestones. In order for these relationships to be beneficial, the caregivers, teachers, and therapists must understand and take into account the child’s individual differences while interacting with the child.
What is the Floortime Approach?
Floortime is the main treatment approach under the DIR Model; it is a play-based, child-led approach in which caregivers, therapists, and teachers interact and play with the child on the floor.
Before beginning treatment, the first step of the Floortime approach involves assessing the child to determine their developmental level, individual differences, and relationships with family and peers. The assessment includes screening with the Greenspan Social-Emotional Growth Chart and a comprehensive assessment from an interdisciplinary team (e.g. occupational therapy, speech therapy, social work, psychologist, psychiatrist, teacher, etc.) to determine the child’s functional developmental level, strengths and weaknesses, and relationship strengths and challenges.
Once the assessment process is complete, the interdisciplinary team creates an individualized intervention plan that takes into account the child’s unique developmental profile.
What is involved in the Floortime Intervention?
The individualized intervention plan will include strategies to be used at home, specific therapies (e.g., occupational therapy, speech therapy, physical therapy), educational programs, and playdates with other children.
What are the essential components of Floortime?
There are three crucial aspects of Floortime:
- The approach is child-led.
- The approach involves facilitating and challenging the child’s creativity.
- The approach involves broadening the interaction and play to include many senses, motor skills, and emotions; this will facilitate learning, development, and sensory integration.