What is DIRFloortime?
This past year I got certified in the Basic Level of DIRFloortime and this certification has forever changed my therapeutic approach in working with children.
When I talk to parents interested in music therapy, I make sure to explain that my approach might be a bit different than what they might be used to seeing in Applied Behavioral Analysis (ABA) therapy. While there are things from ABA that I have gleaned and use, I have found that it does not support the child in every aspect.
Most approaches in therapy for children with disabilities is taught through the lens of fixing behaviors. But what research has found is that children are taught behaviors that are fixed to a social standard. Much of the child’s potential is repressed to fit into a mold that does not suit them or their needs.
Example: “Is your child with autism stemming in public? We need to teach them how to mask so that they don’t do that and make people feel awkward”. While this may be a more “severe” example, these are the things we as a society we often overlook for children with autism. It is not the child’s behaviors that need to change so much as our perceptions and understanding of autism and how that child needs to feel regulated by stemming.
DIR stands for Developmental, Individually-differences and Relationship-based and is an approach to working primarily with children with autism developed by Dr. Stanley Greenspan. However, it can be applied to all children. Essentially, this approach looks at the developmental level of the child instead of where they should be behaviorally at a certain age. For example, a child may be 6 but developmentally his communication skills are at the level of a 2 year-old. Individual differences honors the sensory needs of the child. Are they afraid of big sounds? Do they need extra time in completing tasks? Do they need proprioceptive input? Do they have anxiety around certain things? Visual needs? And the relationship-based emphasizes the importance of building a relationship based around connection and safety and this is done through co-regulating with the child.
I love the way this Pediatric Occupation Therapist explains co-regulation:
Much of DIRFloortime is sculpted around research around the nervous system. Stephen Porges, a pioneer in Polyvagal Theory, emphasizes our automatic nervous system’s need for survival dating back to our cavemen era and how our nervous system reacts with a fight, flight, freeze or fawn stance depending on the situation. For us humans nowadays, this still shows up. Many of us, without really knowing, have learned to stay and fight or turn and flee when our nervous systems encounter danger. This can show up in relationships. When we feel threatened, our nervous system reacts in the best way it knows how to protect ourselves.
What is often overlooked, I believe, is that children with disabilities have nervous systems. Their nervous systems are doing the same thing as everyone else’s with added complications that make processing and understanding it difficult. So it is up to us to guide and help them discover their needs. Children cannot grow or learn if they don’t feel emotionally safe. Their academic, emotional, cognitive, and even physical growth is stunted.
It is important for children to learn how to play, since play is how children often express their emotions, frustrations, or fears in a safe way where they are in control. Because of this, when I am first starting out with a child, much of the sessions are child-led. What interests them most? Sometimes, we don’t even do music right away. I might try a few music interventions to test their limits, but if they show disinterest, then music in this case is not a helpful therapeutic tool and must be introduced gradually. I may continue to challenge them by asking them to do something different, or by creating moments of sabotage in play, but ultimately, my primary goal is to make sure they feel safe with me in play. This greatly helps me discover things that the child is naturally good at, creative ideas that they might have or certain instruments and objects that they are more drawn to.
Thank you for reading!
For more information regarding DIRFloortime, please visit:
Books about DIRFloortime written by Stanley Greenspan: