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Floortime™ - Greenspan Method

Dr. Stanley Greenspan, a child psychiatrist, is known for his approach to treating children with autism and other developmental disorders. His method centers on interactions, while taking into account underlying sensory issues. The Floortime™ model mobilizes the child’s developmental capacities and is based on the thesis that effective interaction can harness cognitive and emotional growth.

Greenspan’s approach encourages the D.I.R.© (Developmental, Individual-difference, Relationship-based) Model or Developmental Approach to therapy. A systematic way of working with a child to help him climb the developmental ladder is the heart of this approach to therapy. It takes the child back to the very first milestone he may have missed and begins the developmental progress anew.

The six “functional milestones” are:

  1. self regulation and interest in the world
  2. intimacy
  3. two-way communication
  4. complex communication
  5. emotional ideas
  6. emotional thinking

The method includes an observation chart wherein the parent can assess through observation where the child stands on the development ladder and which milestones in particular need strengthening.

By working intensively with parents and therapists, the child can climb the ladder of milestones to acquire the skills he is missing. It can be implemented both as a procedure and as a philosophy, at home, in school, and as a part of a child’s different therapies such as speech or occupational therapy and together with conventional Discrete Trial-ABA therapy.

Part of the Greenspan method uses “Floortime™”, an intensive, 20 to 30 minute period when you get down on the floor with your child one-on-one, interact and play in a spontaneous and fun manner. By interacting in ways that capitalize on his emotions – by following his interests and motivations – you help him climb the developmental ladder. You can help him want to learn to attend to you, engage in dialogue, take initiative, to learn about causality and logic, to solve problems. The parent becomes the child’s very active play partner, who’s job it is to follow the child’s lead and play at whatever captures her interest, but in such a way that encourages interaction with you. For instance if she wants to build with blocks, you build with her, adding blocks to her tower, even knocking a block off her tower with an “oops” – doing whatever it takes to create an interaction.

The four goals in Floortime™ are:

  • Goal 1 - Encourage attention and intimacy
  • Goal 2 - Two way communication
  • Goal 3 - Encourage expression and the use of feeling and ideas
  • Goal 4 - Logical thought

The unique differences separating this intervention model from others is its focus on relationships and affect, developmental level, individual differences and comprehensiveness. The theoretical rational for this intervention is that the child’s symptoms are often secondary to underlying biologically based processing difficulties. Relationships and affective interactions become derailed secondarily. These secondary disturbances, however , have a very large range of possible configurations and are often more rapidly responsive to intervention than the underlying processing dysfunctions. Therefore the first goal of the intervention is to help the child try to work around the processing difficulties and to re-establish affective contact with primary caregivers and begin the process of mastering the pre-symbolic stages that serve as a basis for language and other higher-level symbolic capacities. Specific processing difficulties continue to be treated through speech therapy, occupational therapy, special education, and other therapies.

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