Social and Emotional Social and Emotional Development through Development through

FloortimeFloortime

By Megan Heath “M.J.T.”By Megan Heath “M.J.T.”

Tools of the TradeTools of the Trade

Applied Behavioral Applied Behavioral Analysis, DTT, Lovass Analysis, DTT, Lovass

PECS, Sign LanguagePECS, Sign Language TEACCH – visual TEACCH – visual

strategiesstrategies Sensory Integration Sensory Integration Social Skills TrainingSocial Skills Training Reciprocal Interactive Reciprocal Interactive

Play - “Floor Time”Play - “Floor Time” Theory of Mind, RDI, etc.Theory of Mind, RDI, etc.

What does a D.I.R. Program look What does a D.I.R. Program look like?like?

Sensory IntegrationSensory Integration Structured Instruction (ABA, TEACCH, Structured Instruction (ABA, TEACCH,

etc.) etc.) Applied Floor Time – Thematic ActivitiesApplied Floor Time – Thematic Activities Floor Time Sessions - 20 min. segments Floor Time Sessions - 20 min. segments

(6-8 times a day)(6-8 times a day) Augmentative Language Strategies if Augmentative Language Strategies if

neededneeded

What Is Floor time?What Is Floor time?

A floor time philosophy means engaging, A floor time philosophy means engaging, respecting, and getting in tune with respecting, and getting in tune with children in order to help them elaborate children in order to help them elaborate through gestures, words, and pretend play through gestures, words, and pretend play what is on their minds. As a technique, what is on their minds. As a technique, floor time is a five-step process that can floor time is a five-step process that can be used by early childhood teachers and be used by early childhood teachers and parents to help support children’s parents to help support children’s emotional and social development. emotional and social development.

Broad Goals of Floor TimeBroad Goals of Floor Time

To become more alertTo become more alert Take more initiativeTake more initiative Be more flexible Be more flexible Tolerate frustrationTolerate frustration Sequence longer actions – plan and Sequence longer actions – plan and

executeexecute Communicate gesturally and verballyCommunicate gesturally and verbally Take pleasure in learning Take pleasure in learning

Major DifferencesMajor Differences DevelopmentalDevelopmental Social-Emotional Approach-- Relationship-Social-Emotional Approach-- Relationship-

BasedBased Highly Individualized due to processing Highly Individualized due to processing

differencesdifferences Reinforcement comes first, then teach in Reinforcement comes first, then teach in

optimal moment of arousal, interest, and optimal moment of arousal, interest, and with affectwith affect

Not Start/Stop, but Continuous Flow ModelNot Start/Stop, but Continuous Flow Model Skills taught in functional “live” contextSkills taught in functional “live” context Process not productProcess not product

The D in the DIR ModelThe D in the DIR Model

““Developmental”Developmental”

Functional Developmental Functional Developmental RoadmapRoadmap

6. Building Bridges / Logical Thinking6. Building Bridges / Logical Thinking

5. Symbolic Ideas5. Symbolic Ideas

4. Problem Solving / Two- Way Complex 4. Problem Solving / Two- Way Complex CommunicationCommunication

3. Simple Communication / Gestures3. Simple Communication / Gestures

2. Engagement2. Engagement

1. Attention and Self Regulation1. Attention and Self Regulation

Pretend Play

ImitationCause Effect

Turn-taking

GesturesSoundsFacial

Expressions

Problem Solving First Words 2 Word phrases

QuestionsReciprocal

Statements

ConversationSkills

Eye Contact

Joint Ref

The I in the DIR The I in the DIR ModelModel

““Individual Difference”Individual Difference”

Individual DifferencesIndividual Differences

Every child has biologically based differences Every child has biologically based differences in sensory processing, modulation, muscle in sensory processing, modulation, muscle tone, motor planning and sequencingtone, motor planning and sequencing..

Including: Including:

1. Auditory processing1. Auditory processing 5. 5.Motor PlanningMotor Planning

2. Visual Spatial processing2. Visual Spatial processing

3. Tactile processing3. Tactile processing

4. Sensory Modulation4. Sensory Modulation

Seven SensesSeven Senses Visual- seeingVisual- seeing Auditory - hearingAuditory - hearing Tactile - touchingTactile - touching Olfactory - smellingOlfactory - smelling Gustatory - tastingGustatory - tasting Proprioceptive – input Proprioceptive – input

from our muscles and from our muscles and joints joints

Vestibular – Movement, Vestibular – Movement, balance, where we are in balance, where we are in relation to gravityrelation to gravity

* These are all inter-related

“the novacane child” -Rosemary White

Sensory Integration is the organizing and Sensory Integration is the organizing and processing of sensory information from the processing of sensory information from the different sensory channels and the ability to different sensory channels and the ability to relate input from one channel to that of another relate input from one channel to that of another in order to emit an adaptive response.in order to emit an adaptive response.

(Ayres, 1972)(Ayres, 1972) It is the ability of the nervous system to take in It is the ability of the nervous system to take in

and regulate various internal and external and regulate various internal and external sensory stimuli.sensory stimuli.

The R in the DIR The R in the DIR ModelModel

““Relationship Based”Relationship Based”

Circles of CommunicationCircles of Communication

1. Eye Contact

2. Facial Expressions

3. Gestures

4. Sounds

5. Words

6. Questions and Statements

7. Etc.

Emotions give direction to our Emotions give direction to our actions and meaning to our actions and meaning to our experiences, they enable us to experiences, they enable us to control our behavior, store and control our behavior, store and organize our experiences, solve organize our experiences, solve problems and think. problems and think.

(Greenspan)(Greenspan)

Emotions in AutismEmotions in Autism

Co-regulating affect signaling is difficult Co-regulating affect signaling is difficult because of biological challenges in because of biological challenges in connecting sensations, affects and motor connecting sensations, affects and motor responses together. responses together.

Difficult to be purposeful and behaviors Difficult to be purposeful and behaviors become repetitive, aimless or simple become repetitive, aimless or simple because there is no affective goal or intent because there is no affective goal or intent to make actions meaningful. to make actions meaningful.

Why a Social- Emotional Why a Social- Emotional Approach?Approach?

““Affect Fuels Learning” (Affect Fuels Learning” (ex. saying Hi, more vs. ex. saying Hi, more vs. less)less)

What we know about typical development What we know about typical development When do we learn best?When do we learn best? Affect gives meaning to the wordsAffect gives meaning to the words Emotions cannot be taught solely Emotions cannot be taught solely

cognitively. “we cannot understand others cognitively. “we cannot understand others emotions until we understand our own”emotions until we understand our own”

Emotions organize the mental teamEmotions organize the mental team

Perseveration vs. EngagementPerseveration vs. Engagement

Five Step in Floor TimeFive Step in Floor Time

ObserveObserve Approach – Open CircleApproach – Open Circle Follow Child’s LeadFollow Child’s Lead Extend and Expand PlayExtend and Expand Play Child Closes CircleChild Closes Circle

Step One: Observation Step One: Observation

Match the mood, tone, energy level, Match the mood, tone, energy level, language abilities, sensory profile language abilities, sensory profile

What are they doing and why are they What are they doing and why are they choosing to do it?choosing to do it?

““Turn the Turn the Action into Action into InteractionInteraction” ” by by making it a ritual or a gamemaking it a ritual or a game

Step Two: Open Circle Step Two: Open Circle Approach - Join in Approach - Join in

1.) imitate1.) imitate2.) assist – be the assistant director2.) assist – be the assistant director3.) 3.) PlayfullyPlayfully Obstruct Obstruct

Tailor interaction to child’s differences in auditory Tailor interaction to child’s differences in auditory processing, visual spatial,motor planning, sequencing processing, visual spatial,motor planning, sequencing and sensory modulation.and sensory modulation.

““Persist in your Pursuit”Persist in your Pursuit” Establish Shared Attention and then reciprocal Establish Shared Attention and then reciprocal

interaction interaction Move child’s focus from object to you – you be the child’s Move child’s focus from object to you – you be the child’s

favorite toy!favorite toy!

Why Follow?Why Follow?

““The larger and very serious game The larger and very serious game being played by the parent is to turn being played by the parent is to turn even what looks like random behavior even what looks like random behavior into intentional acts that get a specific into intentional acts that get a specific response, and thereby become the response, and thereby become the means of nudging the child’s crucial means of nudging the child’s crucial affective development back on track.” affective development back on track.”

Step Three: Follow Child’s LeadStep Three: Follow Child’s Lead

Allow the child to initiate, set tone, and Allow the child to initiate, set tone, and control the dramacontrol the drama

Do Do NOTNOT give commands, ask questions give commands, ask questions you know the answers to, or teach you know the answers to, or teach concepts. The goal is connect and concepts. The goal is connect and establish reciprocal engagement. This establish reciprocal engagement. This takes practice. We are to be the ultimate takes practice. We are to be the ultimate play partner!play partner!

Step Four: Extend and Step Four: Extend and ExpandExpand

Help the child climb as high as he can up Help the child climb as high as he can up the ladder.the ladder.

Play dumb, do it wrong, pause in the Play dumb, do it wrong, pause in the interaction.interaction.

Goal to open and close more and more Goal to open and close more and more circles and then do it in more and more circles and then do it in more and more sophisticated ways.sophisticated ways.

Do something novel, add a step, “morph it” Do something novel, add a step, “morph it” This is the teaching moment!This is the teaching moment!

Child Closes CircleChild Closes Circle

When the child shows interest in When the child shows interest in something else we start over again with something else we start over again with step one.step one.

Tricks of the trade for each

functional developmental

level

Becoming Engaged and PurposefulBecoming Engaged and Purposeful

Work on the bottom Work on the bottom three levels three levels simultaneouslysimultaneously

Fill in any holes for a Fill in any holes for a child with lots of skillschild with lots of skills

Level I: Attention and Self Level I: Attention and Self Regulation Regulation (Birth to 3 months)(Birth to 3 months)

What is self – regulation?What is self – regulation?1.1. Strategies one uses to increase attention and to self calmStrategies one uses to increase attention and to self calm2.2. One’s ability to monitor behavior in response to environmental One’s ability to monitor behavior in response to environmental

cuescues3.3. Impulse control, flexibility and decreased need for structure reflect Impulse control, flexibility and decreased need for structure reflect

self regulation. self regulation.

Initially the nervous system learns to regulate temperature, tone, Initially the nervous system learns to regulate temperature, tone, sleep/wake, hunger etc. Next, self regulation is reflected in sleep/wake, hunger etc. Next, self regulation is reflected in sensory-motor strategies to achieve appropriate state. Thirdly, it is sensory-motor strategies to achieve appropriate state. Thirdly, it is accomplished through problem solving and using language.accomplished through problem solving and using language.

GOAL -- GOAL -- Bring the child to homeostasis and then teach them to do it Bring the child to homeostasis and then teach them to do it to themselvesto themselves

We can change the We can change the “R” according to “R” according to their “I” to help their “I” to help

make progress on make progress on the “D”the “D”

Suggestions for Attention and Suggestions for Attention and RegulationRegulation

Draw the child into Draw the child into shared attention by using shared attention by using the preferred sensory-the preferred sensory-motor profile.motor profile.

Follow child's focus and Follow child's focus and affectaffect

““Up regulate” the hypo-Up regulate” the hypo-responsive child responsive child (excitement and novelty)(excitement and novelty)

““Down regulate” the Down regulate” the hyper responsive child hyper responsive child (calm and repetitious)(calm and repetitious)

Slow down speechSlow down speech Use salient languageUse salient language Let the child initiate Let the child initiate

movementmovement Use all available sensesUse all available senses Be animatedBe animated Attract with magic!Attract with magic! PlayfulPlayful obstruction obstruction

Level II: Mutual EngagementLevel II: Mutual Engagement

Capacity to interact in relationships for Capacity to interact in relationships for pleasure, comfort, soothing, and later to pleasure, comfort, soothing, and later to express anger, jealousy, overcome fears express anger, jealousy, overcome fears etc.etc.

Feelings of intimacyFeelings of intimacy Beginning use of joint attentionBeginning use of joint attention Prefer people to objects Prefer people to objects

Tricks of the Trade to EngageTricks of the Trade to Engage

Persist in your pursuitPersist in your pursuit Build on pleasurable Build on pleasurable

interactionsinteractions Use toys to enhance Use toys to enhance

interactioninteraction Use repetition to Use repetition to

create anticipatory create anticipatory games games

Play dumb – waitPlay dumb – wait Encourage child Encourage child

initiationinitiation Stop and let them Stop and let them

restart preferred restart preferred activitiesactivities

Match language Match language abilities “Verbal Ping abilities “Verbal Ping – Pong”– Pong”

Level III: Two-way IntentionalLevel III: Two-way Intentional CCommunicationommunication

Child conveys intentions in back and forth Child conveys intentions in back and forth signaling using gestures, facial expressions etc.signaling using gestures, facial expressions etc.

Level III : How to…Level III : How to…

Treat everything as Treat everything as intentionalintentional

Keep it going as long Keep it going as long as you canas you can

Help child “do to you”Help child “do to you” Playfully obstructPlayfully obstruct Turning around Turning around

immature gesturesimmature gestures Add meaning – open Add meaning – open

the symbolic door.the symbolic door.

““No talking dust”No talking dust” Teach that the child's Teach that the child's

actions have poweractions have power Teach non verbal Teach non verbal

solutions to emotional solutions to emotional triggerstriggers

Level IV: Problem SolvingLevel IV: Problem Solving

Children learn how to solve problems with their Children learn how to solve problems with their new ability to move and use complex sequenced new ability to move and use complex sequenced gestures and then words to get their needs met.gestures and then words to get their needs met.

Multi-step actions and later words to express Multi-step actions and later words to express what they need or want. ( ex. Milk in the fridge)what they need or want. ( ex. Milk in the fridge)

Motor planning,Motor planning, or praxis, is foundational or praxis, is foundational because it is the ability to create, plan, and carry because it is the ability to create, plan, and carry out an unfamiliar motor activityout an unfamiliar motor activity

Level IV: Problem SolvingLevel IV: Problem Solving

Extend the circles by Extend the circles by adding stepsadding steps

Add sequences and more Add sequences and more actionaction

Increase emotional rangeIncrease emotional range Challenge child’s closureChallenge child’s closure Increase interaction Increase interaction

across processing areasacross processing areas Go for continuous flowGo for continuous flow

Use language to spotlightUse language to spotlight Encourage imitationEncourage imitation Use augmentative Use augmentative

Stratedgies as neededStratedgies as needed

Level V: Creating IdeasLevel V: Creating Ideas

The child begins to express thoughts and ideas The child begins to express thoughts and ideas through symbols using through symbols using pretend play and pretend play and wordswords. The child can communicate what they . The child can communicate what they imagine representing real experiences though imagine representing real experiences though symbols.symbols.

Problems in this area reflect difficulty adapting Problems in this area reflect difficulty adapting and expanding his plan as well as anticipating and expanding his plan as well as anticipating outcomes – therefore the child becomes rigid outcomes – therefore the child becomes rigid and uses scripts and uses scripts

Creating IdeasCreating Ideas

Drama, drama, drama –Drama, drama, drama –

Be a player!Be a player! Encourage use of ideas Encourage use of ideas

in real and pretendin real and pretend Use ideas off child’s Use ideas off child’s

affectaffect Declarative languageDeclarative language ““Words, Affect, Action”Words, Affect, Action” Create challenges where Create challenges where

words are necessarywords are necessary

Encourage all types of Encourage all types of ideasideas

Help move drama along Help move drama along without taking overwithout taking over

Turn toys into ideas!Turn toys into ideas! Respond to reality with Respond to reality with

symbolssymbols Substitute one object for Substitute one object for

anotheranother Extend, elaborate, Extend, elaborate,

expand expand

A World of SymbolsA World of Symbols

Goal to have a substitute reality through Goal to have a substitute reality through symbols or imagessymbols or images

Goal to elevate impulses to the level of Goal to elevate impulses to the level of ideas and express through words and play ideas and express through words and play instead of acting outinstead of acting out

Symbols create a safe distance to practice Symbols create a safe distance to practice for the real world for the real world

Emotional ThemesEmotional Themesin a Symbolic Worldin a Symbolic World

JealousyJealousy Sadness/ DisappointmentSadness/ Disappointment Dependency/Joy/ Dependency/Joy/

SeparationSeparation Anger/ AggressionAnger/ Aggression FearFear SurpriseSurprise Power/revengePower/revenge CompetitionCompetition LoyaltyLoyalty JusticeJustice

Level VI: Building BridgesLevel VI: Building Bridges

Encourage logical bridges – Who, What, where, Encourage logical bridges – Who, What, where, when, why, If / then, how?when, why, If / then, how?

Debates, relative ideas, opinions, humorDebates, relative ideas, opinions, humor Use special interests to create affective interest Use special interests to create affective interest Child needs to close all symbolic circles, throw Child needs to close all symbolic circles, throw

out silly ideas to non-responsesout silly ideas to non-responses Challenge child to connect subplotsChallenge child to connect subplots Provide multiple choice – obvious firstProvide multiple choice – obvious first Beginning, middle, end with anticipated Beginning, middle, end with anticipated

outcomes outcomes

Intimacy through all Intimacy through all EmotionsEmotions

Challenging BehaviorsChallenging BehaviorsChilds ActionChilds Action Suggested SolutionsSuggested Solutions

Stays stuck, doesn’t know what to do Stays stuck, doesn’t know what to do nextnext

Provide destinationProvide destination

Give new meaningsGive new meanings

Use ritualized cuesUse ritualized cues

Uses scriptsUses scripts Join inJoin in

Offer alternativesOffer alternatives

Change directionChange direction

PerseveratesPerseverates Join, imitate, helpJoin, imitate, help

Make interactiveMake interactive

How many times?How many times?

““special” timespecial” time

Protests, rejects, refuses Protests, rejects, refuses Act sorry, play dumb, restore, blame Act sorry, play dumb, restore, blame figure,figure,

More things to say no to, give choicesMore things to say no to, give choices

Says something off topicSays something off topic Insist on a response, notice change or Insist on a response, notice change or bring closurebring closure

The DIR model is “The DIR model is “a framework”a framework” for a for a comprehensive, developmentally based comprehensive, developmentally based approach to working with children with approach to working with children with special needs, learning disabilities, and special needs, learning disabilities, and learning differences, as well as for learning differences, as well as for promoting the development of all children, promoting the development of all children, including children with special including children with special strengths. strengths.

Empowering ParentsEmpowering Parents

PrioritiesPriorities My child is not the sum of his behaviorMy child is not the sum of his behavior Cost (Dr Rick Solomon PLAY project)Cost (Dr Rick Solomon PLAY project) ““I am not the cause, but I can provide a I am not the cause, but I can provide a

huge part of the cure!” huge part of the cure!”

A DIR-based programA DIR-based program

GOALSystematicInstruction

AppliedFloor time

Floor time – Continuous flow

Use Augmentative strategies as needed

*See handout for comprehensive program outline

Further informationFurther information ““The Child with Special Needs” and The Child with Special Needs” and

others by Dr. Greenspan others by Dr. Greenspan New Book -- “Engaging Autism” New Book -- “Engaging Autism” ABLC – The Affect Based ABLC – The Affect Based

Language CurriculumLanguage Curriculum www.floortime.orgwww.floortime.org Web Radio show on Thursdays @ Web Radio show on Thursdays @

8:30 (MT) and archived8:30 (MT) and archived www.icdl.comwww.icdl.com Clinical Guidelines Clinical Guidelines RDI by Gutstein and Sheely at RDI by Gutstein and Sheely at

www.rdiconnect.comwww.rdiconnect.com Dr. Solomon’s Play Project Dr. Solomon’s Play Project

www.playproject.orgwww.playproject.org ““More than Words” Hanen InstituteMore than Words” Hanen Institute Floor time message board at Yahoo Floor time message board at Yahoo

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