See VIDEO BLOG created on September 20, 2016

This week I’ll talk about the DIR® model’s developmental ladder: The Functional Emotional Developmental Capacities (FEDCs) for Learning. There is a lot written about childhood development but only the DIR® model describes it in terms of functional emotional developmental capacities.

These capacities are likely different than any you’ve seen elsewhere because they are based on AFFECT. They are the foundation of the DIR® model in the context of safe, loving and nurturing relationships. Dr. Greenspan describes nine stages of development, but it is the first six we are the most concerned with.

Typically, babies progress through these stages into early childhood but developmentally delayed children can progress through them much later. The final three stages, or capacities, are more advanced stages that can happen into the teenage years and adulthood in neurotypicals, and even in children with developmental delays.

The good news is that anyone can continue to develop throughout their lifetime—it just might happen more slowly the older they are, and the earlier intervention starts, the better.

In developmentally delayed children it is also important to note that moving through the stages is not linear. You don’t necessarily master one and move to the next, then master that and move to the next, and so on. This is why they are referred to as functional emotional developmental capacities rather than “stages” in the model.

More common is that children have holes in the early capacities of development as they move forward through the later capacities, and these holes always need to be addressed and “patched up”. We’ll talk about this a lot more going forward. Below are the first six developmental capacities, as described in the book Engaging Autism by Dr. Stanley Greenspan and Serena Wieder, PhD.

Capacity 1: Shared attention and regulation

As Dr. Greenspan says in “Engaging Autism” on page 31, “A typical infant connects his emotions to his actions and sensations.”

This means that the child is calmly showing interest and responds purposefully to sensory input such as the sight of his or her mother, the sound of his or her mother’s voice by turning his or her head, the touch of his or her mother’s hand on his or her skin, or the movement of an object in front of his or her face, etc.

In typically developing children, this begins in the first 3 months of life. In children with developmental challenges, this typically is an ongoing challenge throughout their development.

As babies, they may find certain sensations unpleasurable thus they don’t attend to them and might cry or seem unresponsive. As older children we might learn that a child cannot tolerate loud noises, or certain types of material against their skin, or certain textures of food, for instance.

When a child is unable to take in information from their senses and feel at ease and focused it will be a challenge to interact with others.

So in DIR/Floortime® the goal is always to first find ways to help the child feel at ease so they can attend to their environment.

For some of our children, this might mean being very animated and active because they are under-responsive. For others, it might mean moving and talking more slowly and quietly because they are naturally so overstimulated.

We will talk more about this next blog when we get to the “I” in DIR®, individual differences. Whatever it is, we have to find the ways that our individual children can be available to us.

This is up to us to do because we know our children best, and it is our mission before we can work on any higher capacities of development to ensure that our child is available, at ease, and interested.

Capacity 2: Engagement and relating

This capacity is referred to as the “falling in love” stage when a baby has a gleam in his or her eye for his or her mother, for instance. He or she smiles and responds to the mother with facial expressions. Infants learn to distinguish caregivers from others and inanimate objects.

In typically developing children, this begins at age two to five months old. In children with developmental challenges, the child may have these developing intimate feelings for his or her caregiver but has difficulty expressing it, so the caregiver may in turn respond less to the seemingly non-responsive baby.

In this case, the interactions between caregiver and child will be more brief and unlike typically developing children, the child will take less initiative in interacting.

This can be an ongoing challenge for children as they get older and we notice it when we try to get their attention or have a conversation. They may just seem unavailable to us or it may appear that they don’t even notice us. This is usually not the case though.

Their biological systems (as discussed next week in the “I” or individual differences) may simply make it too hard for them to engage. When working in capacity two we always want to first make sure that our child is available and interested or regulated before we try to engage and relate with him/her.

The other important point about the 2nd capacity, and DIR/Floortime® in general, is that we want the initiative and desire to come from the child. So we would never force the child to look at us by moving his or her face in our direction, for instance, or saying “look at me”.

Rather, we entice children into engagement by using affect so they want to. We do this by following their lead through what is emotionally meaningful to them, even if it is rubbing a spot on the floor.

The DIR® Model assumes that all behaviour is communication and purposeful, even if it doesn’t seem to be that way to us.

Capacity 3: Purposeful emotional interactions

Here we start to see a baby respond with interactions using eye contact and gestures, such as grabbing a pacifier from the caregiver’s hand.

Caregiver and infant exchange signals with one another for a reason such as smiling to get a smile in return.

Infants are able to let the caregiver know what they want using gestures and signals. They may grunt with delight while reaching their hand out when they want something the caregiver is holding, for instance.

They are also starting to perceive a spatial world as they watch an object fall, and are forming a sense of me versus you, and a sense of reality. In typically developing children, this stage begins at age four to ten months old.

In babies where the sensory-affect-motor connection is a challenge, they may only be capable of very brief interactions. They find it difficult to express their needs without screaming or crying. Thus, their behaviour may be more impulsive and unpredictable.

When a bit older, they may hit another child to get what they want because they can’t figure out how to use eye contact and emotional signaling to show the child they want a turn, for instance.

Rather than initiate interactions, the child will mostly respond to caregivers.

In DIR/Floortime® we would first try to get the child regulated and attending, then engaged and related with us before we work on the back-and-forth interactions.

It can be done, though, when we follow what the child is most interested in because this is the window into their emotional world.

When we are good observers, we can join them in that world and entice them into these back-and-forth exchanges, or “circles of communication” as Dr. Greenspan likes to call them.

Capacity 4: Long chains of back-and-forth emotional signaling

and shared problem-solving (e.g., joint attention)

Capacity four is a big milestone for any child, but especially for those with developmental delays. It is at this capacity that many things start to happen.

A child will begin to figure out that if they want a toy that is up on the shelf, they have to pull Mommy’s hand to get it for them. That is, they are now using capacity three to problem-solve.

There will now be three or four steps towards a goal. The child develops pattern recognition before language which leads to language development and scientific thinking later on as they figure out cause-and-effect. They also see patterns within themselves and others such as being able to be happy sometimes and also being able to be sad sometimes.

Even more at this capacity, a child will be able to tame their emotional outbursts because they can signal back-and-forth to understand that a look from Mommy means that the food is coming in a minute, for instance.

In typically developing children, this stage begins at age ten to eighteen months old. In children with developmental challenges this stage is a very difficult one to master.

Many parents refer to their children as “high functioning” because they have good receptive language and can even recognize numbers or letters.

 

But even with these skills, these children are unable to maintain sustained, ongoing interactions (30 or more back-and-forth exchanges) and are unable to socially problem-solve (even if they can independently problem-solve).

At this capacity we need to see that a children can have joint attention with their caregivers in order to figure out a problem together. We need to see that they initiate an interaction with the goal in mind and signal back-and-forth with you to solve the problem of getting that goal achieved.

A child who struggles with connecting his/her affect to his/her motor skills will tend to give up if faced with a challenge and move on to something else rather than persist. (S)he is not forming the pattern-recognizing skills. (S)he might engage in repetitive behaviour.

Almost all children with autism spectrum disorder struggle at this capacity and remain stuck in the lower stages of development. They might learn to talk and read but their speech is scripted and repetitive. They might read but don’t comprehend what they are reading.

The good news is that in Dr. Greenspan’s clinical observations, his team found that through meaningful, emotional interactions children could reach this stage, but it requires a lot of practice.

Capacity 5: Creating ideas

At Capacity 5 children begin to engage in pretend play and show their imagination. They interact with their caregivers and peers in their pretend play because they understand symbols.

We see their creativity emerge as they share new ideas. Children use words meaningfully so that when they say “apple” they understand the experience of eating an apple rather than just having memorized a symbol “apple” to mean a round, typically red, fruit.

In typically developing children, this stage begins at age eighteen to thirty months old. This stage is quite challenging for children on the autism spectrum.

It is important that the use of language be functional and children with developmental difficulties might recite language they’ve memorized without conveying meaning.

They have difficulty attaching needs and emotions to actions and words.

It is common in DIR/Floortime® to hear that children show “islands” of capacities. So a child might have islands of ideas or pretend play, but there are many holes in the lower stages of development.

The goal is to continue to work on the lower stages to fill in the holes and again, once at ease and attending, get the engagement and relating, working for the back-and-forth until that gets “cooking” (as Dr. Greenspan liked to say), until you can keep the circles of communication going to solve a problem together.

Only if all of these capacities are present would we then push into working at Capacity 5.

Capacity 6: Building bridges between ideas: logical thinking

Here at capacity 6, the meaningful ideas from capacity 5 are linked together. In typically developing children, this stage begins at age thirty to forty-two months old.

Typical toddlers can know and express that they want to do something because of some reason, such as wanting to go outside to play. They can answer “wh” questions (who, what, when, where…).

At this capacity, children now understand that one event can lead to another across time and space. In “Engaging Autism”, Dr. Greenspan uses the examples of something knocking something over, being good now leading to getting a treat later, or Mommy not being here now, but being close by.

Children can also distinguish between what’s inside of them such as fantasies versus reality.

For children with developmental challenges, we will typically see either no words, or memorized scripts and random or unrealistic use of ideas and irrational behaviour.

Again to work at capacity six, we would want to have the child “cooking” in all five previous stages first. And again, we might see islands of capacity 6 despite the child operating in lower capacities most of the time.

Our goal is to fill in the holes in the earlier stages of development. These first six capacities are typically mastered by typically developing children by the age of four or five before they start school.

But in children with developmental delays it can take much longer. The goal is always to start as early as possible, but even if you’re later rather than early, you can still make great strides using DIR/Floortime®.

Beyond the first six stages of development, Dr. Greenspan lists three more that children would ideally reach into their teenage and early adult years, but some people may never reach these capacities. They are definitely higher order emotional capacities.

Capacity 7

Capacity 8

Capacity 9

Multicausal and Triangular Thinking

In this stage you can think of more than one reason for why something happens. Perhaps my friend didn’t want to play with me because he was busy or because I ignored him last time, for example.

One can also compare why one likes something or someone more than another and understand that there is more than getting your own needs met.

As Dr. Greenspan puts it on page 51 of “Engaging Autism”, at this capacity you “must be able to invest emotion in more than one possibility”.

Gray-Area, Emotionally Differentiated Thinking

Here one will understand degrees of feelings, events, or phenomena.

One now can compromise because you understand that there are different reasons for things and a differing level of importance of some things over others.

Some examples are feeling only a little bit mad today, or realizing that your math test is more important than your soccer practice and why.

A Growing Sense of Self and Reflection on an Internal Standard

Ideally this would develop in early adolescence when a child forms their own set of morals.

One can understand that what is acceptable for one person is not acceptable for themselves.

One can reflect that they are feeling angrier than they felt yesterday about something.

They can take two perspectives at the same time.

Now that you understand the functional emotional developmental capacities, we can talk about what capacity or capacities your child is operating at, how to meet him/her there, how to help him/her up the capacity levels, and how to fill in the holes.

In a few weeks, I will start to focus on each capacity in more depth. But first we will move to the “I” and the “R” in the DIR® model. Next week I will talk about the “I” which is Individual Differences and in two weeks, the “R”.

Until next week, here’s to affecting autism!

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