See VIDEO BLOG created on November 22, 2016

By now, if you’ve read all the blogs, you should have a good grasp on what DIR/Floortime is all about. We’ve covered most of the theory but the success of this intervention lies in the implementation of it. Last week we talked about the nuts and bolts of starting the Floortime session. This was just a start. There are so many factors to consider.

I left you with a few questions:

  • What if my child won’t stop crying or having a tantrum?
  • What if my child appears to ignore me no matter what I try?
  • What if my child just wants to repeat the same thing over and over?
  • What if what my child wants to do is be violent or do something dangerous?

Here’s where we get into the interaction of the child’s developmental level, “D”, their individual sensory profile, “I”, their relationship with you, “R”, and how we conduct a Floortime session.

Recall that the goal of Floortime is to move the child up the developmental ladder.

By increasing the frequency of affective, reciprocal, back-and-forth interactions between you and the child, we help the child connect affect to their motor planning in order to move them up this ladder. But this is all easier said than done.

Within everything we discussed last week, we always want to be asking ourselves: what Functional Emotional Developmental Level is the child currently operating at in this moment?
This brings us to our questions left from last week:
If your child is having what Dr. Greenspan calls a catastrophic emotional reaction, is (s)he exhibiting shared attention and interest in the world?
If your child is ignoring you, does (s)he have shared attention and interest?
If your child is exhibiting perseverative behaviour, is (s)he regulated with shared interest and attention?
If your child is exhibiting behaviour that is violent or dangerous to her/himself or another, do you think (s)he feels regulated and at ease?
Of course, the answer to all of the above is “No”.

Here is where we have the interaction of the Floortime session with the “D”. Developmentally, you will have to co-regulate your child until (s)he is at ease and regulated enough to attend to the world with interest.

The interaction with “I” comes next because to help the child feel at ease, we need to know their individual sensory profile. We need to know that talking too loudly or being in a room that is too bright, for instance, might provoke anxiety.

The interaction with “R” is most important here because in order to feel at ease, the child needs to feel safe with you. If you are demanding the child to calm down, for instance, or otherwise provoking anxiety in the child, this will sabotage his/her capacity at level 1.

Getting shared attention and interest in the world from a child who feels at ease and is regulated may only be the first functional emotional developmental level, but it is the most challenging, the most important, and the first thing to do.

Here is a video of our son who is very mad that I took him away from the model trains down the hall to use the washroom.

Clearly our son was not at ease or regulated, but I was working on co-regulating with him. And even though this was not a Floortime session, it nonetheless demonstrates the point.

One key to helping the child move up the developmental ladder is for the child to expand the range of feelings (s)he can tolerate.

We need to be accepting of all of the child’s feelings but our children may need guidance in the expression of these feelings.

Not only do we want to label feelings for our children, but we want to show that we understand with appropriate facial expressions and reactions. This is called mirroring.
You could not see me in the video example, but I had a look of great concern on my face. I was nodding as I was repeating back what he was expressing: that he was mad! He didn’t want to leave the trains!

This connects us to the child (the “R”) who sees that we empathize with what (s)he is feeling and accept it.

This promotes his/her sense of safety and security because (s)he doesn’t have to censor him/herself around us.

Our children are very sensitive so this is very important. If they sense that we disapprove of their emotions, they will defend themselves from feeling vulnerable with us and we lose trust.

During catastrophic emotional reactions, our children are in fight or flight mode so they are not capable of reasoning. This is not the time to teach them how to behave.

The behaviour you hope for comes when they feel safe and when they reach the appropriate developmental stage.

If they are stuck in catastrophic emotional reactions, they will not move up the developmental ladder. We are their guide and must help them through every one of their emotions.

This will be very challenging to do if we ourselves are not comfortable with our own range of emotions. This is where the “R” really can make or break a DIR/Floortime approach.

Self-regulation isn’t unique to the DIR model. Dr. Stuart Shanker applies it to all of us. CLICK HERE

 

The answer to the next two questions from last week–ignoring or repetitive behaviour–is playful obstruction which was discussed last week. We’ll show examples of this going forward.

The child who is violent or dangerous requires co-regulating to put them back at ease. But in this case you will want to know if the aggression is an outlet due to a sensory need, “I”, or if they are reacting fearfully out of defense, “R”. Again, we’ll get into this in future examples.

Next week we will explore this concept of co-regulation in much more depth; that is, helping our children feel at ease and regulated so they can share attention and interest with us, which is level 1 of the functional emotional developmental capacities. It is a cornerstone to the DIR model and especially to doing Floortime.

Until next week, here’s to affecting autism…

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