Parents can find it challenging to implement DIR/Floortime with their child. Today we will look at why this is the case by exploring the barriers that exist for parents. A huge thank you goes out to local Occupational Therapist, Ellen Yack, for the conversation that sparked this post.
#1. What We Hear is “ABA”
The biggest barrier to parents embracing DIR/Floortime as their intervention of choice is what they hear. Everywhere you look and most professionals you speak with tell you that Applied Behavioural Analysis (ABA, or Intensive Behavioural Intervention, IBI, in Ontario) is the only choice that is evidence-based.
Even for those parents who don’t feel comfortable with ABA who look elsewhere, and who find that other options are indeed research-based are bombarded with messages that instill doubt that they are not giving their child the best chance by avoiding ABA. You’re constantly made to question yourself: “What if I’m wrong?”
#2. Evaluating All the Treatments
The parent who dares to look beyond ABA finds so many options that it’s overwhelming. Even the most educated and informed parents will discover that the more they look, the more they find. It feels impossible to know what the correct choice is.
It seems that every option has people who sing its praise and many parents feel burdened to try it all “just in case”. We hear that early intervention is essential and we feel like we are fighting the clock, so we better try everything! But it’s too much. You cannot do it all.
#3. Everything is So Individualized
The latest research has finally validated what we all know: no one treatment works for every child with developmental delays! An individualized and family-centred approach is essential. We need to focus on the question, “What are the barriers to this child reaching his/her potential at this time?”
This can be a daunting task because each person you go to might suggest a different priority. Parents have to weigh what they feel is their priority for their child with what others tell them is a priority for their child’s development to determine what to go with first.
#4. Listening to Our Gut
Most parents have that gut feeling when trying out a new intervention or therapy. Only some parents listen to their gut, though. There can be many reasons why, but with so many choices, and so many voices telling us what to do, it can be very hard to even figure out what our gut feelings are!
I feel grateful that I had very strong gut feelings and went with them. I didn’t feel that behavioural services met our needs at all and that DIR/Floortime did. However, even with this strong opinion, I still felt incredible doubt turning down publicly paid for Intensive Behavioural Intervention (IBI) of 35-40 hours/week for our child because it was what we were supposed to do.
#5. Parenting Style and Personality
Occupational Therapist Ellen Yack gave me a great example of parental style and personality affecting decision-making around treatment. One mother she worked with liked that with Applied Behaviour Analysis (ABA), she knew exactly what to do, could measure her child’s progress, and could relay to her husband at the end of the day what she had accomplished. She found Floortime very challenging.
On the other hand, I found ABA challenging for different reasons. I couldn’t see the purpose of teaching my son to memorize things on cue cards when memory was already a great strength of his, and when he was restless as heck during a session. Floortime was perfect for our very active son who wanted to move, play and have fun.
#6. People Don’t Value Play
Despite the mountains of research supporting play as the most essential component of cognitive development in the early years, people still do not respect play! We are sending our children to structured learning settings at earlier and earlier ages and “play-based curriculum” has continued to include learning activities.
There are parents who bring children for Floortime sessions only to feel they’ve paid for someone to play with their child. Somehow that does not seem to hold value when they don’t understand the core concepts of the DIR model and how true play is a safe way to bring in and explore emotions they feel in the real world.
Many parents also struggle to be playful with their own child for a variety of reasons. Perhaps they did not have those experiences with their own parents, perhaps they feel they need to be teaching skills, or maybe they feel the need to control their children’s expressions of feelings. These are all barriers.
#7. Floortime is Conceptually Simple, But Challenging to Implement Effectively
You can do Floortime yourself, but you have to be willing to learn and take the time to train yourself (by reading the works of Dr. Stanley Greenspan starting with Engaging Autism) or by working with a DIR/Floortime practitioner. It’s far-less structured than behavioural approaches. It is a parent-level intervention but must be learned, and it doesn’t come natural to everyone.
Occupational therapist, Maude LeRoux, shared with me that one reason why it’s hard for many parents is that DIR/Floortime requires parents to go to emotional places they might not be comfortable going to. If you can’t go there yourself, it will be hard for you to help your child go there and expand his/her emotional range, which is essential for healthy development.
#8. Parent Not Wanting to Be the Therapist
It is much easier for parents to bring their child to therapy and have the therapist work with their child. It is daunting to try to take it on yourself. Afterall, the therapist has years of education and training and experience with many children. They are the expert! But, we cannot diminish the fact that we are the expert of our own child! We know what is best for our child!
A DIR/Floortime therapist is trained to coach parents how to use your time in the best way to bring out your child’s potential. Use the time with the trained therapist to learn to hone your own skills as your child’s expert. Apply what they teach you and learn, bringing questions to them each visit so you can feel more and more confident helping your child at home.
#9. Lack of Support
Depending on where you live, it is difficult to find professionals who know anything about DIR/Floortime. DIR/Floortime practitioners tend to be scattered here and there and work in settings with professionals who have other areas of expertise. There are also not many paediatricians who know about DIR/Floortime.
When you first learn of your child’s challenges, you will be given so much information about developmental delays and different options. You usually don’t hear about DIR/Floortime or explore more about it for awhile. Then, when you do, you find that Floortimers are in the minority. Not only is there no financial support for services in most places, but there is also little professional support for it. This is discouraging enough for a lot of parents to pass it by.
#10. Lack of Time
When you first learn Floortime techniques, it takes time. Dr. Stanley Greenspan would recommend four to six 20-minute play sessions per day with young children. This can seem daunting to parents who juggle working full-time with household duties, siblings, appointments and other daily living activities.
Much like with other things in life, you have to schedule it in. Use the therapy sessions with a DIR/Floortime therapist to learn how to play with your child in a way that helps push him/her up the developmental ladder, respecting his or her individual differences and sensory challenges. Soon you will be doing Floortime all the time, everywhere.
There are many more barriers out there for parents. It is tough. But most parents who have chosen DIR/Floortime will tell you that it is worth it. What barriers have you faced as a parent and what helped you persist with DIR/Floortime? What about our practitioners? What barriers have you seen parents face in your practice? Please share your experiences in the Comments section below…
Until next time… here’s to affecting autism!