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A few months ago we reviewed a Floortime video with psychologist Andrea Davis of the Greenhouse Therapy Center in Pasadena, California, and co-author of Floortime Strategies for Promoting Development in Children and Teens: A User’s Guide to the DIR Model. She gave me some suggestions to try going forward. Today we will review my implementation of these strategies.

Floortime Strategies Follow-Up with Dr. Andrea Davis

by Affect Autism

Review

Recall from last time that Dr. Davis suggested I try a few strategies next time I tried this activity with my son. I chose to focus on two. First, I tried Gaze Tracking (Strategy 2.2) where instead of making something with him, I just watch him closely so I’m not into what I’m doing myself. She says to watch what he’s making and describe it, watch his affect and his ebb and flow of his regulation, and don’t get distracted by the objects.

She also suggested Sportscasting or narrating (Strategy 3.4) every moment of what he’s doing. Observing the child without judging what’s going on with them should, over time, help them become an expert of what their body is feeling so they can generate their own regulation strategies when Mom is not there. It will also make him feel seen and embraced, so he can feel safe and comfortable to receive even more of my playful challenges.

Follow-Up

I shared with Dr. Davis that I felt like the strategies I applied did not work. I felt like I was just commenting on what my son was doing without really expanding or challenging him to move up the developmental ladder. I felt like he was so upregulated and overly excited, spewing out idea after idea, that I couldn’t get that back-and-forth. I wasn’t able to get him to slow down to take in what I was responding. Then, when I watched the video and examined how it went–the practice of Self-reflection, I saw that it wasn’t all I worried about. And when Dr. Davis reviewed the video with me, I was quite surprised at all of the positive observations she notes in the podcast.

Here are Dr. Davis’ notes to me, from her discussion in today’s podcast from watching the video:
  • This is great because right from the start, I can see that he is thinking about your contingent responses and turning to you to attend, wait, process, and answer, so he is highly engaged even while being very excited (which seems like that ideal where we want robust engagement across all arousal levels and across all kinds of emotions).
  • He is using symbols and creating ideas easily, deciding what sorts of fruit he is imagining you both are making.
  • From the start, You are nicely demonstrating many of the strategies from the book:
    • A.5 Using Natural Interests
    • 2.1 Develop Joint Attention
    • 2.2 Gaze Tracking
    • 3.4 Waiting Long Enough
    • 3.4 Be the Sportscaster/Narrator
  • All of it, especially 3.4, is leading to a wonderful back and forth reciprocity (the hallmark of what is difficult and triggers a diagnosis of autism spectrum) and at the outset very nice, natural rhythm of trading ideas and making your responses contingent upon the other person’s.
  • As it progresses, it seems he does get a mixture of excitement to be playing with these ideas/materials and yet a little bit frustrated at the challenges of interacting at such a high level.
  • By 1:32 I notice that his rhythm or pacing of turn-taking has been speeding up so that he interrupts you several times in a row at the end of your utterances, so I’m wondering if more of an easy-going, more relaxed style with a focus on 2.3 Shared Pleasure and A.4 Use Play and Playfulness would be a way to B.3 Adapt yourself to B.4 Calm (or Energize) him a bit.
  • And, that’s indeed just what you do! He gets up to play against the wall and you lighten things up a bit, still 2.2 Gaze Tracking and 3.4 Sportscasting/Narrating. Yes I see where he didn’t seem to receive the narration about him loving the splat against the wall, but it was because he didn’t get his question answered about whether you could make him a new one, but I do think he likely felt very accepted by the observation anyway. And he is integrating his play, verbal requests, and mutual gaze beautifully (a key differentiating skill on the diagnostic scale, the ADOS-2).
  • My favorite moment so far is when he giggles a little and you notice, saying, “Oh, that’s funny” and he undoubtedly feels the satisfying sense of shared pleasure and shared meaning that keeps him positively addicted (as we want all kids to be) to the sense of “we” and “we are having fun together”.
  • At 2:30, I also love watching you show that you are giving him your undivided attention by watching his face and showing you are tracking his affect and his meaning even non-verbally with your expression and your nod. Yes!
  • The next time you 3.4 Sportscast his thoughts: “You were thinking really hard about that crabby patty“, he stops mid-sentence and turns around to drink in your face and your understanding! I think it really engaged him there.
  • At around 3:00, he adds the idea of the cooking timer and then he even shows his interest in you and your mind as different from his (mentalization) by switching to a question, using your name, “Mama, Mama, what are you making?
  • At 4:00, you are doing such an excellent job of staying with him and tracking him that you can see it happen on his face. You are 6.6 Helping him build bridges between ideas and 6.8 helping him 6.10 be the Event Planner as he literally pauses to think about the logic of his new plan of the Tornado train and the sequence of steps he wants.
  • Yes, it’s hard when his ideas keep switching so fast that he literally can’t really get satisfied with any plan. Then he upsets himself–I think because he can’t inhibit the impulse to get the wonderful feeling of squishing the play-doh when he squished the tornado train. Maybe you could get playful around that. I have seen that work. Make it a shared comical moment when the squish is something in the playful scenario. Be silly like, “Oh! Mr. Bigfoot stepped on the Tornado aGAIN! He LOVES to squish our train!” or treating it like he meant to tease you, reacting in mock playful aggravation, “Ohhhh you SQUASHED it like a BUG!
  • At 5:00 you may feel this didn’t go well but I’m over here seeing how your slowing your tempo for him clearly cues him to try to slow down and he watches you intently and mirrors your gestures and takes the same slower tempo to say “and a stop lightand a red light.” It’s tricky because I think his exciting ideas are hitting him so fast that when you slow down to understand exactly what he wants, that is unfortunately foiling his idea of you making things just about as fast as he thinks of them. I wondered if it’s almost like he wants the magical power of your duo where he thinks and immediately you make it appear and then move on (versus talking about it). It’s fine that you don’t do it, but I just say this to help note when/why I think he gets a bit hyperaroused.
  • And what do you know! At 6:31 you did what I had just typed might work! You made it funny when he squished it and it worked for him as a shared moment of humor!
  • So yes, as I watch, he doesn’t want the description of his state: “I see that when you squish, it feels good” because it feels like slowing down his ideas. Maybe narrating his thoughts at his tempo such as, “You want me to make an X train now! With little balls for wheels! Right now! Ok!” to see if he feels less foiled and more like you are 2.7 Advancing his Agenda to B.4 Calm (or Energize) him or 1.1 Help your Child get Regulated before Expecting More. Narrating their thoughts/feelings can be calming and bonding, unless it feels like it is stalling what he is requesting of you.
  • At 7:00, you start to do what I had just typed a moment ago! Here you start to speed up to 2.7 Advance the Agenda and make the “Red Knight” with yellow wheels and then to use mock upset when he is going to break it, demonstrating well the key strategy of 4.2 Don’t Judge during play, in other words, not mixing play with our parental wish to moralize or direct the play.
  • At 7:50 is the best moment yet, when you start getting your body and your face into the play and you make a hilarious and engaging face and 2.9 Use Anticipation to invite his attention to your turn. I’m enjoying this!
  • At around 9:00 you start to decide to 4.5 Playfully Obstruct and 4.7 Allow More of your Genuine Self in the interaction, with gorgeous 3.2 Total Communication system and 2.5 Exaggerating Affect which is working, as it appears that he knows this is one way you are playful with him, so he stays engaged. But I think I would only lightly sprinkle those resistances in with mostly advancing his agenda.
  • Playfully 2.9 using Anticipation and teasing him about you squishing yours works perfectly as he does his. However, when you go to do yours, he tells you to “wait” because he is playing WITH you about this fun idea. (I should point out that this idea of smashing the creations would probably be a very fun and POPULAR idea with a friend, whereas us adults are less tickled about their youthful funny ideas usually, right? Same with the repetitiousness of their games. If they have a “bestie” and they both happen to like the play idea, the repetitiousness is the joy of the friendship and becomes cherished memories).
  • At 9:49 you are definitely using 3.2 Total Communication with the sound effects to narrate the squish and I think that works well, as he is staying QUITE regulated and SUPER engaged.
  • At 10:39 there is this MAGIC effect again of when you take him seriously, slowly narrate what he just said that didn’t go together (“two wheels and three wheels”), and he stops to consider, and then logically and sensibly makes a choice that is clearer “two wheels!”
  • At 11:00 with your great affect expression, he gets interested in your new idea of using the machine to squish. I wonder about trying 4.4 Assigning Meaning and 6.6 Building Bridges–something you started at the outset but didn’t keep up. So when he keeps switching between routine requests, you can try to combine them such as, “So maybe I should make a crabby patty train with wheels?” “No?, well maybe you want me to make a train that is carrying the crabby patty to be squished?” This takes time for a child to accept often, but it is planting a seed that sprouts later.
  • At 11:27 you can see that whenever you use sound effects and big affect, it really helps him orient and calm down.
  • At 11:45 is my 2nd favorite moment because you are seeking the shared humor and you get that together (!) when you joke about checking with him about the funny squishy sound of the lettuce coming out.
  • At 12:00 the comment about his arousal state actually lands with him (and he is not interrupting you any longer here), then you land one when you 6.1 Empathically Narrate Feeling States BIG TIME: “Do you feel better when I make it?” “Yup!” (which he paired with eye contact and full body gesture (perfectly integrated communication) where you are forming the BASIS for his self-understanding and Capacity 9 self-reflection! And, he shared the humor when you made the assigned meaning, when the skittering away toy you made into a magic train and abracadabera and mock surprise!
  • At 13:00 you are using the realm of symbols (Use Play and Playfulness A.4) to teach manners (you sneak in a please to the machine) and to teach to slow down the thinking (“but this can only do one at a time“).
  • At 13.40 you are clearly getting his whole body involved in the heavy work of pushing on the mold, which is calming for him (B.6 Sensory Connections)
  • At 14:00 you display 4.5 Genuine Self of confusion about crabby patty or train which worked well to help him once again slow down, organize, and clarify, really forcing some executive functioning of selecting, inhibiting, prioritizing!
  • At 15:00 the 5.3 Plot Thickening strategy is working just great as the two of you are co-creating a more elaborate idea.
  • Then at 16:00 I thought “Wow!” You didn’t disapprove or correct but rather you used 2.4 Mirror Emotions and you JOINED him with the excitement about so MANY trains. Then HE stopped himSELF and slowed and without a reminder, did the executive functioning of selecting, ordering, prioritizing and said to you, (holding you in mind, because you are helping him gently build his theory of mind) when he said “I want to make….Black Five first!” and you showed a little sad affect about the Black Five breaking into pieces. So he reassured you by doing more Executive Functioning planning and sequencing about the next steps in the play.
  • At 18:00 you have been gently 3.5 Playfully Persisting at helping him to expand his idea beyond the old familiar routine of “Mama making a new one and destroying it” to “What are we going to do with all these trains and where will they go?” Nice!

Floortime is always a bit of trial and error. You try your best to connect and move up the developmental ladder and sometimes it works. Next time, you try other things. But the importance is the shared joy and connection you make with your child every day. If you found this podcast and Floortime review helpful and informative, please share it on Facebook and Twitter, and share your experiences in our Comments section below. We all learn from self-reflection, and from each other’s experiences!

Until next week… here’s to affecting autism!

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