In the last two blogs we talked about starting to implement a DIR/Floortime for your child by first determining their individual sensory profile, and then by determining their developmental level using a basic checklist. This week we will talk about the nuts and bolts of starting the Floortime session. Please review the Introduction to Floortime blog for a refresher as well.
The Set Up
Eventually when you are comfortable with the principles of the Floortime session, you can do Floortime anywhere and everywhere. To begin, though, let’s start with planning to hold the session in a preferred area at your home where your child is comfortable.
Depending on your child’s sensory profile, you might want this to be a place with minimal visual, auditory and other distractions. This will allow you the best chances of engaging your child and keeping their attention.
Have a few items on hand that your child might enjoy playing with. Avoid toys with batteries that entertain your child such as toys with buttons to press that make noises. Simple items such as balls, pillows, blankets, balloons, or bubbles are good.
- In the photo below the therapist chose the patio area for the session which had minimal visual and other distractions and it was a beautiful summer day.
- Our son loves ‘accidents’ such as spilled water so the therapist used a highly motivating activity of a simple bin with water in it, knowing our son would be motivated to spill the water.
TIP: The goal is to keep the child the continuous flow of interaction for as long as possible.
1st: Follow the Child’s Lead
OBSERVE AND JOIN: To start your session you will first want to be the observer. Note what your child is doing and simply join your child in what they want to do.
Do not ask your child questions. Do not direct your child’s play or suggest to them what to do. Do not physically move or help your child do something. Just observe and follow their lead to join them in their play.
Some children may have seemingly purposeless (to you) behaviours while others might engage in play that makes sense to you. Either way, we want to participate in what is motivating for them.
With more repetitive behaviour, this is more or less imitating what the child is doing with the intention of getting the child to notice that you are doing what they are doing.
Regardless of the type of play, it is about engaging in an activity the child enjoys so they are motivated to play with you.
Dr. Greenspan always said that you want to treat every behaviour as purposeful.
- If the child is simply rocking back and forth, or picking at a spot on the floor, then you assume that is a motivating activity for the child and do the same thing beside him/her.
- If they are moving a car back and forth or spinning the wheels, you join them with your own car and start by imitating what they are doing beside them.
- If they whack a balloon across the room, you grab a balloon and whack it back. If they jump on a big pillow, you jump on another pillow.
- If they want to build a tower the knock it down, then you help them build a tower.
- In our example above, the therapist followed our son’s lead when he wanted to put water in the bin and spill it. She helped him get the bin out, put water in it, and then is about to spill the water in the photo above.
TIP: You also want to always USE AFFECT to engage the child. Use sound effects, facial expressions, intonations, exaggerated gestures or body movements and the like to invite your child into a shared world.
2nd: Present a Playful Challenge
INVOLVE YOURSELF: You want to take joining the child a step further by involving yourself into the child’s play in a playful way to share a joyful moment of interaction.
PLAYFUL OBSTRUCTION: Playfully entice the child to interact with you–even if it only lasts for a single moment. Using affect and following the child’s lead to get the child’s engagement, you can begin to present little playful obstacles–always respectfully–to encourage simple interactions.
USING WONDERMENT: A great way to prolong every interaction is by using wonderment. Dr. Gil Tippy likes to say that he hopes to hear from his students one day how they thought he was so slow to figure things out! So what is this about?
Dr. Tippy says it’s like having your foot on the gas pedal and brake at the same time. You stop and look puzzled, like you are waiting and wondering what to do next from the child, and wait for the child to initiate what to do next.
You don’t want to play clueless to the point of your child getting frustrated and moving on to a new activity, but neither do you want to just do all the steps for them. We want it to be something we do together, in a way that the child enjoys. The child just may need support on how to do it together with you.
- If the child grabs a ball and throws it just to grab it and try to throw it again, you want to fetch it first and say “My turn!” and then toss it to them.
- If they reach for a desired toy, you might playfully grab it and hold it on your head with a fun, playful expression so they will enjoy coming to get it off your head.
- If they’re running in circles, you might playfully jump in front of them, laughing or smiling, so they have to move around you, playfully interacting.
- In our example from above, the therapist is waiting on cues from our son about what to do because he is motivated to spill the water, and she used affect to entice our son in each step in the process.
- First, they needed water. She waited and wondered with him until my son initiated going to the sink. She stopped there and “Hmm…” (wondered again) until my son initiated turning on the tap.
TIP: RECIPROCITY is an important aspect of Floortime. Reciprocity means we are about equal participants in the interaction rather than one of us doing more than the other. If the child gives you a glance, gesture, or a word, you respond with about the same amount or a tiny bit more, rather than using a lot of words.
3rd: Expanding the Interaction
Whenever we would try to do a Floortime session with our son, we could join him and follow his lead and even challenge him, but then what? We would lose him as his attention was diverted elsewhere.
This can be the most frustrating part of Floortime and many parents find this the most challenging piece.
Since one of our main goals in Floortime is to get a good chain of affective reciprocal interactions going with the child: a good back-and-forth interaction–verbal and/or non-verbal, prolonging every step in our interaction by slowing it down and making it playful and fun can create an enjoyable interchange between you and your child.
So once we join and challenge the child, the next step is to add a new element into the play. This will add the novel element that helps our children’s brains learn about new experiences.
By adding or changing one thing about the play, we aim to continue to capture the child’s interest in being with us in our shared world. We are still following their interest, but expanding it just enough to get prolonged interactions with the child.
When a child seems stuck, Dr. Greenspan would offer two choices to move the process along: a logical choice first and a silly choice second (since many kids will just repeat the last thing they heard).
Each step in prolonging the interaction promotes another circle of communication, or back-and-forth interaction.
In summary, we want the session to be practice for the child in looking for affective cues (which is our facial expressions, vocal intonations, etc.) that help with co-regulation, and having a good, continuous flow of balanced back-and-forth of gestures, glances, and/or words.
In the example where the child reaches for a desired toy and you playfully grab it and hold it on your head for them to come get, you can expand this idea by putting it behind you the next time, and then under your leg the third time.
If you are knocking down a tower with your hands, you might do that for a few times and then change it to body bumping into the tower, and after that, use a ball to knock down the tower.
In our example above with the bin, if wondering what to do next was losing our son’s attention, the therapist may have asked our son “Bin in the sink or on my head?” If he replied “head” then she would oblige and put the bin on her head.
He would protest because he really wants to put water in it, so she could exclaim, “Oh! You want it in the SINK!“. He might then say, “Sink!“
Back to our example, once outside she could continue to expand the interaction by holding the bin up high until he initiated an interaction to spill it. She would prolong it by saying things like “Bin over here or over there?” “Up high or down low?“
She could have first spilled all the water, then spilled a tiny bit of water, changed the container that was used for spilling the water, or even had our son help to grab and tilt the bin to spill the water.
"3 ways to Expand Play with Cars" from our friends at PEEK-A-BOOST PLAY
For a much better description than I could ever provide, please listen to Dr. Greenspan himself talk about how to do Floortime
This is all nice and good… but… WHAT IF?
- 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?
Next week we will talk about the interaction of the Floortime session with the ‘D’ (developmental level), the ‘I’ (individual profile), and the ‘R’ (the relationship with you).
Until next week… here’s to affecting autism through playful interactions!