This week, Clinical Psychologist Dr. Andrea Davis of the Greenhouse Therapy Center in Pasadena, California, and co-author of her User’s Guide to the DIR Model joins us to review a Floortime session I did with my son back in November. The focus was on promoting functional emotional developmental capacities 4 and 5.
Promoting Capacities 4 and 5 with Floortime
Today’s example of a Floortime session is broken into three parts. First, I was trying to start an activity that I had done in a video from a few years ago, but ended up following his lead instead when my son wasn’t interested. The next video gets into a back-and-forth flow with some engaging and social problem-solving around a PlayDoh activity. In the final clip I’m really trying to challenge him at FEDC 4 (shared problem solving) into the symbolic world at FEDC 5 (using symbols and creating emotional ideas).
Strategies from Dr. Davis’ co-authored book mentioned above are cited throughout the blog. While Floortime is about being in the moment and sharing joy rather than applying prescriptive strategies, having a list of strategies is often helpful for beginners so the process is teachable and repeatable.
My goal was to demonstrate my son’s growth since a previous video we had shown in this blog post on self-reflection. I started with the same activity where my son was not showing joint attention about four years ago: running the trains along the table pushing the soap off the table.
My son wasn’t interested in my idea. He only wanted to talk about where the box went from his toy. So the video clip shows me co-regulating with him through this concern about the box being gone to the recycling box. Dr. Davis is so excited to see how far he’s come and to see me making the experience with him joyful.
Where we were in 2014:
Part 1 video:
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She says that a simpler behavioural model would see this as a behaviour problem with him perseverating on the box being gone, so they’d ignore it and re-direct the behaviour to get him to co-operate. Instead I co-regulated with him by mirroring his emotions (Strategy 2.4), and embracing his feelings (Strategy A8). Floortime is an affect-based model.
I was being responsive (Strategy A.2) to everything he was saying to me (rather than ignoring it because it was distracting from the activity), and I prioritzed attunement by tuning in to what he was experiencing in my face and heart, with my tone, and by being calm and soothing to show him that I cared.
Finally, I didn’t judge (Strategy 4.2), but rather connected with him. I narrated what he was saying (Strategy 3.4) to show him I cared about what he was saying. And then he moved on! It’s so easy to say “Stop that! Don’t do that!” But when we connected, he was so strengthened by the relationship, that he could move on and face the world together with me. This model is about Relationships.
In the video from a few years back, our son was so interested in the physical world, playing with the trains and soap. Now he’s so interested in wondering what’s happening with things that disappear. This is a significant developmental step and he is working through it. I was able to keep him in that space of wondering so he could play with the ideas over and over again. He will continue to repeat these sequences until he can resolve them and move on.
Dr. Davis liked that I was able to pick up on the important ideas that my son was repeating about “Where did the box go?“, “Why isn’t it here?“, and “Why can’t I see it but I can worry about it?” This will help him deal with issues of loss and possibly the thought of death in a more mature way, with my help as he moves forward.
So what seems like going over and over the same conversation so many times is actually a lot more important and it’s our son’s way of working through a very serious human dilemma.
Self-Reflection (Strategy A.10) Dr. Davis asked how I felt during this experience when my son kept harping on the same idea about the box even though I had another idea of what I wanted us to do. I did feel mildly frustrated because we have been through this so many times, and I knew I was filming this for this blog post. But, I’ve had a lot of practice at this since my son’s birth when I’ve realized this is what he needs now and so this is what we’re doing.
Dr. Davis pointed out that I was actually self-regulating by thinking to myself that this is what he needs so this is what I attend to. If I had rather categorized it as a ‘problem behaviour’ focusing on the incidents and the length of each behaviour, this turns us to a negative, disappointed feeling when up pops another repetition.
When I thought of it as a need in him, it brought forth a caring side of me that helped him feel felt, heard, seen, and able to then move on because it was so regulating for him. This process may help him get to the core distressing aspect of his concerns that he will eventually resolve after many repetitions.
Neurotypical kids do this all the time through play such as with G.I. Joe, working through difficult feelings, and we don’t see it as frustrating because they tend to play on their own or with other kids. This might take more time and patience on my part, but in the end it helps support my son’s development.
We really have to realize that just because your child has an autism diagnosis, they are still human. They go through developmental stages and do the same things as other children do; it just might look a little bit different. Dr. Davis says that when we see that our child has the same issues that other children have, it brings out the side of us that is more nurturing and patient.
Self-Awareness Dr. Davis points out that it’s very self-aware to understand and be open to and embrace all of your own feelings, rather than saying “That’s not a good feeling so I’m not going to pay any attention to it“. This helps us be full, complete, thorough, and present in the moment with our child when they bring up their own feelings.
Part 2: Facilitating complex communication and shared problem-solving
Now in the second video clip here, we are working at Capacity 4. Let’s first review the ‘D’, the ‘I’, and the ‘R’.
Development We can see that my son is regulated (FEDC 1), engaged (FEDC 2), having back-and-forth interactions (FEDC 3), and we are problem-solving together (FEDC 4) around the PlayDoh machine.
Part 2 video:
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Dr. Davis really enjoyed that this was a great demonstration of FEDC 4 with the emphasis on the ‘shared’ problem-solving of how to have an interaction with another person that is effective. She said that we see throughout this clip. One aspect that is so important in this clip, she said, is that while I did constantly make sure I was attending to his regulation state–remembering that we’re always building up from capacity 1–I was sensing the just right challenge that he needed.
Individual differences My son is a mover so by him standing and being able to move (Strategy B5), as well as getting the proprioceptive input of pressing the machine, his capacity to stay connected with me was supported (Strategy B1). I mentioned in the podcast that I wasn’t too animated. Dr. Davis said that the reason we want to animate our affect or expression (Strategy 2.5) is when our child isn’t engaged with us. She felt that my son was engaged, so it was fine that my affect was subdued. But you will see he’s getting up regulated jumping and flapping his hands at times and that’s when I try to slow him down with my use of affect by becoming much quieter and slowing down myself (Strategy 1.2) which helps keep him regulated.
Relationship The cocoon of our relationship gives my son the safety to play where I can challenge him and he trusts me. When the turtle flies away and I giggle saying “Oh! Should we try that again?” he giggles with me which is a great moment of shared joy (Strategy 2.3), our goal in Floortime. I’m supporting him where he is while I’m also trying to support his higher capacities.
It’s the envelope of the trusting relationship, but it’s also in the moment, even if you were working with him for the first time. He senses I’m following his lead, meeting his cues (Strategy A.1), attending and attuning to his affect, and centering the activity around his highly natural motivating natural interest (Strategy A.5) so that he wants to make this work together, even as I’m challenging him.
Part 3: Facilitating emotional ideas and symbolic play
Part 3 video:
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Dr. Davis says that so much of learning starts with imitation, so he will use what I introduce and become creative with it on his own once he has had a chance for it to percolate inside of him. I attend and attune to where he’s at, follow his cues, and playfully persist (Strategy 3.5), which is part of Floortime: bringing in new ideas, but not forcing it. Rather, we entice him into enjoying my ideas to enrich his own ideas, introducing it playfully.
It’s not because we want him to be a good player, but we want him to be a good thinker.
You develop the capacity for abstract thinking by playing with these ideas. It goes back to the concrete idea in part 1 of “I don’t see the box. Where did it go?” The more he joins me in symbolic play, he’ll have way more effective ways about handling more abstract ideas like “Where did the box go?“
When I said, “Well what does the sun taste like?” and he exclaims, “I want a sandwich!” it might be that for him, eating is regulating. It could also be that because of his motor planning challenges he doesn’t know how to respond. Dr. Davis points out that with motor planning challenges, he also has abstract planning challenges of what to do next, so he goes to eating.
She liked how I seemed to be bring in a little bit more of my genuine self into the play (Strategy 4.7). For example, I had an idea of having a second turtle to play with when he wanted to make a flower (Strategy 5.7). He may have had an idea, but I had an idea too and I stuck with that, while gently bringing the idea in to the interaction. I was gently challenging him even though he wanted to revert to a set, fixed idea that he had that felt safer.
Dr. Davis says that I bridged ideas (Strategy 6.6) (preparing for capacity 6) by suggesting that the turtle has a friend and then we make a flower. Maybe they can both be hungry and want to eat a flower. This was me setting up a way to move into a place where it’s not just trading information back and forth at capacity 3, but now the child is using more negotiating and realizing “I’m a person, you’re a person and we want to have an effective social interaction to work something out together”.
How do we build trust? It’s through these moments of attunement to my child’s emotional state where I help him calm down if he needs to regulate–down regulate or up regulate–bringing in the right amount of stimulation. And when we want to introduce something new to challenge, we always make sure to get his permission so he’s in control. If they’re not ready, then right away you say, “Oh OK! You don’t want that!“
Another piece that’s so crucial is the issue of having fun because it’s a nice thing to do. Shared joy is the core of why we have relationships. We are enticing our children into a shared world so they can experience shared joy. A digital world is enticing them with a strong pull when they find the social world such a challenge. We want to make sharing joy the most important moments.
Sharing joy is the ultimate goal no matter what, even if you’re enticing him into pretend play and socially problem-solving. Shared joy is the pinnacle. That’s what we’re going for. The twinkle/sparkle in his eye in those moments is so deeply bonding, and keeps him coming back for more, even when he is thinking about other ideas. He wants to be with you. This is the thing we can’t teach behaviourally: The DESIRE to connect, the curiosity about you, and the longing for intimacy. We know that’s going to change his life as he begins to develop that.
Dr. Davis made a few suggestions to try, so in a few months we’ll do another blog post reviewing me trying them out.
Sportscaster or narrator (Strategy 3.4) One of the most effective ways her Center works to facilitate regulation is helping clients learn about their own regulation needs. In today’s video, when my son gets uncomfortable with me introducing the turtle eating, he says he wants a sandwich. At Dr. Davis’ Center, they will say things like, “Oh yeah, when you get bored, I think you think of eating” or “When you get uncomfortable, you think of eating.“
Over time–days or months–you observe the child without judging what’s going on with them. Then, over time, they can become an expert of what their body is feeling so they can generate their own strategies when Mom is not there. I want my son to start developing that internal monologue to notice what his body is feeling and come up with what will help his body start to feel better.
Besides narrating his regulation, Dr. Davis also suggests that when he isn’t really tracking with me, that I could do a bit more sportscasting of what he is doing to make him feel seen and embraced, so he can feel safe and comfortable to receive even more of my challenges.
I think that practicing this will help my son to narrate for himself what I see that he’s experiencing. This should help him feel acknowledged and put it together so he will be able to narrate it for himself going forward. With my experience being immersed in Floortime, maybe by the summertime or next Christmas he might be doing this and I think this is a realistic and tangible goal.
Gaze tracking (Strategy 2.2) While I’m using a motor planning activity, Dr. Davis suggests I also try to use more gaze tracking so I’m not into what I’m doing myself. Instead of making something with him, just watch him closely. 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 suggests just really watching exactly what he’s doing and sportscasting every moment of what he’s doing.
Combining the strategies So in this video I could have said, “Oh it’s hard to push that PlayDoh thing down without it slipping away!” or “That idea was a little too scary and you really like that train book“. Then, watch his reactions each time. Is this working for him? Does he enjoy my sportscasting/tracking or is it distracting? Perhaps I might lower the amount of words I use to short descriptions of what he’s doing instead, for instance.
Dr. Davis on Gaze Tracking and Narrating & Sportscasting
Gaze Tracking (Strategy 2.2) is crucial for so many reasons. It’s hard to accomplish when you are very involved in the manual activity, but you see some of it in our video. I wonder if he would feel even more seen/heard/felt if you watched him work with the PlayDoh (which does seem very regulating for him as it involves so much proprioceptive input) and Narrated or Sportscasted (Strategy 3.4) all he was doing with the PlayDoh, letting him take the lead in the ideas, conversation, and activity, even if it doesn’t make sense. If he can maintain the engagement, it’s great because so many kids just eat up that sort of ‘following their every step’ so that when you do add a twist or a Thicken the plot (Strategy 5.3), they really sit up and take notice and delight in your addition.
Animate (Strategy 5.2) An advance technique is to go the opposite direction and avoid eye contact when enticing into him the symbolic world because it ‘breaks that spell’ or brings the child into the here/now reality vs. the world of symbols and pretend. For example, if you are playing puppets with a child or voicing toy characters, you don’t look at their face, you look at the puppet or toy character to draw their attention away from the real person acting out the characters and instead draw attention to the character.
I did a little bit of this when I pretended to be the turtle saying “Ouch! Ouch!” when he was squishing it and when I was being the turtle eating the flower saying “Nam nam nam!” Important to remember is if you get that moment of shared joy, you make sure you meet his gaze and share that knowing glance of delight together.
I’m very eager to put these suggestions to practice and see how my son responds and if it helps him feel more empowered and connected, understood and more in charge of his expression and in control of his regulation. It’s a parent’s job to support and help our children grow to their potential. And I see that light in him that is so eager to glow once he can master the nervous system that holds him back. He is so happy each time he is able to master another milestone and I am so overjoyed to be the one to help and support him through that.
It’s so important to see how far he’s come along. Dr. Davis notes it. So different from a few years ago, in this video it’s apparent that if I left the room he would be upset and want me to return. Dr. Davis points out that he’s now remembering and holding the experience in mind of what it is to trade ideas, to share ideas and affect, to stimulate one another’s ideas in thinking and he wants more of it.
There was a lot of information in this podcast and blog accompanying the three videos. Hopefully you found it insightful and helpful for your own Floortime practice. Please consider sharing this post on Facebook or Twitter, and if you have any comments or examples to share, please add your Comment below.
Until next week… here’s to affecting autism through playful interactions!