I often hear parents say that they have a hard time finding examples of how to do Floortime with an adolescent or young adult. We’ve provided a few references to Floortime with adolescents including the introduction of the Threshold Community Programhere with Dr. Andrea Davis and colleagues’ book User’s Guide to the Developmental, Individual differences, Relationship-based (DIR) ModelFloortime for children, adolescents, and young adults, and in scattered examples from Dr. Stanley Greenspan‘s writings here and here.

This week I am very lucky to be able to share with you a video of a father and his 18-year-old son doing Floortime. Dad is relatively new to Floortime and has been receiving parent coaching in the Developmental, Individual differences, Relationship-based (DIR) model. He is really working on engaging and interacting with his son: the early social-emotional developmental capacities. I think you’ll see that he’s quite a natural at it!

Here is a 9-minute video of Dad and son playing together. Dad’s goal going in was simply to engage and interact with his son, trying to get as much back-and-forth communication going as he could using some activities he thought his son would enjoy.

It’s very evident in this video that Dad and son have a very safe, warm, nurturing Relationship in tact. You can see the connection as they share a lot of eye contact and laughter together.

The ‘D’ for Development

Today’s adolescent has challenges at all six core functional emotional developmental capacities (FEDCs). At the first capacity of Shared Attention and Regulation, he tends to be under-aroused and very low key which can make sharing attention challenging. He can get overwhelmed by loud noises and certain anxiety-provoking situations cause him to dysregulate. In order to engage him at the second capacity of Engagement and Relating, Dad joins his son in what he’s interested in/what he’s doing and uses large and demonstrative affect to achieve and maintain connection.

The third capacity of Purposeful emotional interactions is especially challenging because of his son’s history of ABA (applied behaviour analysis) and other behaviour-based therapies and interactions. It has resulted in his son always waiting on others to lead an interaction or provide direction and instructions. Thus, he does not tend to initiate interactions and waits for his parents to guide him. So a goal for this Dad was certainly to build up the engagement in order to begin working on back-and-forth affective reciprocal interactions in order to get his son to a place where he will be interested in communicating his needs and initiating social interactions with others when he cares to do so.

The ‘I’ for Individual differences

Our adolescent, like all individuals, has a unique sensory processing profile and set of individual differences. He lives with his parents and attends public school in a moderate special needs classroom and takes the bus to school. He has low muscle tone, challenges with motor planning and sequencing/praxis, and various sensitivities in the other sensory systems. He also suffers from a seizure disorder which often overrides everything else. When he becomes self-absorbed he tends to have more seizures, despite his medication, so his parents sought Floortime to work on the engagement and relating as part of his seizure prevention strategy.

The ‘R’ for Relationship

Our father and son example in today’s video have a very safe, warm, loving, nurturing and close relationship, as they both do with his mother as well. This relationship is the safety net within which the son can feel safe to be himself and feel accepted. Both mother and father accept him for who he is and are so eager to support him in whatever nurturing, loving way they can. He also has two older sisters who are now out of the house but with whom he also has good relationships.

This Relationship is the key to success in Floortime. Through the security of the relationship, the son will trust his parents and their genuine attempts to share joy through engaging and interacting with him. The relationship will allow them to challenge him developmentally as he is ready to relate and communicate with them in more and different ways, and across different contexts. This is the key to helping him then be able to relate and communicate with others, as he has expressed an interest in having friends outside of school.

The Floortime Video
History Dad reported that often, his son listens to a song he likes on the iPad by himself over and over again on the chair. He’s happy but he is not engaged. Dad wants to discover more about his son–about what’s going on in his head. Dad also reports that although he has a very animated and engaging teacher at school, his son often gets left out of activities like the class play or field trips, and that saddens them. So Dad is excited to work on interacting more and also sharing this process with school to foster the same interactions there.

Strengths Throughout the video, what stuck out to me more than anything was how attuned Dad was to his son, checking in with him to see what he might be experiencing in the moment. Another thing that jumped out at me was how Dad is so nicely changing things up in the interaction while keeping with the same activity. This is the challenge and expand part of Floortime. And notice how much the son stays engaged and connected through it all! This is likely due to Dad’s wonderful use of affect throughout the video!

Dad shows great natural affect when he’s cueing his son by shaking the basket and saying “Oh… oh… oh!” and “Woo… woo… woo“. It’s clear by the son’s big, broad smiles that he loves engaging with his Dad. It’s also clear that the son knows what’s going on in his own head and is restricted by his body. So with Dad’s support to get more interactive back-and-forth communication going, his son can learn more and more how to relate and communicate what’s inside of him.

I just love how Dad commented on his son bending down and how they shared a laugh when Dad said “That was hard!” I also love how Dad asked his son what to do and his son clearly answered he wanted Dad to throw the balls back to his basket, so Dad did. They were clearly having a ball! Then Dad does the basket on the head and moves around saying “Moving target“. That was just amazing because Dad embraces being silly and playful, which is exactly what brings out his son’s engagement and affect.

Challenges Near the beginning when we see the son in a stupor with the ball in the air, we want to watch for what is happening right before he finds himself in that place to get some clues as to why. We will see that he’s struggling throwing. This is likely a motor planning struggle. Here, it’s important for Dad to remember in the future to keep his analysis–which was not intentional on his part–to himself because when he says “You can do better than that!“, his son hears “You can’t do it.” And this is due to the motor planning.

We see more clues to the motor planning piece as we go forward. When he has the basket and he’s holding it with his right hand and trying to throw with his left hand you can see how challenging it is for him. He probably has an idea, but he can’t sequence out the steps to figure out what to do next, or can’t make his body carry out the action. Dad nicely suggested he switch hands. Dad could have also put his hand on his son’s hand to see if he can be more aware and involved in his own problem-solving.
We see that the son’s eyes are on Dad, because he can’t do it. He’s doing too many things at once–bouncing on the ball, holding the basket, holding the ball, and yet he’s engaged with Dad. Think about all those expectations when motor planning is hard for him. Dad gave him some input when he pushed his hand on his son’s ball and the son stood up and answered “yeah” when Dad asked if he was OK. Dad called that getting him ‘unstuck’. Those things that are challenging for him make it harder for him to do that interaction piece, which is what we’re after.

Tips for next time With all of Dad’s great affect, engagement and attuned attention, he can always slow it down to stretch out the interactions. Dad can do this by waiting, watching, and wondering a lot more. Instead of asking questions such as “What should we do now?” and “Are you going to pick it up or should I?“, which are fine, Dad could just wait to see what his son does. Dad could have a puzzled look on his face or say “Hmm…

The more practice Dad gives his son interacting with him–first by responding and offering choices to his son, the more likely it will be that his son will initiate more interactions as well. This will lead to the continuous flow of back-and-forth non-verbal and verbal communication which is a pre-cursor to social problem-solving, having emotional ideas and more complex symbolic and logical thinking. And to do this, Dad has to continue to join and attune to his son, share those joyful experiences, and foster that interaction between them that we saw in the video.

Defending Floortime

There could be some who watch this video and say “They aren’t doing anything! He’s not learning anything!” This is a short-sighted comment. The DIR model looks at the whole person and their development, taking into account their individual differences that affect how they relate and communicate–which can sometimes look like ‘behaviour‘.

As discussed many, many times on this site and in the podcasts, what’s so important–especially for older adolescents or young adults–is helping them with their early social-emotional capacities for relating and communicating. Not only is it more valuable than anything else they could be learning, but it is an essential pre-cursor for them to be able to use other skills they have to interact in the world, and to share themselves and their learning with the world.

As his initiation increases, he’s going to start showing more sequencing and motor planning capacity. We start to support his motor challenges as his initiation starts. He’ll start to acquire the skills about processing. Dad’s focus doesn’t want to be on the motor skills, but on helping his son figure things out by supporting him around those challenges, not trying to fix them, like Dad did when he suggested, “Here, why don’t you try to do it with this hand?” or “Bend your knees“.

Thank you to DIR Expert Training Leader Jackie Bartell for her input into the content of this blog post.

I hope you found our presentation of this video helpful to your work or with your older child. Thank you to this family for sharing their experience and growth process with others. If you have any constructive or positive feedback or questions, please comment below and/or share on Facebook or Twitter. Floortime is a process and a journey and it’s great to share our experiences with one another as we support our children’s individual and unique developmental process.

Until next week… here’s to affecting autism through playful interactions!

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