Developmental and clinical psychologist, Kathy Platzman from Floortime Atlanta, an expert on the Developmental, Individual differences, Relationship-based (DIR) model returns this week. Not only is Dr. Platzman an Expert DIR Training Leader, but she is the Director of Clinical Training for the Interdisciplinary Council on Developmental and Learning (ICDL). She is also a Fielding Graduate University faculty member and is here to cover a few topics with us today, including answering a question from an Affect Autism patron.
Today we have a few topics of discussion. First we’ll discuss Floortime as a multidisciplinary approach. Dr. Platzman will be presenting as part of this year’s ICDL Conference on this topic twice. Her talk with her colleagues, occupational therapist, Mili Cordero, and speech and language therapist Mary Beth Stark is entitled, “Transdisciplinary Work with a DIR framework: Opportunities and Challenges“.
Navigating our therapy teams and social circles
Multidisciplinary/Interdisciplinary/Transdisciplinary Work
Dr. Platzman says that the three basically mean the same thing: professionals from different disciplines coming together with a common goal. There are many fields, especially in social psychology, that use transdisciplinary models including community development and urban planning. There are ethical codes about it and about its power. There are many benefits from it. Having many team members prevents one professional from becoming dangerous, so to speak, says Dr. Platzman.
When a neurodiverse child comes in to a practice, a child might be prescribed occupational therapy, speech therapy, physical therapy, and ideally these will all be provided by professionals who are all on the same page using a DIR Framework. Where is the child developmentally, what are his individual differences, and let’s develop a relationship with the family and with each other as professionals. The professionals on the team meet regularly to discuss progress.
A lot of different disciplines can own a shared perspective. Drs. Greenspan and Wieder came from the Infant Mental Health network, Zero to Three where this was a tradition. Another thing Dr. Greenspan added to this is that he said this is a parent-mediated model where parents are the cornerstone. Covid has brought back this part of the model by delivering coaching online to parents, rather than directly to children. The parent knows the child more than anybody.
A Sports Analogy
More Perspectives
The thing that makes multidisciplinary work so easy for us is that we are humbled by the opinion of others. The magic is that the developmental capacities burst through every discipline. It’s not a stay-in-your-own lane. The goals can be worked on by every discipline even though the goals can be discipline-specific as well. I gave the example of my son having articulation challenges with verbal language that the speech and language therapist might work on while incorporating tips from the occupational therapist who has identified auditory processing challenges in our son, and his need to move in order to stay regulated.
Dr. Platzman gave the example of a speech and language therapist informing her that one of her clients processes language slowly, so suggested she speak more slowly and not expect responses quickly from the child. This allows her to then work on her mental health goals more effectively. I shared that I enjoy the concept of aggregation because by meeting with a number of professionals, I get a number of eyes looking in from different disciplines, seeing what can help my child develop and flourish. I also understand Floortime concepts better the more I hear them described in unique ways by different experts.
Dr. Platzman shared that she loves listening to Affect Autism podcasts for similar reasons. Hearing what Eunice Lee has to say about parents, or what Dr. Ira Glovinsky has to say about Interoception allows her to tune in to her virtual team of people who are dealing with the same issues that she is, but they’re saying or thinking about it differently than she is. It makes her feel more confident when she then sees a child or a family.
She feels that support from her colleagues, even if it is virtual. Even when her teams met in person she would get that sense of euphoria from realizing that her colleagues all agree that a particular functional emotional developmental capacity (FEDC) requires a lot of support, so she has permission to support it even better, maybe in a few new ways.
Parent Guilt
I reviewed a couple of concepts covered in our last podcast, Avoiding the blame in Floortime including getting out of the feeling like a victim mentality to empower yourself, and starting from where you are rather than looking into the past. Dr. Platzman said any parent of course worries about their child and if something happens to them, it effects you. When we try things with our neurodiverse children as a parent or practitioner and it doesn’t work, we tend to blame ourselves even if it had nothing to do with us, or development is happening slower than we’d expected.
When things are hard and we blame ourselves, saying things like, “Why didn’t I know better?” we are using 20/20 hindsight, Dr. Platzman offers. It’s natural and fine to do this, but when it costs you your energy or ability to problem-solve, she says, it’s time to be your own best friend. Say anything to get your energy back, she suggests. If you’re anxious, you’re worried about the future: “What if this happens. I’m worried this could happen.” If you’re trying to resolve the past and fix things that already happened, that’s depressing.
You want to find a balance. Be able to look back and say, “Oh, I guess I didn’t know that back then,” “I was making my best choice then,” or “I didn’t have the energy to do that back then.” You just name it, Dr. Platzman says, and it’s over. It makes your body feel a little bit better about it. We know from brain science now that imagining something feels the same as it actually happening to your brain.
Depressed people tend to look into their history. Anxious people tend to look into their future.
We can’t change the past, but we can change how we feel about the past and how much we think about the past.
When you go through the day criticizing yourself, you feel lousy at the end of the day. When you go through the day and instead say, “Well, I don’t know how I’m going to do this, but I know I’m going to try” you feel better. Try to bring more energy into the present. Name it to tame it can give you energy in the moment.
Ironic Lives
Society at large is not ready to help you as a parent with your neurodiverse children. You have to maintain your own goals and try not to be aware of society. She gave a great example from cognitive psychologist Morton Ann Gernsbacher who told the story of a family having their autistic son’s birthday party at the local landfill because he loved everything to do with trash and recycling. That is going against society in a heroic way. That’s saying, “My child will be engaged. My child will have a good time.“
You can hold this and carry this good feeling without worrying about what the neighbour’s think. Society works against us and that takes our energy away. Companies are now seeking out employees who possess skills typically held by those on the spectrum. Parents can change the meaning of the uphill battle. This can give others the courage to go forward and future parents can stand on your shoulders.
Provide meaning for a bad day and a good day. This is the weave of the fabric we’re in.
One Dad told Dr. Platzman that the day his son was diagnosed, he instantly had more friends than anyone because he felt that he was the friend of every father with a kid on the spectrum, while at the same moment he became the loneliest person in the world because he didn’t have time to reach out to his community. Dr. Platzman said that it is ironic the way many of us live our lives as neurodiverse families.
Self-awareness
We all cope differently. Dr. Platzman gives the example of her husband who plans his next day at the end of the day while Kathy wants to relax at the end of her day. To know yourself, the more you can be your own best friend. If you don’t know yourself, it’s worth spending the time for that exploration. Many need to isolate, comfort themselves, and take time to let it sink in: a satiation orientation. Even when you satiate yourself, you are working on it. Others need to take action immediately: an action orientation.
Parents are the ones who know the most and the best about their child. There are those who have a gut instinct and are assertive about it versus others who seek answers from everyone because they think the experts know better. The parent knows everything about one child and the therapist knows a few things about a lot of children, Dr. Platzman says. The therapist and parent can work on that overlap.
Patron Parent Question
Today we started a new bonus for Affect Autism members where they can ask a question on the podcast! Today’s question is about navigating our social circles, whether it’s making new friends or with family.
How do we handle the complexity of getting together with several people? It’s always a challenge to find that right way, whether it’s with family or potential friends, to explain our children. Is there any inspiration in the DIR Model?
I’ve experienced this challenge many times when in a restaurant if my son knocks over someone’s coffee, or throws something across the place, or at a relative’s home where he knocks over something breakable. I tend to just name it. I introduce new people to my autistic son, and will say, “Oh he’s very excited and this is him showing his excitement” if he is hand flapping, for instance. Or I might respond to my son saying, “Oh wow, you’re so excited!” to convey to the other family that this is my son being excited and this is normal for us.
Dr. Platzman says that tactics are always welcome. We can use a multidisciplinary approach to survey what each person would do in this situation. Of course, there will always be Aunt Matilda over there saying, “Why aren’t you using your napkin ring correctly?” But likely, the people want to engage with your child, but don’t know how to do it.
The inspiration that the DIR model might have is to say that when you focus on the developmental capacities, you see that when you focus on co-regulation, you get engagement for free. If you work on engagement really hard, you kind of get reciprocity for free. You work on reciprocity and all of a sudden, you get problem-solving, perspective-taking, affective range, and all of that stuff for free.
Dr. Platzman says focus on that developmental question, but not for your child. Where is everybody else struggling? When you turn it around, you can work on engagement and reciprocity. How can you get cousins, for example, to know that playing with your child in this way means this or that. Everyone is looking for safe, co-regulating engagement. So if you can be the broker of that for the people trying to engage with your kid, you can help them both. You can help the other side see where the other side is coming from.
For families who have cultural rituals, this often takes care of co-regulating and engagement because the rituals and traditions are repeated over and over. You can depend on these traditions. Think of this issue as an inside-out problem. It’s not how you help your child bridge the gap with them, but how you help the other people bridge the gap to your child. Kristy Gose discussed this in our podcast about Floortime with family and small groups: that she often focuses more on the neurotypical kids in groups.
Similarly, Eunice Lee said in our last podcast that when you work with children you need to determine where the parents are at by looking at their own D, I, and R. Dr. Platzman says that when she has two clients playing with each other and someone asks her which is her client she says that the idea between them is her client. With that, will come true intimacy. If you can’t get true engagement, just set the stage for it, Dr. Platzman advises.
What about another side to this question? Other than family gatherings, what if this parent wants to make new friends but her child is with her? You can say, “I have to split my attention now. I really want to meet with you, but my child is needing this right now.” The other person might meet you halfway and suggest going to grab food to get a visit in. Note that Kathy didn’t say, “I’m so sorry about my child.” It’s just objective. “I’d love to talk more, but I just need a few minutes.” Usually people understand and are willing to be flexible.
If you notice the other person is being judgmental or a bit rude, you can always wait until later and say, “I noticed you didn’t seem to understand what was going on earlier. Do you mind if I explain my child to you a bit?” and if they aren’t interested, or are rude, then let it go and move on. You don’t have to explain yourself to anyone.
Please consider supporting Affect Autism by becoming a member and have your question asked on an upcoming podcast!
Thank you to Dr. Kathy Platzman for meeting with me to discuss these topics and to answer a great question from one of Affect Autism’s Patrons! If you found this podcast helpful or interesting, please do consider sharing it on Facebook or Twitter! Please also feel free to add related comments, questions or experiences below in the Comments section! Next week, we have a new guest who will discuss Parent Support Groups. Stay tuned!
Until next week… here’s to affecting autism through playful interactions!
