This and next week we’re talking Floortime Summer Camp with Occupational Therapist, Rosemary White, of The Offices of Rosemary White OTR/L & Associates, just outside of Seattle, who is a DIR Expert Trainer and on the Senior Faculty at Profectum. Rosemary is one of the original Floortimers who worked with Dr. Stanley Greenspan and she brings this experience to her summer day camps that she has been running for over 20 years. This week we’ll hear all about the camp including the history and how it’s progressed, and next week we’ll hear from the parent of a child who has been attending for a number of years.

DIR/Floortime Summer Camps

by Affect Autism

The History of the Floortime Summer Camp

This year would have marked the camp’s 22nd year, but due to Covid last year, it’s the 21st. The summer camp started in her house in 2000. Rosemary blended Floortime with a portable lift program which is a portable Tomatis listening program. Then she began renting a space at a school. Then families wanted to do the camp without the lift so they shifted to just doing Floortime. The number of kids has gradually grown over the years.

What’s really evolved, Rosemary continues, is the training of the staff. From the very beginning they’d meet to talk about the children who were coming to the camp and how to best support them. She also had ideas about having one Floortime player to support two or three players, but ended up bringing on more Floortime players so that each child was supported by one player, and she added a few extras as ‘floaters’.

What is the Floortime Summer Camp?

The camp typically involved lots of indoor and outdoor play at different schools, and on basketball courts. Usually they rent two rooms, and bring toys from their office and we had inside and outside areas, and two sessions per day: a morning and an afternoon session, for four weeks. In each session there was Rosemary and another OT lead therapist from her practice. In the 2019 session, there was about 35 children in each session, with one-to-one Floortime player support. They’d bring pillows and pop-up tents, face paint, blow-up swimming pools that the kids have to blow up and carry out. The adults hold the hoses. They have a sprinkler. These 4 weeks in Seattle are the most sunny of the year. 

What’s unique is that children aren’t assigned to a room. They arrive and put their backpacks on the shelves, then they can go wherever they want to play. There’s lots of dynamic flow in and out as kids play, but they have two structures:
Half-way through the 3-hour camp they have half-time snack time sitting on mats on the basketball court to eat their snack. Then, 15 min before the end, the kids clean up then they sit down and sing a goodbye song on the court as parents arrive. The Floortime players meet with them to describe the highlights of the day.

Summer camp this year is modified. This year they are using a large room at Rosemary’s office and having three sessions per day, with 5-6 children in each two-hour session, and again one-to-one Floortime Player support. There will be about 30 children over four weeks, which is 15 children each day for two weeks, then another 15 for the next two weeks. In 2022 they will return back to a full camp, Rosemary says. The children are called campers and range in age from 3 to 22. The Floortime providers are called Floortime players. 

The Staff and Training

The staff, or Floortime players, include junior or senior high school students, undergraduate and graduate college students, some psychologists and educators, and Occupational Therapists (OTs) from other states or countries including Canada, Australia, Brazil, Italy, Ukraine, UK, Ireland, Turkey and South Africa, to name a few. Many of the players have gone on to become OTs, Special Educators and Psychologists. Rosemary’s colleagues, Jeanette Wake, who has worked with her for over 25 yrs, and Kris Jones Johnson, who has been with her since 2003, co-lead the camps with her. 

After a few years, Rosemary formalized the training. They video tape all the time. Then she started to do four pre-camp trainings with video for the staff, with the focus on the philosophy of camp reflective work as we view video clips from previous years. At camp, Rosemary and her colleagues are coaching all of the Floortime players while they are with campers and supporting them. Every day after camp, Rosemary goes through the videos and puts together a video and presentation for the next morning’s training where Rosemary leads a reflective tutoring session, review videos clips from the previous day. 

Parent Nights

This year Rosemary will also do one parent night for each 2-week session and combine video from each of the 3 sessions. This will be on-line for the parents where she goes through videos highlighting the philosophy of DIR, how they’re supporting the campers’ social and peer interactions (which is different than being a parent) and gives the parents an opportunity to ask questions. She describes how they’re helping social interactions, how to share attention with one another and promoting engagement. It’s about figuring out what the campers’ intention is in the interactions and for the campers to figure out what the intentions are of the other campers, too.

Promoting Groups and Peer Play

This camp is promoting Floortime with groups and peer play, and supporting peers playing together. Using the OT lens, they look at supporting each child’s ‘I’. What are their strengths? Where do they have their challenges? What types of affective, emotional and cognitive support can they can use? What does the staff need to do visually–be close or farther away from the child? What tone of voice and pacing should they use with the child? What physical support will they need to provide? What’s new this year is that Rosemary is bringing in from within Profectum the Foundational Capacities for Development (FCDs), or the 5 C’s: Comfort, Competence, Confidence, Control and Communication. Rosemary thinks of the 6th as Collaboration.

The players are encouraged to think about what it is that can bring this child comfort and when they feel competent. Let’s access that ability for them to have confidence and help them to feel in control and not overwhelmed by things, Rosemary says. It’s thinking abou what their avenues are for communication whether it’s through verbal, gestural, or non-conventional. The focus of the group is for the children to engage in free play with their peers, Rosemary explains. The role of the staff is to facilitate engagement and interaction between the peers using the DIR/Floortime approach

The group is not structured in the sense of the therapists and aides teaching skills, rather they facilitate each child’s functional emotional development during spontaneous play. They highlight supporting shared attention, engagement, the intent of the children, and supporting a long continuous flow, shared problem solving and regulation in the flow of interactions with peers. Another unique thing is that Floortime players switch who they play with every 3 1/2 days. They do a ‘switcheroo’ at the half-day. In the morning they find out who their next player will be and the children will tend to seek out their original player so they can interact with the new child their first player is with as well. 

Over the 4 weeks, the kids have been with many different players. The players talk about the ways they’ve supported the children before they switch. Many of the players come back year after year and what they notice as the most important thing is forming a relationship with the child. Rosemary said the model should really be called ‘RID’ rather than ‘DIR’ because this approach is Relationship-based, tailored to the Individual profile to support the Developmental capacities.

Handling Conflict Resolution at Camp

Conflict resolution is a big part of promoting peer play at the summer camps, too, because many of the kids have regulation issues. The Floortime players are not being the adult who jumps in and takes control. Rather, they help children really be able to slow down. Rosemary gives a classic example which involves a child leaving a toy only to come back and see another child playing with that toy and wanting it back. They’ll coach the Floortime players to come in and put their hand on the car and say something like, “Oh it is a gorgeous car. I love the wheels. What do you like?

This takes it from being emotionally charged and reactive to slowing down and thinking about it. The campers typically end up playing together with the car. The Floortime players are working on ways to support the children to collaborate and manage conflict resolution by looking at individual profiles and affective interaction that supports each individual child. I gave the example of my son calling his friends Mario Kart names and how his DIR therapists will comment, wondering if he is thinking a character such as calling a girl ‘Toadette’ because she has braids that day, which benefits the child being called the name as well. Rosemary says it’s diffusing the volcano of emotion that comes up.

Rosemary gave an example of how one boy threw a shoe over the fence where there was a dog. For about 45 minutes, they had to problem solve how to get the shoe back, using duct tape and figuring out what to do. She thinks of social problem solving as how do I stay in an interaction with a child and navigate that piece, but this was shared problem solving of a real physical problem. They take advantage of anything like that that comes up at camp, she says, such as how do we get the blow-up swimming pool through the door?

Real Life Situations

Rosemary explains that there are a lot of camps that are very structured, but when you go to the park, you don’t select who will be at the park with you. We stated how wonderful it would be to have Floortime players at every school at recess, and in every school for all kids. I mentioned that I appreciate the work of Stuart Shanker’s Self-Reg which is trying to promote these ideas in general in schools across Canada and beyond. This made me think of a question that has come up in the ICDL Parent support meetings that I facilitate each week. A few parents described going to the park for the first time in a long time after lockdowns only to be met with discouraging experiences.

A situation would arise where another caregiver wasn’t so understanding of something their child innocently did, so much so, that the parent was brought to tears when back home wondering why people can’t be more understanding. I asked Rosemary what we can do in such situations as parents? Rosemary suggests that if your child is enthusiastic and runs to other kids and wants to get in there, try front loading at first. That is, sit and do a visual observation of what the other kids are doing first to take a breath and take in the sights and sounds. Hold their hand and say let’s take a peek and look around.

Rosemary continues that even at camp, there are kids who run to the climber where other kids are climbing and startle them. She suggests helping people understand what’s happening by saying something like, “Wow that was really fast!” or “That was loud and unexpected, wasn’t it Moms and Dads?” to give meaning to the action that your child is engaging in and for the benefit of the other kids rather than saying, “You scared the other children.” I gave my example of commenting on my son being so excited as he looks at model trains in public where I might exclaim, “You’re so excited! Look at that cool train!” and how one older man said to me, “We’re all just as excited as him. We just don’t show it!

Rosemary says that it also helps us as caregivers give a neutrality to the moment rather than panicking about what your child is doing. Let’s not go to the abstract terminology or the emotion, she says, but stay in the physical descriptions in the moment because there can be misinterpretations of actions too when kids might be running and bump over someone’s bike but not mean to, for example. We want to say, Oh, that’s what happened and become a thinker again, shifting away from putting the child in a vulnerable position. I asked about a more negative interaction such as my son knocking down another child’s tower impulsively. Similary, Rosemary would comment something like, “That was such a gorgeous big tower!” and maybe, “That was so fast and unexpected.” It happens a lot at camp, she shares. 

Starting from where they are at

Rosemary has seen how the evolution of play has become more and more robust in the kids who come to her camp year after year. Kids play basketball, kick ball, and games like four square. In camp they began to explore physical play when they originally had not been interested in. I commented that it must be a lot of trial and error with the new kids, too, which is the great part of reflection. “And part of DIR!” Rosemary adds. 

She compares it to doing telehealth where she doesn’t know what she will get that session. It’s about asking, “How do I support under this DIR umbrella and the 5 C’s where you’re at“. If you come in with an agenda of what you want to get done, it usually backfires. Just like Mili Cordero said a few weeks back, Rosemary says we meet the person where they are in the moment, whether it’s in an individual session or in camp. It all starts there.

This week's PRACTICE TIP:

This week let’s take Rosemary’s suggestion of making meaning for other children and caregivers in spontaneous interactions our children have in public.

For example: If your child approaches a child who is a stranger at the park really quickly and the caregiver looks nervous about it, comment something like, “Oh that was really fast! You’re really interested in playing!” and then taking your child’s hand and commenting on what is happening around the park.

Thank you to Rosemary for sharing this wonderful summer camp experience with us! You can learn more about the summer camps here and see Rosemary’s training video about how she trains her Floortime players here. Also, check out Profectum’s Parent Toolbox that Rosemary helped create. If you enjoyed and found it useful and helpful, please do share it on Facebook or Twitter and feel free to share relevant experiences, questions, or comments in the Comments section below. Also stay tuned for next week’s podcast where a parent whose child attends the summer camps will describe their experience!

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

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