Curiosity is the quality that urges a child to keep finding out more, to connect actions with outcome, people with feelings. Wondering why is the powerful engine that drives discovery.
- Stanley Greenspan, MD, Author, and Founder of DIR®/Floortime™ Method
DIR® was developed by Drs. Stanley Greenspan and Serena Weider. Greenspan and Weider studied typical development for the National Institute of Health for many years and they were able to break it down into levels, noting the types of interactions at each stage that best support healthy, robust development. DIR® strives to assess the child’s function in relation to these levels of development. Strategies are used within playful interactions to facilitate robust growth in all developmental domains. In children with developmental difficulties, DIR® provides a framework to determine where the child veered off the typical development path. The child’s sensory profile as also assessed. DIR® then uses a variety of interventions (speech therapy, occupational therapy, biomedical intervention, listening therapies, and Floortime™), all geared to help the child get back on the path of typical development, to improve sensory and emotional processing, and to fill holes in development so that the foundations for healthy learning and relationships are in place.
RESEARCH SUPPORT FOR DIR/FLOORTIME
The developmental levels, as created and defined by Dr. Stanley Greenspan and Dr. Serena Wieder are:
Level 1: Shared Attention and Regulation – This process begins immediately after birth. As the baby takes in sensory experiences, they must learn to distinguish different sounds, smells, and sights. And, they must learn how to organize themselves in the presence of a variety of stimuli. If those early sensory experiences are overwhelming, though, the baby can tune out the world and lose their desire to interact. Or, they can be in a consistent state of hyper-arousal. This stage focuses on the child’s ability to regulate his or her attention and behavior while being interested in the full range of sensations (sights, sounds, smells, their own movement patterns, etc.). The child’s ability to enter into a state of shared attention with another person. This is a child’s ability to process their environment, filter out distractions, engage with others, and attend to play or tasks (ex. pay attention in the classroom).
Level 2: Engaging and Relating – Babies next begin learning how to express themselves to be understood and are beginning to experience the joy of an engaging relationship. They learn that coos bring mom, and that cries can, too, but in different ways. They are beginning to experience different emotions and to distinguish between them. Babies of this age are able to obtain joy from interactions that are nurturing and responsive and to are beginning to actively engage in relationships. The related feelings, such as assertiveness or sadness, can be incorporated into the quality of engagement and the stability of the child’s engagement (ex. does he/she withdraw or become aimless when under stress?).
Level 3: Ideation, Intentionality and Two-Way Communication – As babies continue to grow, they begin to transform emotions into signals for communication. There are many different types of exchanges going on now between the caregiver and the baby. The baby learns to read the caregivers’ cues, and to respond with cues of their own. Babies are learning that their actions are purposeful and they can participate in two-way, logical interactions. At this level, this involves helping a child open and close circles of communication and babies also begin to initiate their own ideas. The child is now becoming intentional in interactions and activities with another person to keep activities going for desired objects or activities, etc.
Level 4: Shared Social Communication and Problem-solving – Once babies have their own ideas and can initiate, intentionally, to make things happen, they begin to take two-way communication to solve problems. They learn to use that communication to get physical and emotional needs met. They can take their mother’s hand and pull them to the pantry and point to a cookie. These interactions become increasingly complex, leading to higher levels of intelligence. Important developmental steps during this time-frame include shared social problem-solving, regulating mood and behavior, forming early sense of self/self esteem.
Level 5: Creating Symbols and Using Words and Ideas – By now, children’s motor skills have developed to the point where they can appropriately use their mouth muscles and vocal cords. The child now develops the ability to create mental representations. To understand words and language, children must first be able to engage in complex emotional signaling (separating actions from perceptions and holding images in their minds). Symbols or words can now be used instead of having to act things out with their body. This allows new flexibility in reasoning, thinking, and problem-solving. And, we now begin to see the ability to do pretend play or use words, phrases or sentences to convey some emotional intention (“What is that?,” ”Look at this fish!,” or “I’m angry!,” etc.). the child begins to have more complex ideas and share them with the people around him. This is the ability to share ideas with others and represent ideas and real life through play or activities.
Level 6: Abstract Thinking, Refection, Emotional Thinking, Insight into Others – Children have now become better at connecting these symbols together logically, making possible thinking and reflecting. They learn how one event leads to another, how to link ideas together, how ideas operate across time and space. Ideas can explain emotions and organize their knowledge of the world. Logical thinking now leads to new skills, such as debating and scientific reasoning. Children can now make up games and play games with rules. The child’s now has the ability to make connections between different internal representations or emotional ideas (“I’m mad because you’re mean.”). This capacity is a foundation for higher level thinking, problem solving and such capacities as separating fantasy from reality, modulating impulses and mood, and learning to concentrate and plan.
On a typical development trajectory, children will usually achieve all 6 of these foundational levels by elementary school. If the child has ASD, Asperger’s, ADHD or other developmental challenges, these levels may take much longer to achieve. And, some children develop well in some areas, but have difficulty in others. DIR® stresses the importance of working through ALL of the levels, in order, as each level builds the foundation for the next. And, it is difficult to obtain the higher developmental levels without mastering the lower levels.
For older children, Dr. Greenspan has added in three additional levels.
Level 7: Multi-causal and Triangular Thinking – In this stage, children move beyond simple causes for reasoning and move to multi-causal thinking. (Maybe Alex doesn’t want to play with me because he doesn’t like me, or because he’s already playing with Joseph, or because he’s afraid I’ll break his tower.) Triangular thinking is being able to compare and contrast two things. Also, if one friend can’t play, he can ask another to play. To learn multi-causal and triangular thinking, children must be able to invest emotion into more than one possibility. At this stage, children can understand family dynamics in terms of relationships among different people, rather than just in terms of whether they get their own needs met.
Level 8: Gray-area, Emotionally-Differentiated Thinking – This kind of thinking enables children to begin understanding varying degrees or relative influence of things. This is important for school, as there, children often must weigh factors and relative influences. This also helpful with peers, as this kind of thinking offers new ways to solve problems and children can now compromise.
Level 9: A Growing Sense of Self and Reflection on an Internal Standard - By puberty and early adolescence, more complex emotional interactions help children progress to thinking in relationship to an internal standard and a growing sense of self. Children can now judge experience and they can say things like “Boy, I was really mad – more than usual.” Or, they can look at a peer’s behavior and say, “That is OK for them, but not OK for me. ” Children can now make inferences and can think in more than one frame of reference at a time. They can create new ideas from existing ones, they can consider both the past and the future. This allows for a higher level of intelligence and more mature thinking.
After the ninth level is reached, people continue to develop throughout life. There are as many as seven more stages. Human development doesn’t stop, even for those on the autistic spectrum. Those later stages includes:
- An expanded sense of self that includes family and community relationships
- The ability to reflect on one’s future
- A stable, separate sense of self (which allows young adults to remain secure when separating from their nuclear families)
- Intimacy and commitment (including long-term commitments such as marriage, home ownership and a career)
- Parenthood and other nurturing roles
- Broadening perspectives on time, space, the life cycle and the larger world
- A sense of responsibility to the environment and future generations, along with a sense of perspective on ones’ place in the grand scheme of things.