Monday, November 3, 2008

Floortime - Reaching Beyond Autism?

My sixteen year old son, Corey, is diagnosed with Asperger’s syndrome. While to most people he would just seem a little quirky, I do have some major concerns about some of the issues that affect him. I don’t have a problem with his obsession on certain subjects – the weather, for instance – but I do worry about his lack of social skills and his difficulties with relating to his peers. So when I ran across an article in the NY Times last week that talked about a special school for teenagers with autism spectrum disorders, I was very interested. In fact, I posted a blog on the 5 Minutes For Special Needs site about the article, and I asked readers for their opinions.

The NY Times article and several other articles I found in my research led me to believe that the teaching technique was relatively new. Readers told me otherwise. And, most readers spoke of using the technique, called DIR/Floortime, with much younger children, not teenagers. Yet the NY Times article raved about the success of using Floortime with teenagers.

So, I was still left confused and wondering if Floortime would be an approach to consider. Then I got an email that really cleared things up for me. The person who sent the email is diagnosed with Asperger’s herself, and in addition to the information in her email, she has also sent me some other articles. I’ve included the text of her email (with her permission) below, and based on her comments, I believe I will pursue Floortime as an option for Corey.

Hi. My name is 'Ekie'. I was reading 5 Minutes For Special Needs and you asked for people to tell you what they know about floortime. I was intrigued by your post because you are the mother of a teenage Aspie. I am 24 years old and I have a non-verbal LD/Aspergers syndrome.

Last year in graduate school I took a class called Introduction to Floortime and I fell totally in love with the whole idea. I now say that I am a total Floortime convert. I just love, love, LOVE it. The whole idea of it is so very right, as compared to more traditional methodologies such as ABA, applied behavior analysis. You know how adults with autism say how much they hated ABA? Well, they will not be saying this about floortime.

The basic premise of floortime is to get the child to recognize that 1, I am a human 2, you are a human also and 3, these human people are useful, kind, and fun. It works to build an emotional connection first and foremost, to get the child to *want* to please you because they get an emotional reward for it - not an external reward as with ABA. Often in the beginning this is a lot of imitation and just going with the flow, but at the same time forcing the child to interact with you. For example if the child is running around the room you might stand in the path of where they are running so they have to go around you. Or if they are lining up blocks over and over you might insert a new block that goes in a different direction. There are a lot of levels - I think they go up to 12 or even higher - and only once a child has mastered one level (and I can't remember the levels enough to explain them properly, sorry) you go on to the next, but you keep reinforcing all the old stuff they learn.

Unfortunately the Floortime/DIR (Developmental, Individual, Relationship-based) is kind of a monopoly controlled by Stanley Greenspan. Getting certified in it is a very hard process because they only do the trainings in CA. I took my course via my university. They do classes for parents and professionals, but they are mostly geared towards working with younger children.

I can't quite explain my feelings about floortime except to say that it makes me all warm and fuzzy inside, unlike ABA, which makes me feel like people are training their kids like dogs or seals are trained. Floortime is completely child-centered, and it is about using the child's strengths that they already have to teach them new things. It acknowledges the inherent dignity and abilities of all kids no matter how young.

Thank you, Ekie, for your comments!


Holly said...

That's very interesting, thanks for sharing the info.

Barbara said...

This post, too, is very informative, Deborah. Please extend my thanks to Ekie.

I attended a Greenspan conf in PA, about 14 years ago. I think he has offered an excellent interactive philosophy. I am disappointed that the information is now held for money (restricted courses) but I guess one has to make a living....

Also, if you have not heard of Bill Stillman, I highly recommend perusing his site, Demystifying Autism.

Anonymous said...

Very interesting. What a cute picture of your son.

I know at M's new school they do a lot of ABA but I have seen it done in such fun ways. It has been nothing like what I read so many people complaining about.

Floor time sounds great. I will have to ask if they do this at M's school as well. Thanks for sharing this and I hope you are able to find someone to do this with your son.

Frogs' mom said...

I have to say we love, love, love DIR/Floortime and the philosophy behind it too. While certification is difficult (intensive classes usually in CA or the Virginia/DC area) it is easier for families to access than RDI. Dr. Greenspan has written numerous books; there is an introductory video series (and an in-depth series for professionals); ICDL speakers talk and teach about DIR/Floortime at conferences and lectures all over the country and the world; And last spring, Dr. Greenspan and Rosemary White put on an intensive introductory training on line - with lots and lots of video clips to demonstrate the technique and the theory; there are a few Yahoo-groups exclusively for Floortime families and professionals to discuss progress and problems; The Floortime Repository is a huge network of DIR Floortime families and professionals where you can set up your own page within the network and have access to information and resources posted by others. There are a few DIR Floortime day schools - Celebrate the Children in NJ and The Oak Hill School in San Francisco. Project Play is starting to grow where you hire a trained consultant to come into you home and provide you with some instruction, then video tape is sent to the Project Play center and reviewed periodically with feedback to you and your consultant on what you can do to improve the interactions and help the child stretch to the next level.

One of the problems with ABA is that it seeks to teach social skills by building scripts for the individual to follow. This works ok for really young children who have the motor planning skills for easy imitation primarily because the social expectations for kids at this age are very low - (although you can usually tell the child who is operating via script from the NT child by the time they are elementary school aged). Dr. Greenspan points out that there are far too many variables in every given social situation to develop and remember the script for each - can't be done. In Floortime you watch the child to determine at what developmental level things started to go off track - then take the interaction back to that level and help the child work forward - encoding the experiences emotionally so they can be accessed naturally in future situations. The result is more flexibility, more generalization of skills, higher ordered thinking skills, more ability to see things from the other's perspective.

I echo Barbara in highly recommending William (Bill) Stillman's work.

Alexie said...

I have been using floortime since before my son was diagnosed. My husband and I created a network to help disimenate information for DIR Floortime and Play Project.

Thats what Floortime Repository is all about. I do like the supports it gives the child. My son has just turned six. I know they just did a Tv Spot on Good Morning America, called "Autism a new way to communicate".

This was about the community school in Georgia I believe. Its the same school that was featured in the Sunday Ny Times Magazine. It is very hard to find support for this.

However the Center for Autism and Related Disorders is conducting a study of the outcomes of DIR/Floortime versus High and Low intensity ABA. It should be interesting to see what they find out.

I am sure there is a way to use floortime for adolescents and adults. Your just going to use the interests and apply the same basics and principals.

It does change your paradigm about autism and other developmental disorders. It sure did for me.

My son is doing pritty well.


We just added live chats and instant messaging to help.

Anonymous said...

That's a wonderful first-hand testimony (and well-written!), Ekie, about the heart of Floortime. It's great that you had a chance to learn about it in your graduate school!!

I just wanted to clear up one point (some of the others mentioned aspects of this, too) about receiving training for Floortime. There are so many levels and ways that parents or professionals can learn about DIR and Floortime. The Institute (for certification) is just one path, and they have been held in northern VA and CA. But there are increasingly more ways online (including a whole graduate program -- yes, online!) and other training online too, plus various one-time or series programs throughout the U.S. and abroad. Check out the website for lots of resources.

Also, not sure what gave you the impression that it is, as you phrased it, a Greenspan monopoly -- Greenspan IS awesome, but though he, and Dr. Serena Wieder, have developed these amazing ideas and led the way, they have ALSO pulled so many, many professionals from all sorts of fields with them who continue to interweave the building of this receptive, ethical, growing model.

I found out about Floortime about ten years ago, and I've never looked back! Good wishes, Allegro

Floortime Repository said...

I do like that they have the online conferences now. I can attend and learn more. Dr Stanley Greenspan and Dr Serena Wieder have really changed the way many view autism disorders.

Its a really nice approach.

Anonymous said...

We are a floortime family and we have had tremendous success for our son who is diagnosed with PDD-NOS and has a wide variety of neurological challenges. He can pretend now; he is engaging in lots of back and forth interactions, and he loves to play! When we started, he was just spinning toys around, and now he is 9 and is in the world. He tells me he loves me and kisses me. he has friends.

We were trained by the ASTRA foundation in Mass. There are videos, and I go to the conference every year to hear about the exciting developments in helping "our children."