The DIR/Floortime Model. Leala Gonzales, LSW Assessing Autism Interventions June 10, 2010. Database Sources. Academic Search Premier ERIC MasterFILE PsycINFO PubMed www.asatonline.opg www.playproject.org www.icdl.com www.yorku.ca. The DIR/Floortime Model. What is DIR/Floortime?
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Leala Gonzales, LSW
Assessing Autism Interventions
June 10, 2010
What is DIR/Floortime?
What does DIR/Floortime claim to do?
What evidence supports the model?
the world around him/her
(Greenspan & Weidner, 1998)
(Heflin & Simpson, 1998)
(Metz, Mulick, & Butter, 2005)
Home-based – Heart of the program is this component to allow practice of skills in the naturalistic comfort and security of the home
Therapeutic Team – Speech therapy, Occupational therapy trained in SI, Physical therapy
Educational Program – Integrated small class
(up to 3 special needs children)
Fetal alcohol Syndrome
Sensory system- taking information in from the world through our senses
Processing system-making sense or interpreting of the information received through the sensory system
Motor system- physically responding to that information
(Greenspan & Weidner, 1998)
Pilot Study of a Parent Training Program for Young Children with Autism. The PLAY Project Home Consultation Program
(Solomon, Necheles, Ferch, & Bruckman, 2007)
Evaluation of the efficacy of a seven week public school curriculum based on DIR/Floortime parent training program for parents of children on the autism spectrum
Developmental progress of children with pervasive developmental disorder and/or sensory processing disorder enrolled in a DIR/Floortime therapy group
-age 2.4 years
-diagnosed with severe speech-language delays and autism
(Hilton, & Seal, 2007)
(Hilton, & Seal, 2007)
(Hilton, & Seal, 2007)
Can Children with Autism Master the Core Deficits and Become Empathic, Creative, and Reflective? A Ten to Fifteen Year Follow-Up of a Subgroup of Children with Autism Spectrum Disorders (ASD) Who Received a Comprehensive Developmental, Individual-Difference, Relationship-Based (DIR) Approach By Dr. Stanley I. Greenspan & Dr. Serena Wieder (2005)
Relationship Focused Early Intervention With Children With Empathic, Creative, and Reflective? A Ten to Fifteen Year Follow-Up of a Subgroup of Children with Autism Spectrum Disorders (ASD) Who Received a Comprehensive Developmental, Individual-Difference, Relationship-Based (DIR) Approach Pervasive Developmental Disorders and Other Disabilities: A Comparative Study
Educating Children with Autism” (National Academy of Sciences, Committee on Educational Interventions for Children with Autism, NRC, 2001)
naturalistic teaching methods
Developmental Patterns and Outcomes in Infants and Children with Disorders in Relating and communicating: A Chart Review of 200 Cases of Children with Autistic Spectrum Diagnosesby Stanley I. Greenspan, M.D., & Serena Wieder, Ph.D. (1997)
September 2009 - the NIMH awarded the P.L.A.Y. Project a $1.8 million grant for a controlled trial of play-based autism therapy.
60 children who participate in The P.L.A.Y. Project to of
60 children who receive standard, community interventions
The P.L.A.Y. Project
York University in Toronto, Canada
“There is a wide range of research and clinical experience not just from the field of autism but from the field of early intervention and child development at large, which, when taken as a whole, provides considerable empirical support (far more than for more circumscribed approaches) for a comprehensive developmental model.”
Videos with Disorders in Relating and communicating: A Chart Review of 200 Cases of Children with Autistic Spectrum Diagnoses
“Although Floortime is an approach that holds promise for engaging children with autism and promoting their ability to relate to others, more empirical research is needed.”
(Heflin & Simpson, 1998, p. 211)
“ Based on scientific research to date, there is not enough evidence to conclude that DIR is an effective treatment for children with autism."
(Freeman, 2007, p. 141)
“Level of research support was found to be Emerging (one or more studies indicate favorable results, more studies are needed to determine the intervention is effective).”
(National Standards Project, 2010, p. 20)
Level 1: Established
Level 2: Promising Evidence
Level 3: Preliminary Evidence
Level 4: Studied and No Evidence of Effect
Level 5: Insufficiently Studied
Level 6: Evidence of Harm
http://www.asatonline.org/pdf/winter2010.pdf p. 3
Metz et al (2005) stated, “ The lack of empirical support is unfortunate because, although this form of intervention remains unsupported, we find elements of the Floortime intervention of interest. At it’s core the model seems to incorporate an intensive form of incidental teaching, creating and capitalizing on interaction and instructional opportunities and teaching new skills using shaping and reinforcement. These concepts of intervention are important to teaching and generalization of skills that should be an integral part of any intensive intervention program. The emphasis on increasing parent sensitivity to, and in practice and generalization of skills in natural setting is one, in our experience, that is occasionally missing from many home intensive intervention programs based on principles of applied behavioral analysis." (p. 258)
Questions???? with Disorders in Relating and communicating: A Chart Review of 200 Cases of Children with Autistic Spectrum Diagnoses
Freeman, S. K. (2007). The Complete Guide to Autism Treatments. Lynden, Wa.: SKF Books.
Greenspan, S. I., & Weidner, S. (1998). The Child with Special Needs. Reading , Ma.: Perseus Books.
Heflin, L., & Simpson, R. (1998) Interventions for Children and Youth with Autism: Prudent Choices in a World of Exaggerated Claims and Empty Promises. Part I: Interventions and Treatment Option Review. Focus on Autism & Other Developmental Disabilities, 13 (4) , 194-211. Retrieved from MasterFILE Premier database
Hilton, J. C., & Seal, B. C. (2007). Brief Report: Comparative ABA and DIR Trials in Twin Brothers with Autism. Journal of Autism & Developmental Disorders, 37 (6), 1197-1201. doi:10.1007/s10803-006-0258z
Metz, B., Mulick, J. A., & Butter, E. (2005)Autism: A Late 20th Century Fad Magnet in Jacobson, J. W., Foxx, R. M., & Mulick, J. A. Controversial Therapies for Developmental Disabilities: Fad Fashion, and Science in Professional Practice. (pp.237-264) New York: Ruetledge.
Muratidis, H. (2009). Developmental progress of children with pervasive developmental disorder and/or sensory processing disorder enrolled in a DIR/Floortime therapy group (Doctoral
dissertation ,Adler School of Professional Psychology, 2009). Proquest Dissertations And Theses, Section 1143, Part 0622.
National Autism Center. (2009). National Standards Project Findings and Conclusions. Randolph, Ma.
Pilarz, K. (2009) Evaluation of the efficacy of a seven week public school curriculum based on DIR/Floortime parent training program for parents of children on the autism spectrum (Doctoral dissertation, Temple University , 2009) . Dissertation Abstracts International, 69, 122A.
Solomon, R., Necheles, J., Ferch, C., & Bruckman,D. (2007). Pilot study of a parent training program for young children with autism. Autism 11 (3), 205-224.