Floortime therapy is a relationship-based approach designed to promote social, emotional, and intellectual growth. Created by child psychiatrists Dr. Stanley Greenspan and Dr. Serena Wieder, this therapeutic model centers on engaging children through play and interaction to help them master fundamental developmental milestones. The intervention is named “Floortime” because it often involves the therapist or caregiver getting down on the floor to interact with the child at their physical and developmental level.
The Developmental, Individual-Difference, Relationship-Based (DIR) Model
Floortime is the practical application of the Developmental, Individual-Difference, Relationship-Based (DIR) theoretical framework. The “D” in the model refers to the sequential nature of development, focusing on a child’s ability to move through a series of Functional Emotional Developmental Capacities (FEDCs). These capacities are milestones that build upon one another, laying the foundation for emotional, social, and cognitive growth. The first capacity involves self-regulation and interest in the world, which allows a child to remain calm and focused on their surroundings.
The FEDCs include:
- The ability to engage and relate, forming emotional connections with caregivers and others.
- Two-way communication, involving intentionality and the ability to exchange emotional gestures in a continuous back-and-forth manner.
- Complex communication and shared problem-solving, where a child can string together a series of actions to express their intentions and solve simple problems.
- Using symbols and creating emotional ideas, which is the beginning of pretend play and imagination.
- Logical thinking and building bridges between ideas, allowing the child to connect feelings and experiences to reasoning.
The “I” component, Individual Differences, acknowledges the unique ways each child processes information, including sensory processing and motor planning. Understanding how a child responds to sensory input is incorporated into the therapy design, tailoring interactions to meet specific processing needs. The “R” component, Relationship-Based, emphasizes that development is fueled by meaningful interactions with caregivers and peers. Relationships serve as the mechanism guiding the child up the developmental ladder, helping them link emotion to behavior and learning.
Implementing Floortime: Following the Child’s Lead
A Floortime session is rooted in “following the child’s lead,” where the adult joins the child’s chosen activity and intent. The therapist or parent enters the child’s world of play, using the child’s interests as the vehicle for interaction. The adult responds playfully and positively, tuning into the child’s emotional signals and preferences. This approach encourages the child to take an active role, promoting empowerment and autonomy in the therapeutic process.
The core technique used to help a child progress through the FEDCs is expanding the “circles of communication”—the back-and-forth interactions between the child and the adult. This process involves the adult opening an interactive circle by responding to the child’s action, and then enticing the child to close the circle with a response. For example, if a child is lining up toy cars, the adult might join by lining up their own car next to the child’s, then gently place a roadblock in the way. This challenges the child to respond, perhaps by moving the roadblock or communicating frustration, thereby opening a more complex circle of interaction.
The parent or caregiver is an active and necessary participant in the therapy. Floortime sessions often include training for parents to implement the principles in daily life, typically in multiple 20 to 30-minute sessions throughout the day. This consistent involvement strengthens the parent-child emotional connection, allowing for the generalization of skills into the child’s natural environment. The success of the intervention is strongly correlated with the level of parental engagement.
Who Benefits and Expected Therapeutic Outcomes
Floortime is a therapeutic option for children with a range of developmental challenges, including:
- Autism Spectrum Disorder (ASD)
- Developmental delays
- Sensory Processing Disorder
- Attention-Deficit/Hyperactivity Disorder (ADHD)
The relationship-based model addresses foundational gaps in social and emotional development that affect learning and interaction. It is a comprehensive framework often integrated with other specific therapies, such as speech or occupational therapy.
Floortime therapy focuses on building capacity for social, emotional, and intellectual function. Expected outcomes include improved emotional regulation, allowing children to manage their feelings more effectively in various settings. There is also enhanced social engagement and reciprocity, helping children better understand and respond to social cues.
Children typically show progress in communication skills, learning to use both verbal and non-verbal means to express their needs and ideas. The therapy also promotes the development of symbolic thinking and flexible problem-solving abilities. For families, a significant outcome is the strengthening of the parent-child relationship.