Kids World provides a family centered play based approach to their clients. We assist the parents in understanding the developmental level of their child, the child’s individual processing strengths and weaknesses,, and how to enhance and develop their relationship with their child. In doing this we follow the DIR® Model developed by Dr Stanley Greenspan, M.D. and Serena Wieder, PhD.
DIR®/Floortime Model is the developmentally appropriate, relationship-based approach that has been developed by Stanley Greenspan MD, and Serena Wieder, PhD. This treatment approach focuses on identifying the individual differences of the child. The goal is to assist parents in developing an understanding of how to promote and develop a continuous back and forth flow of interactions with their child. The DIR®/Floortime Model focuses on ‘Developmental levels’ which are the six core capacities of Functional Emotional Development, the ‘Individual Differences’ of the child in their processing capacities and the ‘Relationship’ which is necessary for creating our learning interactions.
To understand a child’s individual differences we focus on the underlying sensory processing and regulation capacities. By understanding these strengths and weakness and adapting their interactions so that the child is not over or under responding to input we are then able to increase the child’s ability to attend, interact and develop their ideas.
DIR®/Floortime Model is an effective treatment approach that emphasizes the interaction between the child and the parent/caregiver, with the goal being directed toward developing attention and regulation, mutual engagement, purposeful interaction with gestures and problem solving, elaboration of ideas and building bridges between ideas. The DIR® approach is appropriate for children who have difficulties in relating and communicating with others. This approach recognizes that a child’s functional emotional capacities and individual difference influence development through the medium of the child-caregiver relationship.
The core capacities for functional and emotional development that Greenspan describes occur in the natural flow of parent/infant interactions in the first four years of life. As core capacities develop they enable the child to remain calm, regulated and attentive, and to then develop relationships and to function as a member of society.
The six levels of development include:
“Attention and Regulation” – In the first few months of life the parent assists the infant to regulate himself while he becomes interested and takes pleasure in the sights, sounds, tastes and touches that the parent offers him. When a child has difficulty at this level their ability to attend and interact is compromised.
“Forming Relationships and Mutual Engagement” – During this second stage of development, between three and six months of age, the baby grows in their ability to engage in a relationship with the parent. They will experience more warmth and pleasure and as they develop a variety of emotions due to the engagement with the parent. This is the time that the infant ‘woos’ the parent and the parent falls in love with the infant. The infant will seek interaction with the parent for comfort and soothing when needed, so that they can deal with satisfactions and frustrations. As the child grows, this capacity for engagement will embrace the full range of emotions (joy, caring, anger, jealousy, fears, competition etc), supported by affect cues (e.g. smiles or scowls) from others. Mutual engagement helps the child stay engaged and feel comfortable and curious about different experiences.
“Intentional Two Way Communication with Gestures” – By the time the child is about nine months old they exchange gestures in a purposeful way. With parental support, by reading and responding to the child’s cues, they will eventually be able to string together longer sequences of interactions. This is the beginning of the child indicating his intentions and desires to start the ‘conversations’ needed to participate actively in the world. The simple gestures of a child less than a year old, such as pointing or playing ‘give and take’, begin to turn to complex gestures in the second year, and then to back and forth conversations as the child develops language.
“Two Way Purposeful Interactions with Complex Gestures and Problem Solving” – By the time that the child is a year to a year and a half, the child will be learning to solve more complex problems. They may take your hand to get you to open the door. Complex gestures involve sequences – all the steps needed to communicate and solve problems – first through actions and then with words as well. When the child grabs the parents hand and takes them to the fridge to get a drink, they are making their first attempt at social problem solving. When the parent nods back, the child may indicate that they want to be picked up so that they can reach the milk or cup for themselves. The child is not only delighted and proud, they are very empowered by their ability to communicate their ideas and be understood.
“Elaborating Ideas, Pretend Play, Creating Symbols” – By the time the child is 24 to 30 months the child is displaying new abilities that are amazing. They will be capable of creating detailed, multi- sensory ideas. The child and parent share the development of the child’s use of ideas and creativity. Now instead of just acting on their environment to get their needs met, they can form mental ideas of their wants and desires, and label it with spoken words. Instead of grabbing your hand, dragging you over to the bench and pointing to the cup, they will look at you and demand, ‘drink!’ The parent and the child share the development of the child’s use of ideas and creativity. This occurs as the child and the parent begin to expand play as they pretend to be ‘asleep’ or ‘eating’, or ‘the mummy and the baby’, or ‘having a tea party’. The child begins to express thoughts, ideas and feelings through symbols, using pretend play and words. A child can communicate what they imagine through role play, dress up, dolls, or action figures, which now represent experiences from real life as well as those, learned from other sources. These become their own as they project their feelings into the characters and actions.
“Building Bridges Between Ideas, Emotional Thinking, Connecting Symbols Logically and Abstract Thinking” – Between 36 and 48 months the child begins to develop logical bridges between ideas. It merges from more elaborate pretend play, as well as from debates over bedtime or treats, and from those around the child asking them their opinions. Questions such as ‘Why do you want to go outside?’, ‘to the park?’ ‘or to the pool?, This teaches the child to connect their ideas and be a logical thinker. As the child begins to build bridges between ideas the play has a logical beginning, middle and end, taking time and space into account the child is then able to maintain realistic conversations and pretend play stories with logically interconnected ideas, clear motives and anticipated consequences. The child can now also abstract and reflect on various feelings and lessons to be learned.
Typically each of these core capacities continues to develop as the child matures, supporting the next level. However, some children may show some capacities in a constricted form at a higher level even if they have not fully achieved more basic levels. This development can be affected by the Individual processing differences in the child.
At Kids World we work with you to help you identify and understand your child’s individual sensory profile, any regulatory issues and difficulties in the areas of motor planning which may impact your child’s ability to develop. Normal sensory processing involves:
Sensory processing is our ability to detect, integrate and process information from our senses and then perform appropriate actions in relation to this information. If a child is over reacting, under reacting or fluctuating in how they register this input it will directly impact their ability to attend to tasks.
To be effective sensory processing must be efficient. Sensory Integration refers to the process of creating efficient sensory pathways and connections in the central nervous system. Experts agree that until about seven years of age the brain is most active in the development of these pathways.
All children are learning to process sensory information and children with more apparent disabilities such as hearing or visual impairments may not receive, perceive, organize or interpret information accurately, however, many children also have difficulties with this which are not so obvious.
A difficulty in sensory processing may result in an inability to regulate sensory input. These include: sensitivity to sensations, inconsistent or confused responses to situations, disorganized behaviors’, poor peer interactions, immature social/emotional development, reduced self esteem or self control and poor academic development.