1. DIR Floor Time Presented By Tracy Vail,MS,CCC/SLP Speech/Language Pathologist

2. Floor time  A warm and intimate way of relating to a child. A floor time philosophy means engaging, respecting and getting in tune with the child in order to help the child elaborate through gestures, words and pretend play what is on the child’s mind. As a technique it is a process that is used to support the emotional and social development of the child. (Greenspan, 2002)

3. Parent- Teacher Role  A very active play partner who follows the child’s lead.  Play at whatever captures the child’s interest but do it in a way that encourages the child to interact with you.  Build emotion-driven reciprocal behaviors in relationships.  Play environment and adult interactions vary depending on the child’s developmental level.

4. 6 Developmental Stages  Shared Attention  Joyful Engagement  Purposeful 2-way Communication  Build Chain of Circles of Communication  Use of Ideas and Feelings  Build Bridges of Ideas Prompting Logical Thought

5. Five Step Process 1.Observation of Child 2.Approach- Open Circles of Communication. 3.Follow the Child’s Lead 4.Extend and Expand Play 5.Child Closes the Circle of Communication

6. Shared Attention and Joyful Engagement  Deal with sensory profile of child- If under responsive, rev up. If over responsive, talk quietly and slowly.  Create Challenges to motivate child into focusing on care giver.  Be playfully obstructive to gain interaction.  Assume the child’s actions meet his current needs.  Join in his activity by doing what he is doing.  Create atmosphere of shared enjoyment by sharing his pleasure.

7. Join In!

8. Follow the Child’s Lead

9. Shared Enjoyment

10. Purposeful 2-Way Communication  Foster simple back and forth communication.  Gain child’s attention with affect.  Change facial expressions and/or body movements rapidly.  Mimic child’s body postures and rhythms  Do silly things!  Let child’s natural interests emerge

11. Tools for Building Engagement  Have “stimmy” toys only available with adults  Organize space to require interactions  Play dumb  Reinforce all vocal attempts  Give the child multiple tools to communicate.  Have FUN!

12. Be Silly!

13. Mimic

14. Foster Communication

15. Use Stories

16. More Stories!

17. Use Music

18. More Music!

19. Build Chains of Circles of Communication  Open and close many circles  Set up challenges in environment  Foster complex problem solving  Make yourself available  Extend gestures and words

20. Tools for Building Chains of Communication  Use fill-ins rather than questions  Use sing-song intonation  Build relationships between words  Stay with child’s special interests  All questions have answers  Keep the child successful- Prompt then fade your prompts

21. Open and Close Circles

22. Shape Speech

23. Give Child a Way to Communicate - Signs

24. Make Sure Child will be a Successful Communicator

25. Picture Exchange

26. Sounds and Pictures

27. Be Sure to Fade Prompts

28. Shape and Fade

29. Use of Ideas and Feelings  Transition from circles to complex imitation  Transition from complex imitation to pretend play  Adult becomes a character in the child initiated drama  Allow child to lead, care giver builds on script  Don’t use question/answer format, keep open ended

30. Build Play Scripts

31. Give Choices

32. Be Available to Meet Child’s Needs

33. Child Initiates Drama

34. Build Bridges of Ideas Prompting Logical Thought  Prompt Bridges through the use of “Wh” questions.  Form dialogs and pretend play to hook ideas together  Encourage child’s use and understanding of abstract ideas  Use developmentally appropriate language

35. Pretend Play  The transition to pretend play is a very important leap in childhood. It involves the use of symbols in creative ways. The child with special needs lots of practice. Begin when the child can close many communication circles.

36. Tools of Play  Thicken the plot  Expand the direction  Introduce challenge or conflict  Negotiate  Monitor your own feelings  Don’t over direct

37. Typical Play Themes  Nurture and dependency  Pleasure and excitement  Curiosity and limit setting  Power and assertiveness  Anger and aggression  Fears and anxieties  Love, empathy, concern for others

38. Use Questions to Guide Play Script

39. Become a Character in Play

40. Teach Abstract Concepts through Play

41. Teach Negotiation and Planning

42. Floor Time Guidelines  20-30 minutes of uninterrupted time  Stay patient and relaxed  Don’t worry about looking silly  Empathize with child’s emotional tone and mood  Monitor tone of voice and gestures  Don’t stop successful activities  Be aware of your own feelings that may interfere with efforts  Set your limits and be consistent

43. The “Hard to Woo” child  Build on sensory preferences  Ascribe intent to all behaviors  Playfully obstruct  Use blankets, veils, scarves to build mutual attention  Use water, shaving cream, paint, whipped cream  Use a variation of favorite things

44. Monitor Yourself  Do I balance what’s showing up in the child?  Do I give gentle looks?  Is my body posture supportive?  Am I able to help the child identify play themes?  Do I approach the child slowly with respect and thoughtfulness?

45. Home Based Opportunities for Floor Time  Dressing and undressing  Mealtime  Car time  Coming and going time  Bath time  Book time  Bedtime

46. Turning Every Day Activity into Problem Solving  Chair not close to table when meal arrives  Bottle not open when you try to pour juice  Bathtub empty at bath time  Shoes hidden from usual place  Changing location of favorite toys  Put 2 socks on same foot  Put shirt on feet  Give child adult shoes  Mix 2 sets of puzzle pieces

47. The Bottom Line  People are fun!  Communication is fun!  Communication is valuable.  Emotions are important.  Play mimics life.

48. Thank You for Listening!