Methods and Strategies: Developmental, Individual Differences, Relationship-Based Approach (DIR)

The Developmental, Individual Differences, Relationship-based Approach (DIR) is a
comprehensive, interdisciplinary approach developed by Drs. Stanley Greenspan and Serena Wieder. The relationship-based approach focuses on using an intensive integrated intervention which is individualized to match the child’s level in the social-interaction development hierarchy. Relationship-based developmental experiences build skills in the core processes of relating, attending, communicating, and thinking. Difficulties in relating and communicating are believed to be secondary to sensory and motor processing deficits. The ultimate goal of the intervention is to help the child develop appropriate affect and form a sense of self as an intentional and interactive individual. Parents and primary caregivers are taught specific strategies which are utilized during eight to ten sessions (20-30 minutes each) per day of “floortime” play with the child.

“Floortime” is a series of reciprocal child-directed interactions resulting in “communication circles.” The goal of “floortime” is to sustain interactions between the child and the adult by gradually increasing the circles of communication. These interactions become the basis for further play development.

During “floortime,” the adult joins in the child’s play to increase opportunities for pleasurable interaction and engagement. The child’s actions are considered intentional and purposeful. The adult follows the child’s lead to validate the child’s sense of self. Preferred objects and activities are used to motivate the child and facilitate persistence and patience. Higher level skills and concepts are taught through interactive play. “Floortime” also provides for peer experiences with typically-developing age-mates.

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