Developmental, Individual-difference, Relationship-based therapy

Developed by Stanley Greenspan, 'Floortime is a systematic way of working with a child to help him climb the developmental ladder, is the heart of what we call the developmental approach to therapy. It takes a child back to the very first milestone he may have missed and begins the developmental process anew. By working intensively with parents and therapists, the child can climb the ladder of milestones, one rung at a time, to begin to acquire the skills he is missing

Most children with special needs are involved with therapists and educators who are helping them master developmental challenges. But to climb the developmental ladder, a child needs intensive, one-on-one work. Even daily speech or occupational therapy often does not provide enough practice. After all, a child may have 12 or more waking hours, during which she is learning something. The question is, what? Is she learning about TV (one-way communication)? Is he learning about staring out a window or repetitively opening and closing a door or lining up toys? Is she learning the pleasure of engaging with others and the satisfaction of taking initiative, making her wishes and needs known, and getting responses? Is he learning to have long dialogues, first without words and later with them, and eventually to imagine and think? Floortime creates opportunities for a child to learn these critical developmental levels. It can be implemented, both as a procedure and as a philosophy, at home, in school, and as a part of a child’s different therapies. First we describe Floortime as an intensive, one-on-one experience; then we discuss the overall therapeutic team and educational approach.

The developmental approach to therapy consists of three parts.

* Parents do Floortime with their child, creating the kinds of experiences that promote mastery of the milestones.

* Speech, occupational, and physical therapists, educators, and/or psychotherapists work with the child using specialized techniques informed by Floortime principles to deal with the child’s specific challenges and facilitate development.

* Parents work on their own responses and styles of relating with regard to the different milestones in order to maximize their interactions with their child and create a family pattern that supports emotional and intellectual growth in all family members.

While all three of these processes are important, Floortime is the hub around which the other two revolve because it is primarily through Floortime that your child will learn to interact in a way that fosters growth. As his specific needs are met with therapy he will bring his new abilities to floor-time interactions. As you learn how your own responses influence your child, you will put that learning to use in the floor time. In the interactions and free play of floor time, you can help your child build interpersonal, emotional, and intellectual skills.

Floortime is precisely that: a 20-to-30-minute period when you get down on the floor with your child and interact and play. How can playful interactions help your child master the milestones? The answer has to do with the nature of the interactions. Certain types of interactions with other people promote a child’s growth.

First, though, we want to explore the importance of human relationships.

Human relationships are critical to a child’s development. Human beings seem to be created to learn and grow in the context of relating to other humans; the brain and the mind simply don’t develop without being nurtured by human relationships. Without relationships, self-esteem, initiative, and creativity do not grow either. Even the more intellectual functions of the brain—logic, judgment, abstract thought—don’t develop without a constant source of relating.

Much of our best early learning happens through our relating to other people. An infant learns about cause and effect in part by dropping her spoon and watching it hit the floor. But she learns far more, and far earlier and more solidly, by smiling and getting a smile back. Later she learns by reaching out her arms and having Mommy pick her up. The pleasure that results from this learning is far more intense; the subtleties in Mommy’s response far more varied. This kind of rich and intense response, which becomes deeply etched in the child’s emotions, is possible only in human interactions. The child then applies this emotional lesson in causality (“I can make something happen”) to the physical world. That the emotional lesson comes first and is the basis for the cognitive lesson is opposite to the traditional view of cognition and learning. This insight is essential for mobilizing intellectual and emotional growth in children with special needs.

Through interactions, you can mobilize your child’s emotions in the service of his learning. Emotions make all learning possible. By interacting with your child in ways that capitalize on his emotions—by following his interests and motivations—you can help him climb the developmental ladder. You can help him want to learn how to attend to you; you can help him want to learn how to engage in a dialogue; you can inspire him to take initiative, to learn about causality and logic, to act to solve problems even before he speaks and moves into the world of ideas. As together you open and close many “circles of communication” (a back-and-forth communication between you and your child) in a row, you can help him connect his emotions and his intent with his behavior (such as pointing for a toy) and eventually with his words and ideas (“Give me that!”). In helping him link his emotions to his behavior and his words in a purposeful way, instead of learning by rote, you enable your child to begin to relate to you and the world more meaningfully, spontaneously, flexibly, and warmly. He gains a firmer foundation for advanced cognitive skills.

Children with special needs require a tremendous amount of practice in linking their intent or emotions to their behavior and then to their words. Like a right-handed person learning to throw a curve ball with her left hand, they need to practice the skill over and over to master it. Floortime is your child’s practice time. Each time you get down on the floor and interact—spontaneously, joyfully, following your child’s interests and motivations—you help him build that link between emotion and behavior, and eventually words, and in doing so move forward on his journey up the developmental ladder.