Can Floortime Therapy Build Intellectual and Physical Skills in Children with Autism?
Floortime is a type of childled therapeutic play. It's part of a larger therapeutic approach called DIR (Developmental, Individual-Difference, Relationship-Based). Floortime and DIR are best-known as techniques for building a child's emotional reciprocity and engagement. But can Floortime and DIR be used to build specific intellectual and physical skills?Dr. Stanley Greenspan, one of the primary developers of this approach,has a weekly web radio show on the Floortime Website. In spring, 2006, I was a guest on the show, and asked Dr. Greenspan about how Floortime might be used for skill-building. The following is an excerpt from the transcript of that show.
Dr. Stanley Greenspan on Floortime and Skill Building
Lisa Jo Rudy: I understand that Floortime is wonderful for building emotional skills. Can it also build intellectual skills?Dr. Greenspan: Yes, but it actually builds – I know where you are going with this – it builds intellectual skills too because remember, the building blocks of intelligence are communication and thinking. That is the essence of the Floortime approach. As we have shown in a different book, called The First Idea: How Symbols, Language and Intelligence have Evolved from our Primate Ancestors to the Modern Humans, which is available at all the bookstores, emotions, and these emotional interactions and this back-and-forth emotional signaling that goes on in Floortime, is actually the fundamental building block of human intelligence, not drilling on flashcards or learning specific letters or numbers. It really starts with your basic communication and thinking skills. As surprising as it may sound, cognition or intelligence comes from our emotional interactions.
Lisa Jo Rudy: That is very interesting. So, would you use Floortime as a technique for teaching a skill?
Dr. Greenspan: Absolutely. Give me an example of a skill.
Lisa Jo Rudy: Oh, brushing teeth.
Dr. Greenspan: Well, if you want to teach brushing teeth, you have to say whether the child just doesn’t want to do it and you want to, therefore, create incentives to make it fun, or does the child need some work in the fine motor skills – holding things and using their fingers. So if they need fine motor work, we are going to do what we call “semi-structured problem solving Floortime” – figure out fun things to do that the child wants to do that uses his fine motor; uses those little fingers in all kinds of ways. It might be coloring, drawing, holding things, it might be brushing the teeth of the dollies. Then when the child has the skill, we can then provide incentives to brush his own teeth and be a big boy or girl just like mommy or daddy.
Lisa Jo Rudy: That is if they want to do that, of course.
Dr. Greenspan: If you get the child to want to do it by doing it with the dollies first, 90% of the ballgame is won.
Lisa Jo Rudy: I see what you are saying. So in other words, you could conceivably simply enforce the child to brush his teeth, but it’s not going to be an ongoing…
Dr. Greenspan: You’ll have to do it all the time because you’ll have conflicts all the time.
Lisa Jo Rudy: With the Floortime process, you are actually getting past the sense that you don’t want to do this but you are going to make me.
Dr. Greenspan: Right, exactly. You get away from the struggle.


