FOR PARENTS, BY PARENTS HOME PROGRAM GUIDE

Home Program Guide Overview

We’ve Lived It
As we begin this guide, let us introduce ourselves. We are two moms who have been
implementing the Developmental, Individual-Difference, Relationship-based (D.I.R.) model,
often referred to as Floor Time, with our sons for over seven and ten years. We have
implemented comprehensive home-based D.I.R. programs. We began with intensive home-based
programs that have evolved into successful inclusion in school
and other peer and social activities. While we continue to work
with our children in specific and important ways, we feel that There is life after
because of the programs we implemented, our children have
“made it to the other side.” Floor Time.
We also want to state at the beginning of this guide, that while It’s more
we pursued D.I.R in its entirety to great success, elements of the
D.I.R. model can be integrated into any program you put Floor Time.
together for your child. There is great value to the D.I.R.
program even if you do not incorporate the entire program.
We give our thanks to:
1. All of the Floor Time parents who responded to our requests for information about how they
developed and implemented their home programs
2. The gifted clinicians who have guided us
3. Our special children, who continued to love and interact with us, even when words, sounds,
movement, and interacting were the most difficult struggles they faced as we began our home
programs
4. Our spouses who joined and supported us on this journey and to the siblings who helped and
loved us, expressed their feelings and learned so much through our families’ experiences
Our purpose in writing this is to help parents and their children’s therapists begin to establish a
D.I.R./Floor Time home program. The program has three components:
1. Floor Time (focused time where you follow your child’s lead, striving to build a sense of
pleasure and flow of interaction as you are wooing, enticing, and flirtatious with your
affect and energy)
2. Understanding and intervening with your child’s individual sensory needs (understanding
that children differ in the way they process sounds and language, take in sensory
information and sensations, the way they see, find, and search, and the way they plan and
sequence their actions with people as well as toys)

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3. Semi-structured play (you create opportunities for play and affect-based learning by
harnessing the child’s motivation). The child should demonstrate the ability to be
regulated and to have strong engagement and eye contact before more specific skill
building.
First, we focus on children who are at the earliest stages of development, working on:
• Sensory regulation
• Joyful engagement (joint emotional involvement) and
shared attention (the child and adult are interested in We know what the
the same thing) beginning feels like.
• Two-way purposeful communication (the child
opens and closes circles of communication with We wish we’d had a
smiles, nods, and vocalizations) guide. We’ll be yours.
• Purposeful problem solving (e.g., the child takes you
by the hand to the refrigerator for juice)

A Note on Autistic Spectrum Disorders

As you read the guide, recognize that children with Autistic Spectrum Disorders (ASD) and
issues of relating and communicating are a varied group, with different interests, strengths, and
weaknesses. It is important to tailor your program to your child’s individual sensory and learning
profile. We hope our suggestions help to jumpstart your creativity and imagination as you begin
to think about what your individual child responds to. No one knows your child better than you
do.
Our purpose in writing this guide is to increase your awareness of your own child as you:
• Learn the basics of how to get started and supported
• Read how different families interpreted the basics in their own child, family, and home
environment
• Realize that as you follow your child’s lead, there is a very clear plan, as well as
developmental guidelines to follow, to enable you to help your child move up the Functional
Emotional Developmental Ladder.
• Hear from the many parents who want you to know that there is no “right way.” In
November 1998, at the Annual Conference of The Interdisciplinary Council of
Developmental and Learning Disorders, Dr. Stanley Greenspan concluded “…the only
indicator of outcome for any child is the optimal program for that child.”
• An optimal program for your individual child puts the elements discussed here together in a
way that matches your individual child’s needs, as well as those of your family’s system and
relational style. Heightening your awareness of these is the key.

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As we revise and expand this guide, we hope to include more information to help you in tailoring
your program to your child. We also hope to extend the guide to include children at the higher
levels of Floor Time and development.
We welcome your ideas, feedback, and suggestions. Please send
your comments to: [email protected].
One final note: As we wrote this we generally referred to
children with masculine pronouns (“he” or “his”). It’s a habit
because we are parents of sons! Floor Time is equally valuable
for girls and we know that there are many girls’ stories out
there. We hope to include more of them in the future. If your
special child is a girl, please picture her, read “she” or “her,”
and visualize a doll or stuffed animal instead of a truck.

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What is The D.I.R. Model?

Why Use the D.I.R. Model?

One of the most valuable aspects of the D.I.R. model is its comprehensiveness. As you use the
D.I.R. model to help your child climb the developmental ladder, you will become an expert in
your child’s developing emotions and cognitive abilities, the development of his strong motor
planning and sequencing abilities, biomedical issues (where applicable), and very importantly, the
avenues by which your child takes in and uses all sensory information.
We recommend that you read about the model before you get started. Here are a few sources to
get you started, and there are many more on the Internet and in print.
• “The Parent Roadmap,” Section 1 of For Parents, By Parents (available online at
www.icdl.com).
• The Child with Special Needs (1998), by Stanley
Greenspan, M.D. and Serena Wieder, Ph.D.
• The Affect-Based Language Curriculum (ABLC): An
Intensive Program for Families, Therapists and Teachers,
by Stanley Greenspan, M.D. and Diane Lewis, MA,
CCC/SLP. Available through www.ICDL.com, or by
calling 301.656.2667.
• Chapter two of The ICDL Clinical Practice Guidelines:
Redefining the Standards of Care for Infants, Children, and
Families with Special Needs, available through
www.icdl.com or by calling 301.656.2667.
• The Guide to the ICDL Floor Time Training Videotape Series, available through
www.icdl.com or by calling 301.656.2667.

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Understanding Your Special Child

We strongly urge you to read Section One, Chapter 6 in The Child with Special Needs by Drs.
Greenspan and Wieder. At an ICDL Conference, Dr. Greenspan pointed out that most young
children are awake 98 hours a week. On average, that means they are available to interact 90
hours per week. Dr. Greenspan repeatedly directed the audience to consider what could happen
for children if as many of those hours as possible were made opportunities for developmentally-
based play practices.
No matter how many hours of therapy a child receives, no one
knows him better or spends more time with him than his mom
You are the expert
and dad. And we can tell you, there is nothing else in your life
on your child as you you will invest more in, or reap more benefit from, than the
spend the most time time and effort you put in now. The way you approach the
with him – and are time you spend with your child and how you feel about it can
most invested. have a major positive impact.
Be prepared to offer your best effort. Don’t offer the best
therapist; offer your own personal best. No one, especially not
your child, expects you to be a teacher. You are a unique member of your child’s team—the
loving parent. In embracing the D.I.R. Model as the right one for your child, you have essentially
chosen to make your relationship with your child one of the primary components. You recognize
that children’s motivations fuel their growth and learning and that the people they are most
motivated to socially interact with are their parents.

A Few Good Resources

Become an educated consumer. Educate yourself, talk to other parents, join Internet list serves,
and stay current. We’ve listed some resources to help you get started.
• [email protected] is a great place to get your questions answered by parents.
• Two books describe what should go into an appropriate
D.I.R. Assessment and the clinicians who can give you
information that will result in a clearly defined intervention
plan. They are Infancy and Early Childhood-The Practice of
Clinical Assessment and Intervention with Emotional and
Developmental Challenges by S. Greenspan, M.D., and
The ICDL Clinical Practice Guidelines: Redefining the
Standards of Care for Infants, Children, and Families with
Special Needs.
• The For Parents, By Parents Guide contains invaluable
information. It is available at www.icdl.com.

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Getting Ready for the Assessment

When your pediatrician suggests that you go for an assessment, start being pro-active. Whether
you are given the name of a clinical pediatric psychiatrist, a developmental psychologist, or a
developmental pediatrician, do your homework. Look for clinicians who are functionally and
developmentally based. You need people who can give you practical information such as, “what
do I do next?” Look for people who not only evaluate, but also can guide you as you develop
your intervention strategy, find other resources, and help you to develop your child’s intensive
home program.
Some evaluators do not regularly allow parents to observe and/or
participate in children’s evaluations. A child, who has difficulty relating
and communicating, may have trouble regulating and demonstrating his
areas of strength.
We recommend that you participate in your child’s evaluations because
you have the best information for discerning how your child did in
testing. You know whether your child was fatigued, whether it was an
on- or off-day, etc. You’ll also learn from observing how your child
responds to the various testing items and tasks. Parents of very young
children can be especially involved in administering some test items in
order to see how children do at their very best or “highest capacity.”
Be prepared to ask prospective clinicians educated questions, such as:
• What kind of assessment do you do?
• How long will this take?
• Can I be present for the assessment?
• How long have you been doing assessments in this way?
• What information will I have at the end of the assessment?
Over time, you will develop your awareness and skills as your child moves up the Functional
Emotional Developmental Ladder that follows. You’ll learn to trust your instincts more, and will
become an educated partner with your child’s therapists and other team members. In time, your
observations and your daily interactions with your child will fuel the therapists’ and clinicians’
suggestions. You will insure that at all times your child is benefiting from his own individual
optimal program at a pace appropriate for him.

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Functional Emotional Developmental Ladder

(These designations are also called Levels or Milestones.)

Ability for regulation and shared attention.

1 For example, the child shows an interest in his surroundings, can respond to sensations
such as sound or light, and can do this in a calm and regulated way.

Ability to form relationships, attachment and engagement.

2 The child is able to engage with warmth, trust and intimacy. You will see it reflected in
eye contact with a caregiver, a smile, and the ability to make other gestures that indicate
mutual pleasure or interest (such as reaching for a ball).

Ability to conduct two-way, purposeful communication.

3 Circles of communication are opened and closed and there is affective gesturing with
smiles, smirks, and head nods. The child has the ability to take these gestures and
organize them into back-and-forth communication.

Ability to problem solve, use gestures in a continuous flow, and support a complex
sense of self.
4 For example, a child takes her mother by the hand, walks her to the refrigerator, bangs
on the door, and when its opened points to the juice. There may be 10-20 circles of
communication all targeted toward solving a problem.

Ability to use of ideas representationally and functionally.

5 The child can use words or symbols to convey intentions or feelings. An example in
pretend play is feeding a dolly or putting the dolly to bed by putting a blanket over her.

Ability to build logical bridges between ideas and emotional thinking.

The child can use language logically and realistically, and shift gears between reality and
fantasy. For example, a child could participate in the following conversation, saying, “I
want to go out.” Caregiver says, “Why?” Child says, “Because I want to play,” or “Dolly is
6 having a tea party.” Caregiver says, “Why is Dolly having a tea party today?” Child
responds, “Because it’s Dolly’s birthday and she likes tea parties.”
This represents the logical use of ideas supporting imaginative play, negotiating, and
problem solving at the symbolic level.

Three additional levels have been developed for the D.I.R. model to promote more advanced
reflective and abstract thinking. (See “Functional Emotional Developmental Ladder” in the
Glossary for more information.)

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Beginning a Home Program

In the beginning, you need information and guidance from those clinicians, therapists, and
consultants who can best support the foundation of Floor Time: sensory regulation, shared
attention, and joyful engagement. You will determine your hierarchy of intervention priorities as
you enlist guidance from clinicians and therapists. For example, incorporating SI/OT workouts
into your child’s program while you play might take initial priority over more formal cognitive
goals. As another example, for some children, severe allergies might need to be addressed before
real progress can begin. This is where your emerging awareness of your child provides the
clues to what may be the real underlying issues that must be addressed. As you become better at
observing and reporting your observations to your “partner clinicians,” together you can better
decide which intervention(s) would be appropriate to create an optimal program for your
individual child.

People Resources to Look For

As you begin your home program, you’ll gather evaluations and information from many different
clinicians. We’ve listed such “people resources.” Remember that your beginning program will
change and evolve over time; clinicians and therapies that are most important in the early stages
might be very different from those that are important in later years.
• A D.I.R./Floor Time therapist. ICDL has a D.I.R. clinician-training program and maintains a
list of D.I.R. clinicians. To find an ICDL D.I.R. senior clinician, call ICDL at 301.656.2667.
If there is no D.I.R. trained clinician in your area, travel to a D.I.R. clinician and/or send
videotapes of your Floor Time to a D.I.R. clinician for feedback and guidance.
• Speech & language therapists
• Occupational therapists that are trained and certified in Sensory Integration
• Developmental psychologists
• Child development specialists
• Medical practitioners who have specialties in understanding biomedical aspects of ASD.
These might include developmental pediatricians, neurologists, gastroenterologists,
nutritionists, as well as other specialists. (See the Biomedical Intervention section of the For
Parents, By Parents guide for more information on this.)
• Visual motor and visual processing specialists
• Technologies to enhance auditory processing and modulation, motor planning and sequencing,
as well as to augment communication.
• Other parents!

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Additional Resources
Check out the www.icdl.com website early and often. There are rich sections on Publications,
Training, and Resources. Many of the materials listed here can be ordered directly from the site;
others are available at www.amazon.com or other booksellers.
Attending the Infancy and Early Childhood training course by
Stanley Greenspan, M.D., and Serena Wieder, Ph.D. is always a
valuable experience. The training course has a different focus
from the November ICDL conference, which is a
multidisciplinary team of presenters. The spring training course
is intervention-oriented and much more parent-focused.
Information about the training course is available at
www.stanleygreenspan.com and also at www.icdl.com. The
training course is offered annually at the end of April or early
May in the Washington, D.C. area.
There are several Internet sites devoted to supporting the D.I.R. model. Some of these sites were
established by ICDL and/or foundations that support ICDL. Other sites were established by
talented parents who have been implementing the D.I.R. model with their children.
• www.ICDL.com. The website for the Interdisciplinary Council on Developmental and
Learning Disorders.
• [email protected]. This is a list serve, managed by a D.I.R. faculty member and
mom, that offers a venue for parents seeking support and ideas as they implement the D.I.R.
model with their children.
• www.eunicorn.com. The Unicorn Foundation supports the work of ICDL and the D.I.R.
model and works to disseminate information about developmental disorders as well as to
effect changes in public policies.
• www.mindspring.com/~dgn/index.htm. This is a website by a father who has done a Floor
Time/Son-Rise program with his son, and today is a counselor working with families in the
D.I.R. Model.
• http://home.sprintmail.com/~janettevance/floor_time.htm. This is a website put together by a
mother who has done an intensive floor time intervention with her own child. There are very
good summaries of the D.I.R. model and summaries of Floor Time techniques here.
• www.polyxo.com/floortime/buildingplaypartnerships.html. On this website you will find a
25-page summary of The Child with Special Needs.
• www.specialfamilies.com/. On this site an inspiring psychologist, author, and parent shares
his insights and experiences on family life with a child with autism, focusing on the special
needs of families and emphasizing the role of fathers.

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Life on the Floor

Overview of Floor Time

Even as the assessment process begins and you are getting your team together, you can begin
playing with your child in the special way that has come to be known as Floor Time. Set aside
30-minute periods of time throughout your day for Floor Time sessions.
Years ago this was called “The 5 Steps of Floor Time” and is a gentle way to begin. Floor Time is
not just getting down on the floor to play with your child (in fact, at their ages, our own kids are
rarely on the floor and we’re still doing Floor Time with them.) Floor Time is a special and
respectful way of playing with your child. Floor Time also becomes a philosophy for the way
you are with your children and other people. Now for the five steps.

Step 1. Observe your child.

Step 2. Approach your child.
Step 3. Follow your child’s lead.
Step 4. Extend and expand on your child’s ideas.
Step 5. Open and close circles of communication with your child.

Step 1. Observe your child. This is the primary step and the step most often forgotten. When
you feel you can create 20-30 uninterrupted minutes in your day to play with your child, stop
and notice what your child is doing and her tone. Is he running around and being loud? Is she
sitting quietly turning the pages of a book? You will want to join your child, no matter what you
may have had in mind, by matching his emotional tone of the moment. This doesn’t mean that
the tone might not vary as you begin to play, but as you begin, you want to join your child
where she is.
Step 2. Approach your child. Now you approach, matching your child’s tone, asking if you can
join what she is doing with words and gestures. Here your facial affect and the tone of your voice
can be used to create shared attention and enjoyment of what she had been doing. Swooping in
with high affect and loud, boisterous verbalizations to a child who at the time is being quiet is a
very effective way to shut that child down. On the other hand, joyously joining a child who
seems to be running in circles aimlessly with a playful “I’m gonna get you” may be just the
match to start the motor plan going!

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Step 3. Follow your child’s lead. Your child becomes the director, as you take the role of
assistant and prop-man. You are in the play to support his interests and initiatives. This is not a
teaching moment. Remember that very specific skill building occurs in every other component of
the D.I.R. model. During Floor Time, your goal at the earliest stages, is to have a child that is well
regulated and with whom you have joyful back and forth, purposeful interactions.
You are there to take joy in what he enjoys and to tell him how good it feels to play with him in
this way. Even if you know that what your child wants cannot be done, do it anyway! Literally,
stand on your head—if asked to—and as you make your outrageous attempts, and your child is
connecting with you through joyous giggles and appropriate eye contact, you are imparting some
very strong statements. “I’ll do anything you ask (as long as no one gets hurt), I love playing
with you, and you have fun ideas.”
In his book, Growth of the Mind, Dr. Greenspan describes in detail the role motivation has in all
learning. It is the first step necessary for any kind of true learning (not rote) to follow. Clearly,
in Floor Time, we must use this as our primary jumping off point for any and all interaction to
occur. What she was motivated to do yesterday or even an hour ago is not the issue; what is in
this moment is the motivation. For example, think of the glass of ice water you brought into your
play space. Suddenly, she gestures toward the glass (and of course your first thought is “why
didn’t I use a plastic cup?”). You realize she might be thirsty, or you could teach her about warm
and cold, wet and dry. You could get glasses and fill each with differing levels of water to make
the musical scale, but if you really observe, her motivation is the lemon floating in the water. A
sour lemon in mommy’s mouth leads to silly faces and peals of laughter. As long as you keep
your growing awareness of your child on what she seems interested in, is excited by, or is simply
looking at, you have a clue for where to go next.
At the very beginning of this process, a highly insightful developmental psychologist asked one
of us to think of three things her son really liked. Well, that was easy. Then she asked the one of
us to think of three things that could be done with each of those three favorite objects. Again, an
easy one. “Terrific,” the psychologist said, “Now you have nine ideas he’ll be motivated to
play!” She was right, it was that simple. By being very observant of what our children are
motivated by, no matter what that may be, and by beginning to engage in simple games with
them, our children can begin to feel the joy of back and forth turn-taking and social interaction
around a theme of their choosing.
To get you started, think about how good it feels to tickle a child and receive peals of laughter for
our efforts. That’s the feeling we’re looking for when we begin to invite our children to play with
us in Floor Time. There are certain props that we know most children, no matter what the issue,
will respond to. When these are added to a warm, engaging smile on the face of Mommy or
Daddy, who will greet any response with large, inviting, dramatic sound effects, gestures and
laughter, the magic of affective exchange occurs. (This is the “tickle me” effect.) So start with
your child’s three favorite things and think of three things you can do with each of them.

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Step 4. Extend and Expand on Your Child’s Ideas. Here is your opportunity, as Dr.
Greenspan has said, to “…turn his soap opera into an epic.” Perhaps a simple example from a
Floor Time parent might help, “We were playing horsy and having great fun together, but after
15 minutes I just couldn’t keep it up. So I collapsed to the floor and said ‘The horsy’s tired.’
Next thing I knew, my son was bringing me a blanket and pillow. I quickly asked “What else
would make him comfy?” and off he went to bring me the bear he sleeps with. I began to snore
and he lay down and cuddled close.
After a few minutes, I realized I could suggest all kinds of experiences from my son’s life to
expand his original idea and still stay on his theme. The horse, over many Floor Time sessions
got hungry, thirsty, and hurt his foot (no more 15 minute rides for me). We went to McDonalds
and to the Horse Doctor and even had the horse’s teeth checked. We built a barn with blocks,
rode to the toy store—after all, cowboys have their needs too, and did all of it in our special play
space during our ‘special play time’ and no batteries required!”
Step 5. Open and close circles of communication. Just as in the previous example, when the
Dad/Horsy said he was tired and his son got the blanket, he was “closing a circle of
communication.” Even though actual verbalizations may not have been used, pre-verbal gestures
got his point across completely and appropriately. If he had brought the horse a flower, then he
would not have closed the communication circle. Clearly his response was not only appropriate,
it lead to the opening of the next circle and that is one of the major goals of Floor Time—a
continuous, rhythmic back and forth, opening and closing of more
and more circles, and a true enjoyment of initiating ideas and
interacting.
A major goal of Floor Time is for your child to have a wide range of
emotions. At first, these emotional themes may show up at
seemingly developmentally younger stages. For a description of the
typical emotional themes a child may express in play, please refer to
Drs. Greenspan and Wieder’s book The Child With Special Needs.
As you move to higher and deeper levels of Floor Time play, and in
concert with the recommendations of your D.I.R. clinicians, this will
shift to become developmentally more appropriate.
A note about handling angry and/or aggressive feelings within a Floor Time session. There are
fewer moments that your child is more motivated than when he’s angry! This is very much a
moment to stay with him, empathize with his feelings (to empathize is to understand, but not to
necessarily agree). Offer him a way to express this strong feeling. For example: pillow fight,
pound a beanbag, scribble vigorously with a crayon (much better proprioceptive feedback than a
marker). If he has some words to express his anger, write them, which makes them oh-so-much
more important (even if he doesn’t read). Ask him to grade the feeling. Is it (using your hands)
this big or this big (arms out) or this big (thumb and pointer)? Depending on your child’s
developmental level, you can ask “Do you feel like a balloon about to burst? Show me. Or are
you a volcano?”

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There are lots of opportunities for circles of communication as well as ways to share and handle
strong emotions. Take aggression for example. Some children choose to play this out because
they are fascinated by it, some because it frightens them, some to see what it feels like, some
because they saw a behavior like this on the playground and didn’t understand it, etc. Since you
don’t need to be the therapist or the teacher in Floor Time, just a supportive play partner, you
don’t really need to know the “why.” However, some parents have told us that this makes them
uncomfortable. We’ve heard concerns like:
• If I go along with this, don’t I give my child permission to be aggressive?
• If my child is supported to play out aggression in Floor Time, then won’t he be aggressive
with others?
• If it’s OK to throw an action figure off a building, what’s to stop him from tossing his baby
sister out the window?
• This makes me feel very uncomfortable.
We find that children who are allowed to play out their emotional themes, with an empathetic
(not necessarily in agreement) play partner, have a better understanding of their emotions and in
fact have no need to act them out in real life. They also get a clear message that all emotions are
fine, having them doesn’t make you a bad person, and that there are socially appropriate ways to
deal with these feelings before they get out of hand. These are good insights for all of us to
remember.

Magic Tricks
A child who is in a regulated/modulated state is the first
requirement to be able to “do” Floor Time, as well as the first
developmental milestone in the D.I.R. model. Next you ask
your SI/OT what equipment is appropriate for your play
space and your child. Then you would ask yourself what kinds
of activities seem to work best, when to use them, and how to
know when to use them. All of this means that after a
reasonable number of sessions, your child’s OT should be able
to provide you with the beginnings of a “sensory diet” for
your child. Basically, a sensory diet includes activities you can
be doing throughout the day and integrating into your play, to keep your child calmly alert and
regulated/modulated.
With time, you discover other “Sensory Diet” preferences your child may have. These may also
change with time and development and may eventually become simply some recreational activity
your child enjoys (e.g., gymnastics, hiking, swimming, running). For some children, one or two
homemade “crash cushions” or “Jell-O pillows” are essential. For others, a mini-trampoline or
swing mount promotes regulation. With your budget in mind (and telling people what your child
could really use for birthdays and holidays, if they ask) your SI/OT should be able to suggest
what is to begin with and how to use it with your child’s unique sensory profile.

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First, ask yourself, “in this moment, is my child regulated (comfortable and alert)?” If not,
employ the appropriate “sensory diet” tricks (suggested by your SI/OT) to calm, modulate and
alert your child to be ready to interact with you or, even better, to initiate interaction so you can
follow her lead.
Once your child seems regulated for the moment, move on to the next step. Aim for shared
attention. To move toward joyful engagement, you might have to “up your volume” from a
warm, loving play partner to someone who is absolutely irresistible. Here are some tricks to help
you show your child that you are absolutely the coolest toy and the most fun there is!
• Always be aware of your facial affect, body language, and
gestures. The bigger, more dramatic, more full of energy and
sillier these are (even when you whisper!) the greater your
chances of connection.
• Try to stay in a position where your child can easily connect
through eye contact, even if only by looking at each other in a
mirror. Hold toys, etc. near your eyes to encourage this. Use
make-up, clown noses, anything playful that draws your
child’s attention to your face.
• Move across the room with your child. Do not be left behind.
Get to the toy or object your child is heading to, just before
your child, so that you are offering it to your child, thereby
creating a circle to open and close.
As you have a regulated, connected child you will already have begun opening and closing pre-
verbal, gestural circles. (This is very important – don’t skip these gestures in your burning desire
to race for language. Research shows that close to 90% of what adults communicate is non-
verbal.) What are these gestures? Head nods and shakes. Shrugs and hand movements for come
and stop. Eyebrows when surprised or angry. Facial expressions for happy, sad, mad, scared.
Now you want to go for lots of circles, extending the “conversation” and expanding the theme.
These guidelines will help you.
• Remember to follow your child’s lead. Don’t change the subject – he’s the director.
Remember that you are building solid joyful engagement as an important foundation. Do not
interrupt or change the activities that are joyful and engaging, even if they feel repetitive to
you. You can expand and extend the play after engagement is solid.
• Match your child’s utterances (see note below). If you only get one-word responses, don’t
reply with ten. One or two words are plenty and then give your child time (count to ten). To
close the circle, a gesture is a fine circle closer! As your child begins to respond with longer
utterances (longer chains of words, perhaps 3-4 at a time), you respond at a similar length,
perhaps adding one more word as your child’s comments become longer.

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• Ask fewer questions. This is not the inquisition, but we all seem to fall into this trap.
Wanting a response so very much, we try to yank it out with questions. However, this is not
a fun way to be together, it’s also not how we converse normally, especially with someone
we really enjoy being with.
• Turn any utterance into something intentional. One Floor Time parent says, “At the
beginning I noticed our son had quite a few favorite things that started with “C” sounds. Our
speech therapist said that B, C, D, and M were
typically first sounds (e.g., Mommy, Daddy, Bottle).
In thinking of what he might be really motivated to
start to say or point to, we made sure to have his
favorite C’s in our play area – cookies, cat, Cookie
Monster and the Count (from Sesame Street). When
he looked at and pointed and said “Ca” we ran like
hell to retrieve and verbally label each, until we hit the
right one. “Cookie – you said cookie!” It seemed very
soon “Ca” became “Coo” which became “Cook” –
well, you get the idea.”
• Turn any focus/interest into a game. One of the best examples of this is in a video Dr.
Greenspan has shown at numerous April training conferences. We are introduced (on video)
to a family whose little girl, on first glance, seems very challenged. She wanders around and
picks up a fabric eyeglass case and starts to flick it. Dr. Greenspan then suggests that
Mommy hide the case where it can be seen. What follows is a joyful hide and seek game
becoming more complex involving Dad too.
• While you do this work, give priority to getting a continuous flow of back and forth
emotional gesturing/communication going between you and the child and challenging the child
to take the initiative. The child should be enticed to want to interact, e.g. to discover in which
hand you are hiding the colorful ball. Too often, we rely on our own bag of tricks rather than
the child’s natural interests. The result is a child who only opens a few circles in a row.
Don’t entertain your child, challenge their initiative.

Functional Emotional Developmental Ladder

6 Ability to build logical bridges between ideas and emotional thinking.

5 Ability to use ideas representationally and functionally.

Ability to problem solve, use gestures in a continuous flow, and support a

4 complex sense of self.

3 Ability to conduct two-way, purposeful communication.

2 Ability to form mutual relationships, attachment and engagement.

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1 Ability for regulation and shared attention.

• You need to provide a balanced environment: one that woos the child into exploration and
problem solving while ensuring that the child feels safe and maintains a regulated state. Some
children get over-focused and don’t know how to explore their environment while other
children need the environment to stay the same and be predictable. It’s also important to
ascertain the difference between focus and distraction versus fragmentation.
Modify the environment to the extent possible and mediate through the challenges through
your interaction with the child. For many children, the play environment can make a huge
difference in their ability to stay with you. If your child is easily distracted, be sure to put
away what you seem to have moved on from. For example, let’s say you’re having a terrific
“I’m gonna get you” sort of peek-a-boo play with your daughter around the multi-purpose
empty refrigerator carton on its side like a tunnel. As she runs to get to the other side (great
play and sequencing!), she is distracted by the Teletubbies book you had been cuddled
together reading in preparation for some high-energy play.
Until some of these children are solid in keeping their focus
on what they are currently engaged in, it is too easy for
environmental factors, (especially objects which are in the
room specifically because they have been chosen for their
clear motivation for this individual child), to make it seem as
if they just drift away. Taking time, especially in the very
beginning stages and/or as long as your child seems to remain
distractible, to put toys away when your child seems to
move on to something else really is a great help in keeping
the child in it with you.
Of course, if you are really extending and expanding his
drama, you would suggest additional toys that would enrich
the theme, but this is very different than the toy left from
the fun being had 20 minutes ago which might draw your
child away from what you were doing together in the moment.

• Now you’re backed into this corner as you left the Ernie doll on the floor and the refrigerator
chase has been forgotten. You can:
− Persist, as in, “Hey, (getting more dramatic, bigger with gestures and sillier) I’m gonna
get ‘ya!”
− Persist and, if appropriate, invite the other toy to join in “OOOOh, (getting even
more dramatic and a whole lot sillier) now I’m gonna get (child’s name) AND
Ernie…Here I come!!!(running in place), or

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− If those attempts seem to have failed…YOU HAVEN’T!!! You may have learned
something about your child in that moment, the effect of the environment, how to use
a highly motivational toy to bring her back to you or that she just needed a break from
the excitement and didn’t yet have the ability to communicate that to you,
− None of the above. You’re the parent, with enough trial and error, you’ll ferret it out.
(Or you’ll remember to put previously played with toys away until they are asked
for, yes, another opportunity to communicate!) Go back to Follow the child’s lead.
Join him in what he is doing with Ernie and look for ways to reconnect.

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Self-Stimulation Behaviors
If there is one area where parents seem to need the most
support, it would have to be what others call “self-stims” or
persevering behaviors. “How do we stop that “stimming”? Well,
actually, you don’t.
We have come to see that these are moments when our children
are doing the best they can. To quote the Co-Founder of the
Developmental Delay Resources and Nutritionist, Kelly
Dorfman, M.S., L.N., who has become an invaluable resource to
families, “…these kids use whatever they have chosen to do, as “self-OT.” As we look at these
movements through the lens of greater awareness, even following our child’s lead, joining the
child to discover what the child’s body is gaining by doing these behaviors, we begin to have not
only a greater understanding of why our children need to do them, but on a deeper level, why
they have to do them.
We are being shown, and given the opportunity to experience, the doorway into some of the
underlying causal issues of why our children flap, spin, run, screech, etc. We learn not to
extinguish these behaviors. Instead we make these behaviors interactive, and use them to
motivate the child. By understanding the underlying sensory issues and interacting with the child
through these behaviors, eventually we can remediate them, enabling the child to move up the
developmental ladder and eliminating the need for the “self-OT.”
One of us recalls that “…no matter what was removed from a space, her son could find or make
something to flap in front of his eyes. He could be in a doctor’s waiting room and know just
which magazine would still have a card left in it to “order your own subscription now.” At two
years old, he seemed to know the exact amount of the card to tear off for the perfect tool to flick
at high speeds in front of his eyes from the side. (If you put all the torn bits in a pile, you’d see
the similarity in size and shape!) It took me a while to get it exactly right when he had his
favorite flicker in hand (back in our own private play space), but as I joined him and sped up to
his rhythm, I began to realize that my vision became so focused all else around me seemed to fade
away.
Since we had just had a very excited and animated Floor Time session, where he had worked very
hard to stay connected with me and closed many circles, I wondered if blocking out all
stimulation gave him a way to take a break. While we flicked and smiled and shared this time
together I also began to think of what else I could have offered his sensory systems during our
play so that perhaps, over time, he would not need to take such an intense break. However, I was
following his lead, joining him in what he was doing and enjoying being with him and frankly, that
felt a whole lot better than the fear and worry that used to come up in these check out moments.
Realizing this, it became easier to join him—wherever he went—inside himself to take a break.
When he was ready, I was right there to catch the eye of a much more regulated kid than he had
been right before the flicking. Bingo! It is self-OT !!

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We also recall counting 15 different types of these behaviors in a single day and then reflecting
back that only one was left. Then came the day I turned to my husband and casually said, “When
was the last time you saw him walk in circles?” We both realized that the last of these self-OT
behaviors had faded away on a whisper. In fact, we had not even realized that we were no longer
seeing it. It took over three months for me to even remember to ask the question!
We all know, as Floor Time parents, that each child and each family’s experience is different and
that no one can tell you in advance what an eventual outcome will be. As we reflect, however, we
realize that by shifting our mindset about these behaviors from “negatives we must rid our
children of” to “signs that help us to better understand what our individual children’s systems are
needing,” we are better able, 24/7, to help our children and to
offer them our best.
Floor Time allows
Armed with this knowledge, we then begin to know how we can you a way to give
not only help our children, but in doing so, we offer our children
your child the
the clearest message of unconditional love we could possibly
greatest gift of all:
communicate. It’s so easy to love our children, typical or special
needs, when they’re being “good.” doing what we ask, or looking your unconditional
cute. With typical children, it’s even somewhat easy to love our love.
children when they’ve spilled the milk or said “no” in that
adorable way that they do.
We would agree that it is every child’s right to expect unconditional love from his/her parents.
However, in the case of ASD, as parents we’ve had the opportunity to fall in love perhaps for 18
months to 2 years. To some it may seem as if, suddenly, with the pronouncement of a label, the
child we’ve loved has disappeared. How do we feel as we watch our children flap? It is so
natural to express our fear for our children and their futures, perhaps unknowingly and certainly
non-verbally. What message do we non-verbally transmit in that moment of flapping or flicking
or screeching? What is the meaning of unconditional love, if not to love in those moments? It is
natural to want to help the child by exploring and shifting the underlying causes. How do we
insure that our children, who may not yet understand us on a verbal level, still know the
unconditional love that is every child’s right? Join them. The more you feel it, so will they.
Why are we telling parents this? We’re not clinicians, therapists, teachers, we’re just experienced
Floor Time moms. We’ve come to know that armed with the D.I.R. Model and a
multidisciplinary approach, even if your child could see a Speech Therapist, 1 hour/day, five
days/week, it could not possibly have the impact or implications for change that you can. No one
knows your child as you do. Your child responds to no one the way she responds to you and
you have opportunities throughout the day that don’t necessarily happen on a therapy schedule.
In fact, we realize that with all the information now available to you, you have an unprecedented
opportunity to have a key role and a major say in your child’s intervention plan. Parents are no
longer helpless; we can become educated consumers and full participants in the outcomes for our
children.

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Where to Play?
Making a commitment to a D.I.R. program means making a commitment to doing Floor Time.
This means your child gets a minimum of 3-4 hours a day of uninterrupted Floor Time sessions
divided between parents and therapists. Set the clock if it helps “keep you honest” or treat this
time as you would an appointment with a doctor. Tearing yourself away from other activities
and chores can be hard, but often seems easier with the closer engagement you strive for and get
with your child during Floor Time. Some parents recommend setting a specific amount of time
(e.g., an hour) to do a session and eliminating distractions (e.g., ignore the phone and the
answering machine). One Floor Time parent said, “I used to tell others in my house that I was
only to be interrupted in case of fire or blood!”
Take time to look at your therapeutic priorities. Many parents find that half-day integrated
programs (preschool programs that include typically developing children as well as children with
special needs) work best so that there is plenty of time daily for a comprehensive home program
as well as out-of-home therapies.
One of the next steps is organizing your child’s play space.
While it can be very helpful to have a specific room for your
Floor Time sessions, remember that Floor Time takes place in all How come we didn’t
areas of your home. Time in the kitchen, bath time, getting
dressed, and getting out the door are all opportunities to open have this great
and close circles of communication with your child. And while play space when
you’re at it, you can playfully challenge motor we were kids?!
planning/sequencing, and problem solving.
For many children, a contained space is best. Many children
with motor planning and sensory problems may be constantly on
the run or may have difficulty focusing on you due to other household distractions (e.g.,
something as simple as a phone ringing, a fluorescent light flickering, or the sound of the TV in
another room). While you and your child may share a running and jumping game as part of your
Floor Time, it is hard to engage a child who is running uncontained through the house with you
in hot pursuit.
As you develop your play space, keep in mind that it should be
chosen and organized to facilitate engagement with your child. Base
your choice on your observations of your child and how he reacts to
sounds, light, and movement. If he is distracted by too much clutter,
then there should be storage spaces for the toys so that there are
open areas for movement. If your child is distracted by visual
clutter, then you want walls to be free of posters, etc.

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A primary goal is to set up your play space so that to your child, you are the most enticing
thing in the room. In addition, you are the person who assists in getting desired toys/objects.
For example, many parents recommended putting toys on shelves on the wall. This means that
toys are always available and easy to see, but out of reach. Mom or Dad is the good person who
hands the child the toy he wants.

Suggestions for Play Areas

Here are some suggestions for adapting your home and organizing your play space and toys.
Many of the play area and organization suggestions below are from Floor Time parents that
we’ve talked to. We hope they get you thinking about your child and which space in your
apartment or house would work best for both him and the rest of your family. Again, your
child’s needs and interests are unique and the play space should reflect them.
• Basement playroom
• Bedroom (either the child’s or a spare bedroom)
• Rooms that include lots of sensory toys and old furniture that children are allowed to
climb/jump on
• A space that can be closed to ward off distractions from other family members
• A space that can be closed so that there is not an easy escape route
• A spaced with easy access to a bathroom
• A space with a bathroom in it
• Shelves for storing toys and materials
• Quiet areas with little visual clutter on walls
• Rooms painted in soothing colors
• Carpet or padding on the floor so that the space is very comfortable to sit, run, and jump
on, as well as easy to clean in case of spills
• Linoleum on the floor over very thick padding, cushioned padding or wood look-a-like
Formica over cushioned padding, both creating a comfortable, run and jump surface that is
very washable
• One family hung Christmas lights in their play space to help calm their child
• Pictures on walls to reinforce connections in life, e.g., photos of family members, posters
illustrating number concepts, pictures or drawings of favorite objects or activities
• Try to design the room so that it is child safe enough so that you do not have to do set
too many limits. For example, play sessions in rooms with beautiful white upholstered
furniture or a TV are not a good idea!
• Many parents have included huge, wall-sized mirrors in their playrooms. (Be sure to ask
for mirrors that are designed to be sturdy and not easily broken!)

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• Parents have suggested that playrooms might have different play stations.
− Organize toys into open baskets (e.g., a car basket, Disney character basket, ball
basket, space explorer basket)
− An art corner
− Train table
− Basketball goal
− An area with a dollhouse, toy kitchen, etc., for pretend play
Some parents have designed their play spaces so that Floor Time sessions can be easily observed
and/or videotaped. This is very helpful when it comes to training and supervising your Floor
Time partners. For example, one family installed a 2-way mirror in the doors of their children’s
playroom so that Floor Time sessions can be observed and feedback and coaching be given after
sessions are completed. Radio Shack sells simple microphones to hear the audio. Others have
purchased and installed a video or security camera (with wide-angle lenses) so that videotaping
can easily be done. These video units do not have to be expensive and black and white cameras
are fine. These units are available on the Internet. They usually come with a wireless monitor that
you can connect to your VCR so that sessions can be videotaped.
One family decided to turn an unfinished basement into a play area to best fit their child. It
included both a large play area as well as a smaller, cozier play area. Durable, well-padded
carpeting was chosen. They avoided using florescent lighting, which can flicker. Several strong
hooks were installed in the ceiling for suspending equipment. An old sofa as well as a child’s
picnic table were included for snacks and table play.
For many children, devoting a portion of your play areas to
SI/OT play is very important. Drs. Greenspan and Wieder
typically recommend three 10-15 minute SI/OT workouts Consult with your
daily for home D.I.R. programs. Some parents also integrate occupational therapist
SI into their play throughout the child’s day, when and other clinicians
appropriate, as part of a “sensory diet” developed in
about what’s best for
conjunction with their SI/OT to keep the child as
regulated/modulated as possible throughout the day. We your child at this
spoke with parents recommended the following for motor point in time.
workouts. Remember that your choices are based on your
child’s individual sensory profile and developmental stage.
Always check in with your SI/OT regarding the best equipment for your child, and how to use it
to get the appropriate results. For example: a low-tone child may gain a great deal from rotational
swinging, whereas the child who tends to be bouncing off the walls might be better served by
back and forth/lateral swinging.

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A list of options follows.

• An open area for running and jumping
• A 2- to 3’ slide
• Ceiling mounts for swings
• Mini trampoline
• Frog swing
• Trapeze How to make Jell-O pillows

• Spandex/Lycra swing Take inexpensive, easy-to-wash sheets,

sew them together on three sides, and put
• Foam crash pads
Velcro on the 4th side. Then, you fill the
• Mats for cushions under swings, etc. sheets with either brick-sized pieces of
• Ramps foam rubber, Styrofoam packing
materials, balls for a ball pit, etc.
• Balance beam
For the foam rubber pieces, try a local
• Stacking boxes upholstery store that may be willing to
• Soft portable stairs give you their scraps. Hint: use an electric
knife to cut the foam rubber into the
• Pillows
brick-sized wedges.
• Junior stomp rocket
• Wagons
• Stereo with good speakers for music to dance to, rhythm, simple aerobics CDs, etc.
• Small picnic table for snacks, art/craft projects, etc.
• Several crash cushions/Jell-O pillows
• Elevated wood boards for walking on at elevated levels, rolling cars down them, etc.
• Aerobie pro (a large Frisbee with a big hole in the center)
• Jumpin’ Joy (Leaps and Bounds toy catalog)
• Jumpolene (Back to Basics, Leaps and Bounds toy catalogs)
• Play tents
• Punching bags
• Therapy balls of various sizes, peanut balls, Hippity Hop balls
• Jump ropes
• Sit & Spins or Dizzy Discs, disc-shaped snow sleds

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Toys-R-U
As we looked at the toy list compiled from the responses of so many Floor Time families, we
realized it could be overwhelming. Please don’t think that you need all these toys, or a special
grouping of toys, or that you need to use a particular toy we mentioned. This list is merely
provided as a jumping off point to get your own creative ideas flowing. It reflects the successes
of a wide variety of children with a wider variety of strengths and interests.

Developmentally Appropriate Toys

Choose toys that are motivating to your own child and that meet your child where he is
developmentally, not chronologically. Of course, you would want to salt your play space with
toys that your “play leader” might find motivating a half a step or two up the developmental
ladder so you can easily glide toward the next level.
An example of this is the child who demonstrates little motor planning ability, and only rolls his
Thomas the Tank Engine Truck back and forth, not knowing what else to do. Regardless of the
chronological age of the child, meet him where he is, perhaps creating tunnels with your hands,
playfully obstructing with our feet and a grin, crashing our Percy into a wall and offering him a
turn to crash his Thomas, crashing the two trains into each other . . . you get the idea. These are
all Developmental Stages 1-3 games of shared attention, engagement, gestural/intentional
communication and lots of circles of communication beginning to happen. The interaction is
joyful, dramatic, and full of sound effects, crashing and laughter. However, up to this point, you
haven’t had to add any toy, except yourself, to make Thomas more fun! Some suggestions for
simple toys to add might be ramps (made of blocks or scrap lumbar or the tops of shoe boxes)
the trains could slide down, string to pull the trains up, simple 3-block tunnels, etc. There is no
need for hundreds of dollars of Brio-land.
You also need some toys and props that you could easily
incorporate into play with those already developmentally
appropriate toys to extend and expand the play—especially as
you begin. These props allow you to bring in themes from the
child’s known experiences. At the very beginning, some
examples of toys and props are blankets, pillows, hats and
Daddy’s ties. Dress-up, especially items that call attention to
the face, is great because we’re going for eye contact and
engagement, here. Then use play dinnerware—a setting for two
will do. Eventually add fast food bags, Play Doh for making
pizza, etc. In essence, you need a good balance of all the themes
that your child is really familiar with for use when you’re ready
to feed, put to bed, read, etc.

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Finally, before we get to the toy list, a word about meeting the child where she is and basic
games. Both D.I.R. and Sensory Integration are developmental models. This means that the best
way to connect is to meet your child at her highest level of capacity, but not necessarily where it
would seem age appropriate. If age appropriate is what you most want, then this is how to get
there. Don’t impose what the child “should be doing at her age,” but meet her where she is best
able to function. (Stop to consider the number of grown-ups you know who should be able to
program their VCR’s, but just can’t. It’s like starting with the idea of turning the thing on and
working from there.)
For many children at the very beginning of play, this is the 6-9 month level. Start playing where
you get giggles and smiles and hands reaching out to you for more. Here’s where the advice from
your professional D.I.R. partners really begins to be valuable. Use your instincts as you see the
fun and flirtatious come out in your child. Build from there. For many children, some variation of
the following games is a sure-fire way to start the fun:
• Hide and Seek
• Throw and catch (or roll back and forth)
• Peek-a-Boo
• Tickle me…tickle you
• I’m Gonna Get You
• “Zerberts” (basically silly sounds made with your lips on a foot, hand, or belly, if it’s OK
with the child)
Following is a list of toys that many parents have found useful
for their children, based on their developmental levels. A toy Remember that the
might be motivating, but when you enter the picture with all goal of joyful
your exuberance, the toy becomes a prop and no toy in the engagement is for
world is more fun than you. Also, many parents told us that your child to regard
they rotate the toys regularly. This produces “new” toys, and
YOU
at the correct developmental level too!
as the best toy
You will note that some of the toys on the following list will
in the room.
take you to higher stages of development or themes your child
may not have personally experienced. However, your child
may use these playthings in a similar way, e.g., themes of
nurturance, curiosity, and empathy to name a few. Just follow your child’s lead. You’ll be
moving on up the Developmental Ladder!
We have included some ideas and examples, here and there, to get your creativity flowing. We
realize that you know which toys turn your little individual on. Note that for some toys, like
whistles and echo microphones, it makes sense to have two so you can easily join your child.
You’ll quickly know which these are.

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Suggested Toy List

• A refrigerator box (as a tunnel, a hideout, a stage, a barn, etc.)
• Balloons: What should I do? Put my mouth where? Bigger? BIGGER??, IT’S GONNA
POP!!! Let it go and watch it fly (great visual spatial!). How big…show me with your hands
(size relationships). Blow it up and make silly sounds (lots of giggles). Fill them up and toss
them into the bathtub (or go outside in bathing suits and try to catch them!). Have the child
try to blow the balloon up, then move on to bubbles, whistles, blowing feathers or ping-pong
balls across the floor for a race. Play balloon volleyball or paddleball or tennis, keep the
balloon airborne with your breath. Fill your play space with 30 inflated balloons. No child (or
adult) can resist the delight of prancing around a room filled with balloons.
• Pirate toys
• Cowboy toys
• Space toys
• A magic wand
• In the kitchen: water, food coloring, food ingredients, and cooking utensils
• Tunnels: the toy kind as well as the “double-knit tube” found in any fabric store for a tight
tunnel
• Books: Enjoy each page. Wonder if your child can
match the character’s facial expression. Notice the
details. Snuggle in a beanbag chair or crash cushion
(proprioception to calm and organize). Act the page
out. Find another word that rhymes, etc. Hold the
book upside down. Read the book backwards.
Pretend you don’t know which book your child is
asking for. Which one is it? Is it a big or a little book?
What color is it? Ask what her favorite part of the
book is.
• Puzzles: Take care with the level of difficulty as we want success and fun at this early stage.
Remember that sometimes the point of doing a puzzle is NOT the motor or visual task, but
how many circles you can close while doing the puzzle. Consider those ABC puzzles for a
moment. There are at least 26 circles of communication built right into an ABC puzzle. Make
sure you scoop up all the puzzle pieces so that YOU are offering them to your child. Hold
them in your teeth as you offer them. Hook the K piece on your glasses. Hide them on your
head, up your sleeve, in your child’s sleeve. Make a silly mistake—perhaps the letters of the
alphabet are presented in reverse order with you offering your silly apologies all along the
way (visual form constancy).

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• Games such as Hungry Hungry Hippos (remember that those hippos should be talking about
how hungry they are, who got the most food, cheering each other on), Charades for Kids,
Kids on Stage
• Toys that will allow the child/parent to make the pretend noises, e.g., baby dolls that do not
already make crying sounds so that the child can make the pretend crying sounds
• Play Doh and Play Doh accessories
− Make food for a pretend picnic
− Make silly, yucky food. Perhaps snails and sticks for supper. Feed them to the mean T
Rex that is always trying to steal the Play Doh food.
• Pretend play sets that reflect your child’s experiences. A castle does not necessarily reflect
his experiences, but the following play sets might give you ideas
− Playground sets
− Picnic sets
− Farm play set
− Dollhouse: Great for playing the simplest of themes (give baby the bottle) to the most
complex (fights between siblings and choices for resolutions…down the road)
− Toy kitchen set, including oven/stove, frig, empty containers from your child’s favorite
foods, plastic plates, etc., plastic food
− Stuffed animals/dolls to play house, hospital, etc.
− School buses and school house sets
− Doctor kits and police officer outfits
• Character toys from movies and shows (e.g., Toy Story, Bob the Builder, Sesame Street,
Teletubbie, and the Gingerbread Man). There are no limits as to how these can be used and
since so many of our kids are so highly motivated by individual characters, they become our
play space partners as we move up the developmental ladder. Let’s take a small Ernie
character (as in Sesame Street) as our example.
− At first, when someone new walks in to play with the child, the child’s only word may
be an angry, motivated “NO.” The new player can simply toss Ernie against the wall with
a huge smile and also say “NO.” Then you run to pick up the figure so the child can have
his turn to toss Ernie against a wall, yelling a rousing “NO” and a sort of back and forth
game with Ernie as the ball has been delightedly established. Rather than the adult feeling
rejected, the child’s initiation has been shifted into a purposeful, intentional interaction.
− The ways to play with this Ernie are countless. He enjoys his bath (the sink or a bucket
of water), we feed him all kinds of foods as we try new tastes too, he talks to his ol’
buddy Bert (the beginnings of greetings and what we say to and do with a friend), they go
for pizza together, Ernie puts a band-aid on Bert’s head, and so on.

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− One day, your child asks for Ernie and out of reach there are two toy Ernies and two toy
Berts. What to do? Which Ernie, you ask? And so begins the process of using more than
one word to describe something (e.g., brown hat, blue pants, etc.) and locate it with
prepositions (next to, under, etc.).
− Another time, your child enjoys a simple treasure hunt with you, searching for a specific
Ernie using clues you had put out the night before.
− Another time, it is discovered that your child’s favorite toy Ernie is attached to a chair leg
by 3 layers of masking tape (or string). The only escape is to unwind the tape (motor
planning).
We hope that by taking you through just a few “Ernie” suggestions you see how easily we
can address the specifics of a child’s individual profile, use objects he is highly motivated to
play with, use ideas he is familiar with and, most importantly, have fun together.
• Toy cash register and money
• Toy shopping cart
• Baby doll, bed, and toy stroller
• Dress clothes up of all sorts, hats, shoes
• Toys that invite turn-taking e.g., building with blocks, marble runs, Lincoln Logs, Gearation,
Tinker Toys
• Musical instruments, horns, and whistles (have lots of different ones that challenge the
child’s oral abilities in different ways), xylophones
• Shape sorters
• Stuffed animals
• All types of balls that vary in size, shape, and texture, Gertie, Koosh, soft balls that are easy
to catch, porcupine balls
• Ribbons and sheer scarves
• Fabric remnants of all textures, each at least the size of a respectable cape. Some parents
suggested getting fabric pieces (about a foot square) that reflect different play scenes, e.g.,
fabric that looks like outer space, has a jungle pattern on it, is blue and has little fishes on it,
etc., so that you can easily give your child’s actions a symbolic destination. If he says that
Ernie is going to the beach, pull out the beach fabric and you are all set.
• Cars and trucks. Give them personalities. Use your best construction worker voice. Call
your child “boss” and ask for building instructions.
• Fisher Price Imaginex series
• Nerf swords

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• Large puppets, cloth hand puppets, and figures. They allow us two voices, the one the child
assigns to the creature and our own voice. If the puppet is a frog, for example, and the frog is
on the adult’s hand, the adult gets to find out from “the director” just what role the frog will
play, what’s his motivation?
− Dad: “I wonder what the frog eats?”
− Child: “Cookies.”
− Dad pretending to be frog: “Me want Cookies!”
− Child: (points to the Gluten Free Oreos, out of reach) “Cookie box.”
− Dad: (seeming a bit dim-witted) “Where are those cookies?”
− Child: (continues to point in earnest) “Look, cookie box, up!”
− Dad a.k.a. frog: “Mmmmm, Me help get cooookies,” as they run together, joyously
anticipating the snack, and many circles of communication, to come.
• Discovery Toys ball boat and pop up rings
• Shaving cream: Be prepared. Put everyone in easy-to-clean clothes, perhaps an easy-to-clean
surface (not wall-to-wall carpet). Doing this on a large, non-breakable mirror is great fun. Try
“ice-skating” Don’t miss the fun you can have with shaving cream on kid’s feet, but it’s very
slippery!
• Bubbles: Did you say blow? Bigger and Bigger and bigger…oh, no ..it’s gonna POP!!! Have
the child pop the bubbles with fingers, then different body parts. Get the candy bubbles
(usually at mall candy stores) and let the child catch the bubbles with her tongue. Do you
want the bubbles high or low, big or little, one big bubble or many, many tiny bubbles? It
doesn’t matter what you come up with; what matters here is the child’s glee and laughter and
that this bottle of gooey stuff is nothing without you! Of course, you’ll do everything to help
your little director blow her own, encouraging her with everything in you and cheering her
efforts and successes on.
• Polly Pocket sets. These toys work well for some children because there are fewer motor
planning challenges with the furniture fixed to the toy houses.
• White board
• Groan tube (self-explanatory). One family takes small pom-pom balls and shoots them out of
the groan tubes at each other or to targets in the room for playful battles. Team up with your
child against the other parent when he/she comes home from work. Think of the fun your
child will have when you pepper your spouse with pom-poms.
• Paddleball: to be used with balloons and Koosh balls
• Children’s exercise videos, e.g., “Elmocize,” “Teletubbies Go Exercise”
• Echo mikes (the ones that simply echo your voice, no electronics)

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• Snap beads
• Pool tubes (noodles) which make great swords
• Colorform play sets that are great for windows, mirrors, the refrigerator, etc. They can also
be combined with washable markers and washable paint, for example, on a big mirror so
“Ernie can go upstairs inside 123 Sesame Street and Bert can be sleeping on the 2nd floor.”
• Felt story boards (school supply catalogues)
• Duplos
• Computer (some use this intermittently, as a reward for the child, while others limit the time
but use this interactively and motivationally as a jumping off point for ideas in Floor Time
play)

A Cautionary Note
Many parents told of toys that we should stay away from. These are toys that make noise
(some children hone in on the buttons or source of noise and become preoccupied with making
the noises over and over) and battery-operated or electronic toys. One parent wrote, “the child
can be too independently stimulated and engaged with the toy instead of you.”

Sources for Toys and Games

Many parents offered specific resources for toys.
• Occupational Therapy Associates in Watertown, MA publishes an excellent list of sensory
and OT toys, their functions, and suppliers. It is available on the Internet at
www.otawatertown.com (you will need to go to their newsletter and download the
newsletter as an Adobe file; the toy list is in the newsletter).
• Toys-R-Us has a toy guide for children with special needs, www.kidtips.com.
• One creative mother put together a website that includes an ideas file, lists of sensory play
materials, etc. The web address is www.geocities.com/motamedfamily/.
• The Out-Of-Sync Child Has Fun: Activities for Kids With Sensory Integration Dysfunction, by
Carol Stock Kranowitz, M.A.(2003), available through Developmental Delay Resources and
online booksellers. An excellent book of sensory play activities.
• Oriental Trading Company offers a catalogue and website that many parents use for
everything from great foam animal masks as well to simple craft kits to all kinds of hats and
costumes for pretend play. The web address is www.oriental.com.
• The Construction Site is a toy store in Waltham, MA that provides a great selection of blocks
and building toys and accessories. Their web address is www.constructiontoys.com.
• Ebay is a great source for toy ideas, inexpensive toys, and purchasing entire sets of toys.
• Several parents recommended www.Smarterkids.com as a resource for toys and toy ideas.

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• Finally, these websites were also recommended. We suggest you put on your “Floor Time
Specs” and pick and choose which, if any, would match your child’s interests and motivation.
− Leaps and Bounds, 800.477.2189, www.leapsandboundscatalog.com
− Museum Tour, 800.360.9116, www.museumtour.com
− Music for Little People, 800.409.2457, www.mflp.com
− Toys to Grow On, 800.987.4454, www.ttgo.com
− Troll Learn and Play, 800.247.6106
− Western Psychological Services (WPS) Creative Therapy Store, 800.648.8857,
www.creativetherapystore.com
− Young Explorers, 888.876.8810, www.YoungExplorers.com
− Cambridge Development Laboratory, Inc. (CDL) Software Shop, www.edumatch.com
− CDL Times, 800.637.0047, www.edumatch.com/special
− Child’s Work/Child’s Play, 800.962.1141, www.childswork.com
− Chinaberry, 800.776.2242, www.chinaberry.com
− Discount School Supply, 800.627.2829, www.earlychildhood.com
− Educational Resources Software and Technology, 800.624.2926
− The Edutainment Catalog, 800.338.3844, www.edutainco.com
− Gryphon House Early Childhood Teacher Resources, 800.638.0928,
www.ghbooks.com
− The Happy Puzzle Company, 800.376.3728, www.happypuzzle.co.uk
− HearthSong, 800.325.2502, www.hearthsong.com
− Highlights Catalog, 800.422.6202, www.highlightscatalog.com
− Imaginart Communication Products, 800.828.1376, www.imaginartonline.com
− McGraw-Hill Children’s Publishing, 800.417.3261, www.MHkids.com
− Professional Development Programs, 651.439.8865, www.pdppro.com
− Sensational Beginnings, 800.444.2147, www.sb-kids.com
− Sensory Comfort, 888.436.2622, www.sensorycomfort.com
− Therapro, 800.257.5376, www.theraproducts.com

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Don’t Forget the Basics

The basic daily supplies depend on your child’s needs. Here are a few to get you started.
• Snacks and drinks
• Used computer paper (the back is great for any size
masterpiece) and washable markers
• Elmer’s School Glue (washable)
• Masking tape
• Blank, small flash cards or 3x5” cards
• Crayons and chalk (better proprioceptive feedback than
markers)
• Paper towels
• Washable paints
• Imagination and sense of humor!

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In Their Own Words

The Impact on the Family

We know that having a child with special needs means a change of expectations and lifestyle.
Now that we have covered many of the basics of beginning a D.I.R. home program, we felt it’s
only fair to address the idea of managing the balancing act. Who are you? Mom or Dad, spouse,
breadwinner, program chair, house cleaner? We’ll also try to help you find the support you’ll
need during this busy and often emotional time.
Most important, take care of yourself. Remember the lesson from the airlines: if we hit
turbulence, put the oxygen mask on yourself then, then put a mask on your child. We know how
hard this can be with all the demands on our time. Whether it is finding time to exercise, have a
cup of coffee with a friend, or enjoy a date night, a hot bath, soothing music or getting to that
new book, finding time to take care of yourself supports all the rest.
Most of us have found it necessary for one parent to work
full-time, outside the home, while the other “chairs” the
child’s program. Tremendous positives can come from this
kind of partnership, but take care that neither partner feels
disconnected from the other. First of all, this is a
partnership! In order to “chair” your child’s support team
and program, and in order for each partner to feel that the
very best has been offered in this endeavor, one of you must
watch the financial resources you feel are necessary for
success. This is a tremendous support.
This enables the parent who is taking the primary role with the child to focus on your stated
goals. The parent with primary responsibility for the child’s program must, on a regular basis,
keep his/her partner fully informed and up-to-date on progress and concerns. You might decide to
have weekly progress meetings so that all your time together is not overwhelmed by this one
topic. You can supplement these by audio taping all conversations you have with team
professionals (if your spouse cannot attend). The bread-winning spouse can listen to the tapes as
soon as possible, perhaps in the car during that morning commute. Families have developed lots
of creative ways to insure that the parent who is working outside the home is kept well informed.
This is essential for two very, very important reasons.
• Many of the misunderstandings that may happen within families are the result of lack of
information and communication. One parent must be willing to provide as much necessary
information as possible. The other parent must commit to taking this information in, reading
or listening to the important information pertaining to the development of the child. You both
are working very hard, each in your own important way, to help your child.

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• Just as important is the voice of the parent who is not “in the trenches” every day. For the
parent who is with the child, moment-to-moment, it is sometimes difficult to see the positive
changes or to notice issues that require attention. When questions come from the well-
informed parent who may only get to spend real extended time with the child for bath time in
the evening or on the weekends, attention to issues can be invaluable. However, if the
breadwinning parent is not well informed and then decides to lob in a suggestion or question
an expenditure, well, that’s where things can get difficult. This communication issue can cloud
what you’re trying to accomplish for your family in the big picture.
There are also many single parents who have to be both breadwinner and “chair.” This group, in
particular, needs support, communication, and clarity in every moment (as tired as we know you
are) as you work toward your goals. In this case, it is critical that the custodial parent
communicate with the non-custodial parent regarding the D.I.R. program and the child’s progress.

Advice from Drs. Greenspan and Wieder

“D.I.R work imposes many demands on a family. Always remember that you need to support a
relaxed and pleasurable home environment. The needs of the whole family must be taken into
account. On any given day, you do the best you can do, but not at the expense of maintaining
joy and warmth in the home. D.I.R won’t work without joy and warmth. Also, do floor time
with your spouse, with other children in the family, and group floor time.”

Advice from the Other Experts

We know that for some parents, even contemplating doing a comprehensive D.I.R. home program
can be a daunting thought. To that end, we decided to ask D.I.R./Floor Time parents some
important questions regarding their own feelings and struggles as they looked back on their
programs’ early years. We hope that you find energy and inspiration in their advice and
reflections. (We’ve listed each question followed by the answers with key ideas highlighted.)
“Now that you are a D.I.R. parent, what do you wish that someone had taught or
told you as you were beginning your program?”
• One mom told us, “The most important and powerful thing for us has been to educate
ourselves about the six functional developmental emotional stages, create a sensory
profile for our son, and understand where he fits in the developmental ladder. To have this
knowledge helps us go forward in every way—both to appreciate the significance of the
important things that our son has accomplished and to understand where he needs to go.
Without this holistic picture, and when times are rough going, it is easy to feel overwhelmed,
to lose patience and faith in your child’s future growth. We are no longer so concerned about
our son’s developmental abilities vis-à-vis his chronological age. We’ve seen how his ability
to master the earliest and most basic developmental stages improved his ability to go forward
even further. The Son-Rise program was particularly powerful in demonstrating over the
course of a week how important those early stages of self-regulation are and it helps us to
understand Floor Time better. It also showed us how powerful our own attitudes could be in
helping us face our challenges in a positive way.”

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• Many parents cautioned not to give up. They emphasized that progress can often be “slow
going” and is not always evident right away.
• From a practical standpoint, one parent said it is helpful to find someone who can provide
the Floor Time training, as well as someone who can help get you over the initial hurdle of
“finding out about your child, finding professional resources, and getting playroom and
program going.”
• One parent advised simply to ask for and accept help from family and friends as much as
possible.
• One parent said that Floor Time involves a great deal of hard work and enterprise, but it does
yield enormous dividends. Remember that each child has his own individual profile and that
outcomes will vary significantly. The dividends may range from a child who is no longer on
the spectrum to children that remain on the spectrum, but who are now warm, related, and
happy human beings.
• One mother was surprised that the importance of OT/SI therapy was not communicated to
her until her child’s program had been up and going for quite some time.
• Other parents wished they had known ahead of time how challenging it can be to implement
the D.I.R. model in elementary schools. They felt that early intervention teams are very
skilled and attentive to developmental and family issues. With the transition to elementary
school services, parents found staff had difficulty implementing a developmental approach
such as D.I.R. within a more structured educational setting.
• One parent found the Floor Time list serve at Yahoo Groups to be a huge resource in terms
of sending questions to list serve members, as well as researching the archives of the Floor
Time list serve. She also found that the ICDL Floor Time training tapes were very useful.
• Do not neglect the gestural system in favor of language. We all use gestures when we speak
and the child’s pre-verbal (before actual speech) communication through gestures is a very
important stage. This should not be overlooked or pushed aside in the desperate rush toward
spoken words. Accept these as communication, and as you run to respond to the
communication, model the word. For example: Let’s say you thought snack was over and you
put the box away while your child took her last bite. Suddenly she looks at you, then the box
and is pointing at the box. Well, there can be no doubt as to her intended communication, so
you’d want to bring the box back saying, perhaps “…Oh,
more cookies!” In this way you’ve encouraged her
communication, accepted her gesture as a way to
communicate, and given her an even more effective and
faster mode of communication…the words, for when she is
ready.

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• One parent shared that Floor Time becomes a way of parenting all of your children. “It’s not
just for my special needs child. It has helped me to become a better parent to my other
child too. Following your child’s lead and meeting him or her at their developmental level are
wise words for any parent to follow.”
• Finally, one parent shared a very important bit of advice that was given to her. “If your child
seems uninterested in something you are trying to engage him in, it could simply mean that he
is overwhelmed. It does not mean that he doesn’t love you and doesn’t want to interact with
you. Reintroduce yourself gradually with a lowered affect, or a raised affect, and don’t lose
heart.”
“What does your D.I.R. day look like? How do you manage your day? How do you
fit it all in?”
• Several parents echoed the sentiment that the more a parent is willing to give and put into
their child’s program, the greater the possibility a child will make progress, and the more
rewarded the parents will feel. Parents told us that they simplified their lives, letting go of
cleaning, laundry being done on time, etc. Some parents suggested that working parents do
Floor Time in early evening as well as at bath and bedtime. They enjoyed “adult life” either
before or after their children went to sleep.
• Many parents use morning preschool sessions for their children, reserving afternoons for
Floor Time and individual therapies.
• One parent wrote, “I gave my son’s Floor Time program
everything I had. In addition, I carried the necessary OT work
into the playroom and incorporated it into Floor Time. For
example, when we were working on him touching different
textures, I bought loads of different kinds of textured material
from a shop and we would use the material as sleeping bags for
pretend camping trips, or hospital beds for pretend stuffed
animal patients when we were playing hospital. We spent
several hours each day in the playroom and when we were not in
there, I made sure that any opportunity to engage my son in
everyday happenings were presented. I will also say it is
important to have breaks. When my other therapists were
doing Floor Time, I would go exercise or do something else for myself.”
• Many parents emphasized that as you learn more about Floor Time, you begin to look at
every minute of the day as a D.I.R./Floor Time minute. This becomes incorporated into your
way of life, in the car, going out for dinner, at the grocery store, etc. One parent said, “Stay
off the computer, keep the child away from the TV, look for ways to do 10 minutes of Floor
Time and then extend it. We all have 10 more minutes somewhere. Use bath time, getting
dressed, all the routines for Floor Time.”

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• One parent described for us how “child-centered” her day is. She incorporates as much
imaginary character play as possible and mixes it with sensory experiences (e.g., making her
son into a cushion sandwich, opening a Play Doh bakery). She emphasizes that as long as she
is actively engaging her son, Floor Time can be done throughout the day (e.g., in the bath,
making divers swim down to feed the fish in the aquarium, under the covers getting ready for
bed, pretending they are camping out or being bears in a cave). This parent even uses cleaning
to incorporate Floor Time. For example, she pretends to be Cinderella and has her son
pretend to be the stepmother ordering her about. She suggests opening a pretend window
washing business together (e.g., giving plain wet wipes or just watered paper towels). As she
folds laundry, she has her son pretend to be a bull charging through the clothes as she swings
them through the air and shouts “Ole’”!
• Several parents told us about the adjustments and changes to their schedules. One parent
shared that “our day is all Floor Time and OT activities with our son, and play with our
other child. Even when eating meals, we try to engage our son. My husband (who is the stay
at home parent) and I take turns going out with friends, and rarely have a night out together.
(It is hard to find babysitters who understand our child). We have been lucky so far to find
speech and music therapists to come to our home. As this is very tiring, I make a point to
come home at lunch to give my husband a break. He usually lies down and takes a short nap
to recharge his batteries.”
• “A D.I.R. Program is time intensive, but my child’s life and future were at stake and nothing
was more important than that. It was easy for me to let go of other priorities. If my house
wasn’t perfectly clean, so be it. I did the best I could. I did wind up losing friends because I
did not spend time gabbing on the phone or lunching out anymore and then there were a few
who just couldn’t relate to me anymore. I did make sure that once my older son came home
from school at 4:00, Floor Time was officially over for the day in the playroom. Also, on
weekends, my husband and I made sure our older child would have a parent to do something
with.... I can just tell you that if a parent is committed to trying to recover their child,
wonderful things will happen. Even if they are just tiny steps, they are accomplishments.
Not every child is successful to the same extent because as you said, all children are different,
but the accomplishments will be there.”
• “Let go of anything that isn’t essential. Recognize that you will lose friends. Know that
you will again someday be able to volunteer at church, etc. Go to therapy for yourself and as
a couple. Find other D.I.R. parents for support. Do your Floor Time first, not after every
thing else is done. Write a tally sheet on the refrigerator and check off when you have done
your time. Both parents should do it!”
• “I have always been an obsessive person about the house being clean and neat, but it finally
dawned on me that it was more important that my son become engaged with the world
and be able to function some day on his own (hopefully). It has also been very important for
my husband and me to make a list of jobs that we are responsible for around the house, so
that we both didn’t feel that we have all of the responsibility on our shoulders.”

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• “I didn’t just let go of housecleaning. I let go of my entire career for six years. I don’t think
you can do this and maintain a full time job. It’s not just the Floor Time that is time
intensive; there is also driving to all of the appointments, following up on the speech and OT
at home as well as the play therapy, managing all of the consultants and schools, dealing with
diet, etc, etc.! I probably did not build in sufficient time for myself. I would encourage
anyone who can afford it to get someone to help with the housecleaning and to hire a
regular babysitter so that you actually get up off the floor and go out with your spouse. The
encouragement I can offer is that every hour you put in makes a huge difference, and that you
can and you will see progress.”
• “I came to the conclusion, very early on, that I would rather be with him in the playroom
working toward connecting than be in the kitchen while he stared at the wallpaper and
flapped. At the very least, it felt like I was doing something pro-active. Since our son was
described to us as being so very severe, I really never had any expectations. My only hope
was that one day he might know that he was loved. If he wound up with only one word, I
wanted it to be functional.
However, as we began our home program, even though the steps each day were so small they
might have been missed—we knew they were there and this so excited us all that we just kept
following him! This eventually meant that I was running a full time program. When I wasn’t
in the room with him, I was training, doing feedback, taking video so that whoever was in the
room could do their own feedback, planning the week’s meetings, researching, contacting
resources, finding and creating materials, etc. I gave over most other household
responsibilities and if there was no one to do it, it could wait. My aunt came to live with us
and she became the glue that kept us going—taking our adolescent son to school, etc. and
being there for him if I couldn’t be.
So my day began at 8AM when I would go to the playroom, clean and arrange it for the day,
perhaps changing out the toys, adding a new one or highlighting another by putting it on the
table. Snacks were all replenished for the day and by 8:30 it was time for “breakfast in the
bathroom,” a small space so he could focus on eating. This was followed by 20 minutes of
interactive computer time, which gave us ideas to play out in the playroom in 3-dimensions.
His sensory systems were so impaired that this was one of the only ways he could take the
world in. We didn’t know how very poor his visual system was, but we used programs that
dealt with themes that would have been part of his experience.
We then would go to the playroom to check the vertical chart of photos (attached with
Velcro) to see who was coming first, second, etc. The rest of the day, I would be doing
feedback or Son-Rise Dialogue, etc., and making sure that I took some time for myself, was
available for our older son, and there was always Date Night. Once every 4-5 weeks we had
our “weekend away” where we would check into any hotel on Friday night, wine and
munchies in hand, put on our jammies, and not leave the room until check out on Sunday.
Prioritizing our time and how we wound up having kids in the first place (because we love
each other), was very, very important and much too easy to drop out.”

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• “If everyone who cares for your child understands the basic principles of the D.I.R. model
and can relate to your child in the same way, while adding their own unique style, then the
burden isn’t on any one person. My husband and I also divide up responsibilities (I run
the home-based program and he attends to all the medical and dietary issues, which are
significant). He also attends coaching sessions with our home-based therapists when he can. I
know that my week will be taken up with four basic activities: doing Floor Time with my
child (the most important), communicating with all his therapists and teachers (up to 10
people) [this includes managing schedules, receiving coaching from them, and reviewing and
redefining our son’s goals], and keeping up with the literature. It helps me accept that a
fair amount of time each week is needed to do these things. It’s important not to get burned
out trying to accomplish everything in a given week.”
• Finally, one parent took the time to outline her daily schedule for us. Whew!!
“Our therapy plan is:
1. Floor Time with him as much as possible, as much dedicated attention as we can find to
give to him with a reasonably high energy level (works out to about 2/30minute sessions
each morning and 3/30 minute sessions each evening
2. Take him for therapy: OT/SLP/Special Ed preschool ...OT is 45 minutes 1x a week.
Speech is 45 minutes 2x a week. Special Ed preschool is 4 hours 5x a week.
3. Arrange for babysitters who will “Floor Time” with him while we go to exercise 2x or 3x
a week (2 hours a day, 2x or 3x a week)
4. Advocate for him with doctors, therapists, school district, etc.
5. Arrange play dates and/or take him to the park at least 3x a week, 2 hours each. Peers can
be Special Ed preschool or typically developing. Both have value.
6. Give him healthy food and a reasonable amount of vitamins.
7. Provide a great home environment of appropriate toys and play including sensory diet
(without too much clutter as to be overwhelming).
8. Take care of the rest of the family and life and keep everything in good order so we can
continue to do the things above.
9. What I’m trying to say is that, when I worry over the past, I’m not helping him. When I
accept and focus on the items above, I am helping him.”

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“How did you manage to let go of certain things (like housecleaning) in favor of
intensive involvement in your children’s program. What encouragement do you
have for parents who will be reading this D.I.R. Home Program Guide?”
• “Knowing that you are helping your kids is the reward.
We saw results with this approach. Our son at 3.5 is very
social, warm, and related. He has a ways to go, but the
progress in 1.5 years has been fantastic. Also, try to find a
Floor Time consultant...even one that will remotely review
videotapes of you and your child Floor Timing. Also, the
consultant can help you fill in the FEAS. You can update it
every month and see where the “holes” are to work on. This is
a great approach and I know several people are doing this
successfully.”
• “The most encouraging thing is that you see wonderful
progress if you just stay committed. It is slow sometimes, but I am confident that he’ll be
O.K. if we can stay on the program.”
• One parent advised parents to do the best they can, but not to judge themselves too harshly.
There will be days on which you feel, as your own bedtime approaches, that you did not do
enough. That your child’s program was not as good as it should have been. While we strive
for the best we can do for our children, take heart and inspiration in the guidance given you,
sleep well, do the best you can to take care of yourself, and wake to a new day.
• “Taking the time to attend to our other children, each other, friends, and other interests, has
helped my husband and me recapture a sense of joy about life. This attitude helps our son
and gives us more energy to do Floor Time with him. The worry and burnout we suffered the
first few years after he was diagnosed did not do him or us any good. Much of it was because
we did not know the best way to help him. The D.I.R. model in its holistic approach answers
so many questions and has given us the confidence, patience, and faith that we can help our
son reach his potential.”
• “Don’t be discouraged. You are on a rescue mission. There will come a day when it is not
so intense, but now it is. If you have other children, they cannot be neglected. So, do the best
you can and do not beat yourself up for what you did not do. And obviously, people (with
and without special needs) take precedence over things. Things are dust, laundry, and dishes.
Do not be discouraged. Every little thing you do is good. Every little connection you make
is good. I remember at a training conference (the spring Infancy & Early Childhood Training
Course by Drs. Greenspan and Wieder), a parent in the audience asked how could we afford
this. All these therapists are expensive and we have no insurance coverage. And Greenspan
said, ‘Don’t worry. The real work is done in the trenches… work with your child.’”

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• As a family, we decided to put in the intensive time now so that as our son got older there
would be a greater possibility he could become a participating member of our family. From
the day we started our home-based program, we began to see him changing and this spurred
us on. Our younger son’s program became the focus of all our lives. We felt like we lived in a
commune. All privacy was lost. There were people coming and going in our house all day
long, all excited about what was happening, all wanting to share. We prioritized our older
son’s needs but, many friends disappeared. They thought we were crazy to think that we
could do the work that “should” be done by doctors and therapists…we knew in our hearts
that we were grateful to have those wonderful professionals in our lives.
We made sure we had support both in our daily lives and emotionally. We gathered
together a like-minded group of parents—only a group like this can laugh over the kinds of
things that go on in our days! We substituted almost weekly support calls with the Son-Rise
folks for vacations that Autism doesn’t take. There were no holidays, no weekends-the shifts
in our daily lives seemed to affect every aspect. Our older son became more independent for
the experience and now, years later has a marvelous sibling relationship with his wonderful,
bright, delightful, loving, recovered brother. In an essay when applying to college, our now 23
year-old wrote, “I know that my parents would have done the same for me if I had needed it.
I had the opportunity to learn from them that by rolling up your sleeves and working hard,
nothing is impossible in life.”

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Notes . . .

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