Floor Time and RDI

Floor Time and RDI

Floortime
Drs. Stanley Greenspan and Serena Wieder developed, DIR, which stands for the Developmental, Individual Differences, Relationship-Based Model. It is an in-depth, interdisciplinary approach that has the emotional development of the child as its primary focus. It takes into account the child's feelings, relationships with caregivers, developmental level and individual differences in a child's ability to process and respond to sensory information
The goal of treatment is to help the child develop emotional milestones that were missed in his early development and that are critical to learning.

Floortime is a vital element of the DIR/Floortime model. It is a treatment methodology for interacting with children (and adults as well) that was developed by Greenspan around 1988. Floortime involves meeting a child at his current developmental level, and building upon his particular set of strengths. It trains parents and caregivers to work together with children using child-directed play, which is what Greenspan calls “floor-time’. His intention is to use play to improve attention and intimacy, promote two- way interaction and communication, encourage expression of feelings and ideas and develop logical thoughts. During floor time, a more child -based methodology is followed. Adults do not impose their thoughts or ideas on the child to engage in adult – directed activities. Parents are taught to view all activities as purposeful and use the child’s interests to expand upon through imitation, expansion and responding in a way that will elicit communication.
DIR/Floortime works on improving six basic developmental milestones that they feel children must master for healthy emotional and intellectual growth. They are:
1. Self-regulation and interest in the world
2. Intimacy or Engagement
3. Two-way Communication
4. Complex Communication
5. Emotional Ideas
6. Emotional and Logical Thinking

DIR/Floortime therapy is parent based but under the very strict control of a clinician trained in the program model. That person may prescribe a number of 20-minute Floortime sessions a day as part of a comprehensive treatment program. Therapy can also be provided through natural routines within the child’s daily routines.

It was difficult to find research that supported the actual DIT-Floortime Model of therapy specifically. According to information on the DIR- Floortime Website, a recent chart review of 200 children with complex developmental challenges found over 50% of children originally diagnosed with autistic spectrum disorders and treated intensively with DIR/Floortime approaches for four to six years have become warm, engaged and loving, no longer qualifying for the Autism diagnosis. These children became active learners with highly developed abilities in the areas of verbal skills, imagination, logical and abstract thinking, as well as pleasurable peer relationships. Many of them attended mainstream schools, and their teachers were often unaware of the child’s original diagnosis. Other children, because of greater neurological challenges, made slow and steady progress.

Progress is measured by observing how the child is relating, communicating and thinking. Improvements in these skills are felt to be far more important indicators of progress than a lessening of symptoms.

For more information on the DIR-Floortime model of treatment for children with autism, please follow the link below:

http://www.icdl.com/dirFloortime/research/index.shtml


RDI

RDI stands for Relationship Development Intervention. It is a parent-based clinical treatment for individuals with a diagnosis of an autism spectrum disorder as well as other relationship –based disorders. RDI is based on a model of Experience sharing developed by Steven Gutstein, Ph.D. this program is based on his extensive research of the development of emotional relationships by typical children. The primary goal of RDI therapy is to teach motivation for and the skills of experience sharing interaction, which Gutstein feel is at the core of autism.

There are 10 basic principles that underlie the model of DRI. They are as follows:
1. Carefully and Systematically Build Motivations
Create strong and positive episodic memories by the use of shared excitement, videotape review, memory books…
Teach functions before skills, which provides the motivation
2. Carefully Evaluate Developmental Readiness before Teaching Skills
3. Children Learn to Be Successful by Experiencing Competence. They Cannot Achieve Competence if They Develop a Dependency on Capable Partners.
4. Learn to be an Experience sharing Coach by Developing a Balance of Guiding and Pacing
5. Employ an Invitational Approach and use Indirect Prompts when Possible
6. Spotlight Important Information using your Face, Voice and Body to Ensure that Critical Information Stands Out.
7. Use Expandable Activities to Develop Experience Sharing and Avoid Activities.
8. Expect to Make Mistakes Lading to New Discoveries
9. Make Sure to Develop Experience Sharing Language
Examples: We can do it! Tray again! Did you see that?
10. Move from adults to dyads to groups
Typical children learn to be competent with adults before desiring to be with peers/ Move from 1 peer to dyads to groups systematically.

The research that supports RDI was completed by Steven Gutstein. The link for this research can be found on the RDI website link provided below. His research summary reports that 17 children aged 2 to 10 who received RDI therapy from their parents were compared to 14 children receiving other therapies. Both groups were administered the ADOS (Autism Diagnostic Observation Schedule) initially then 9 months later. Although both groups were similar at the initiation of the study, 70% of the RDI group had improved their ADOS scores, while none of the non-RDI group improved their classification.

For additional information on RDI please follow the following link:

http://www.rdiconnect.com/default.asp

Comparisons of RDI and Floortime

RDI and DIR-Floortime interventions are similar in that both are based on improving and increasing the emotional and relationship aspects of those children with autism, as they feel that this is the core deficit in autism. Both use trained clinicians to monitor the program and both programs use parents as the actual ‘teachers’ or executors of the actual program. The RDI program has an assessment that is completed prior to starting, which is called RDA or Relationship Development Assessment. This assessment is then used to monitor progress. Floortime works through levels that are set up within the program. Specific data collection for either of these programs was not mentioned. Additionally, peer reviewed research was not available for either program.