We proudly adhere to a DIR/Floortime framework when working with all of our families/children. The following explanation can be found at www.profectum.org
What is DIR® and Why is it Important?
The Developmental, Individual Differences, Relationship model (also known as DIR® and DIRFloortime®), developed by Drs. Stanley Greenspan and Serena Wieder, revolutionized the concept of development. It was the first model to identify the functional emotional developmental capacities that provide the foundation for lifelong learning and relating. The DIR model training was the first to relate these developmental capacities to the biological/neurological individual differences in sensory processing each person brings to the world. It identified relationships as the pivotal force that nurture and optimize development. Further, it was the first to propose a relationship based model of comprehensive intervention for autism spectrum and sensory processing disorders focusing on the core deficits of relating and communicating.
Overview of the DIR® Model
The DIR model has been created and informed by experts in the fields of pediatric medicine, developmental psychology, education, speech and language, occupational and physical therapies – making it the first truly integrated multi-disciplinary approach to children with an Autism Spectrum Disorder (ASD) or other special need.
Breaking Down the DIR® Model
I (Individual Differences) refers to individual differences related to sensory reactivity and regulation, visual-spatial and auditory/language processing, and purposeful movement and communication.
R (Relationship) refers to relationships with caregivers that are the vehicle for affect-based developmentally appropriate interactions. Parents and families are central to this model because of their ongoing opportunities to support their child’s everyday functioning to carry out emotionally meaningful goals based on developmental levels. Cultural and environmental influences are also considered.
Intervention begins with a therapist supporting both parent and child engaging in pleasurable, developmentally appropriate, and interactions building, as well as strengthening the core relationship between caregiver and child to support developmental progress. The treating therapist typically has advanced (preferably certified) training in the DIR-FCD™ model and may come from the fields of medicine, mental health, speech and language therapies, occupational and physical therapies, special educators and early intervention providers. Parents are typically encouraged to engage in multiple DIR-FCD™ sessions daily with their child, both formally and informally.
Progress is measured in the beginning by establishing a baseline FEAS (Functional Social-Emotional Assessment Scale), with quarterly updates.
Functional Emotional Developmental Levels (D)
Level 1: Shared Attention/Regulation and Interest in the World
Level 2: Engagement/Forming Relationships
Level 3: Two-Way, Purposeful Interactions with Gestures/Intentional Two-Way Communication
Level 4: Two-Way, Purposeful Problem-Solving Interactions/Development of Complex Sense of Self
Level 5: Elaborating Ideas/Representational Capacity and Elaboration of Symbolic Thinking
Level 6: Building Bridges Between Ideas/Emotional Thinking
Level 7: Multi-Cause, Comparative, and Triangular Thinking (Grade School Children)
Level 8: Emotionally Differentiated Gray-Area Thinking (Grade School Children)
Level 9: Intermittent Reflective Thinking, a Stable Sense of Self, and an Internal Standard (Grade School Children)
the foundational capacities for development (fcd) model is profectum’s approach to integration
Cuong Do, Dr. Serena Wieder, Monica Osgood and the Profectum Faculty Developmental problems need developmental solutions. Drs. Greenspan and Wieder developed an integrated bio-psycho-social framework to profile typical development, which became a guide for assessment and interventions for individuals with special needs.
The Developmental, Individual Difference, Relationship based model (DIR® / DIRFloortime®) identifies the functional emotional developmental milestones that integrate emotional and intellectual development. Not only do interventions have to be tailored to the unique profile of the child but depend on relationships as the vehicle for learning and affect to engage and give meaning to experiences.
This framework provides the anchor for a comprehensive intervention approach that changes as the child grows.
What If ?! …
- despite all intensive efforts, development does not progress at a steady rate?
- the child and caregiver learn how to co-regulate and engage, but have trouble progressing for there?
- the child’s sensory system results in the child experiencing the world as an unpredictable and scary place?
- the child’s motor system is so disorganized that he or she cannot express their ideas and intentions, even when they know what they want to do.
- the intervention program and daily interactions fall into a rut that don’t promote development at the child’s specific developmental level?
The Foundational Capacities for Development (FCD’s) provide the construct for adapting experiences, strategies and intervention programs to allow each individual to realize his or her developmental potential!
this often starts with the adults in an individual’s life adapting their responses to foster feelings of…
- Sensory Experience
- Emotional State
- Judgement Free Zone
- In SELF
- In Environments
- In Activities/ Situations/Demands
- With People Control
- I can make something happen, or not
- I can be an EQUAL contributor to interactions/situations
- I am in control of myself Communication
- Expresses who you are!
Because every child, family system and environment is unique, modifications and adaptations to intervention goals and programs must also be flexible to recognize and support the individual needs of each individual at various stages of development.
For over 40 years The DIR model has changed the lives of thousands of families and professionals caring for individuals with special needs. Over the last two decades we have learned, and research supports, that the complex sensory and motor systems of people with autism and other challenges in relating and communicating require a dynamic, not static, approach to intervention.
The DIR model provides a clear guide for development based on the Functional Emotional Developmental Levels (FEDL’S) also know as the “D” in DIR®. We know that relationships, the “R,” are our strongest mechanism for promoting developmental progress.
We also respect that other factors play a role in the child and caregiver’s ability to deepen the quality their relationship to support some areas of development.
Some of these factors include:
- Socio-economic environment
- Safe and stable home and community
- Relationship patterns with caregivers, siblings and peers
- Individual Sensory and Motor profiles
Finally, our model has always recognized the need to tailor intervention strategies to each child’s individual sensory and motor profile, the “I.” This component of the model is the least obvious to assess and often, the severity of how the individual profile impacts a person’s ability to act on, and communicate his or her intentions is highly underestimated. We also understand how differences in the sensory and motor systems interfere with a person’s availability to successfully engage in meaningful interactions and experiences needed to attain developmental progress.
Thanks to our beautiful relationships with thousands of families, insights shared with us from the children and adults we work with, and ongoing, cutting-edge research, we have a much more accurate understanding of how all individuals can develop the Foundational Capacities for Development (FCD’s) that are needed to allow each person to maximize progress through the FEDL’s. These capacities are:
We created the FCD model to provide guidance for adapting the child’s experience to provide the emotional foundations needed to maximize progress through the FEDL’s at different stages throughout the lifespan. This may include integrating principles and strategies from a range of intervention approaches in order to tailor intervention programs to support each individual’s unique sensory and motor systems, ability to connect, communicate, learn and be independent. The FCD’s complement the DIRFloortime® framework by defining critical elements and experiences, which further enable children to climb the developmental levels. These capacities are dynamic and change as the individual grows, progresses through the developmental levels and experiences build memories, comprehension and contribute to one’s sense of self.
Semi-structured and structured activities designed to foster feelings of COMFORT, COMPETENCE, CONFIDENCE, CONTROL AND COMMUNICATION = The reduction of stress and abilities realized!
Setting up successful interactions = CONFIDENCE!
Development is Never Straightforward …
Neither is intervention. Despite research advances made in the last decade, attempts to translate these into best practice(s) face many challenges and obstacles. While early identification now has some reliable tools and clinical trials are underway in early intervention, it is not yet possible to capture the complexity of autism spectrum disorders and the variability in how different children respond to different interventions, especially as children grow older and become adolescents or adults and outcomes vary so widely. Identifying the potential capacities of each person and guiding their development to realize this potential is the most important goal we have.
Most importantly, in a dynamic intervention model, every child is viewed as having an inner world with feelings and desires and experiences that they cannot always express but can let us know about in different ways. The feelings, insights, and experiences of parents must also be considered; providers and caregivers need to reflect on the complexity of the child’s development and functioning, as well as their own feelings to best support the child’s development.
Since we are very far from knowing which interventions will benefit which person in this diverse disorder, we must rely on extensive clinical experience and developmental models to guide best practice. Two key principles are relevant.
• First, intervention models must address the unique characteristics of each child and the families and systems they are part of.
• Second, individuals develop across the lifespan and can continue to advance if (or when?) provided with foundational capacities for development to support learning and functioning.
In the last century development began to take on various meanings. For some it was the behavioral and regulatory aspect of growth. For others it involved a progression of skills to support functioning and competence and for still others, the essence was an emotional and thoughtful life with relationships at the center. Development encompasses all of these meanings.
Foundational Capacities for Development (FCD) Model Explained
At Profectum we believe development advances when experience captures the child’s affects and interests and activates new learning, gets organized through interactions, and gets integrated into the child’s repertoire of thinking, feeling and functioning.
These experiences build the foundational capacities for development that carry through one’s lifespan (“Foundational Capacities for Development” or FCD). They are integrative capacities that go beyond specific sensory motor processing and environmental challenges, as they are more fundamental, dynamic, interactive and underlie how, and to what degree they effectively integrate experience to advance development.
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