The Greenspan Method (Floortime)

Treatment Overview

Dr. Stanley Greenspan, a child psychiatrist, is known for his approach to treating children with autism and other developmental disorders. His method centers on socail interactions, while taking into account underlying sensory issues. The floortime model is based on the thesis that effective interaction can harness cognitive and emotional growth mobilizing the child's developmental capacities.

Greenspan encourages the D.I.R. (Developmental, Individual-difference, Relationship-based) Model or Developmental Approach to therapy. The heart of this this approach to therapy a systematic way of working with a child to help him climb the developmental ladder. D.I.R. takes the child back to the very first milestone he may have missed and begins the developmental progress anew. The six “functional milestones” are:

• self regulation and interest in the world
• intimacy
• two-way communication
• complex communication
• emotional ideas
• emotional thinking

Greenspan's method includes an observation chart wherein the parent can assess through observation where the child stands on the development ladder and which milestones in particular need strengthening.

By working intensively with parents and therapists, the child can climb the ladder of milestones, to acquire the skills he is missing. It can be implemented as a procedure and as a philosophy. Most importantly, this method can be used at home, in school, and as a part of a child’s different therapies.

Part of the Greenspan method uses “floor time”, an intensive, 20 to 30 minute period when you get down on the floor with your child one-on-one, to interact and play in a spontaneous and fun manner. By interacting in ways that capitalize on his emotions – by following his interests and motivations – you help him climb the developmental ladder. You can help him want to learn to attend to you, engage in dialogue, take initiative, to learn about causality and logic, and to solve problems. The parent becomes the child’s very active play partner, whose job it is to follow the child’s lead and play at whatever captures her interest, but in such a way that encourages interaction with you. For instance if she wants to build with blocks, you build with her, adding blocks to her tower, even knocking a block off her tower with an “oops” – doing whatever it takes to create an interaction.

The Four goals in floor time are:

Goal 1 - Encourage attention and intimacy

Goal 2 - Two way communication

Goal 3 - Encourage expression and the use of feeling and ideas

Goal 4 - Logical thought

The unique differences separating this intervention model from others such as the behavioural approach (Lovaas) and the TEACCH program, is its focus on relationships and affect, developmental level, individual differences and comprehensiveness. The theoretical rational for this intervention is that the child’s symptoms are often secondary to underlying biologically based processing difficulties. Relationships and affective interactions become derailed secondarily. These secondary symptoms, however, often respond more rapidly to intervention than do the biologically-based difficulties. The first goal of Greenspans intervention is to help the child work through processing difficulties and re-establish affective contact with primary caregivers. Thus begins the child's process of mastering those missed early stages that serve as a basis for language and other interactive behaviours.e Specific processing difficulties continue to be treated through speech therapy, occupational therapy, special education, and other therapies.