Floortime

Floortime therapy derives from the Developmental Individual-difference Relationship-based model (DIR) created by child psychiatrist Stanley Greenspan, M.D. Its premise is that adults can help children expand their circles of communication by meeting them at their developmental level and building on their strengths.

According to the organization Greenspan Floortime Approach, the technique challenges children with autism to push themselves to their full potential. It develops “who they are,” rather than “what their diagnosis says.”

As its name suggests, Floortime encourages parents to engage children literally at their level – by getting on the floor to play. Families can combine it with other behavioral therapies or use it as an alternative approach.

In Floortime, therapists and parents engage children through the activities each child enjoys. They enter the child's games. They follow the child's lead. Therapists teach parents how to direct their children into increasingly complex interactions. This process, called “opening and closing circles of communication,” remains central to the Floortime approach.

Overall, Floortime aims to help children reach six developmental milestones crucial for emotional and intellectual growth. They are: 

  • Self-regulation and interest in the world 
  • Intimacy, or engagement in human relations 
  • Two-way communication 
  • Complex communication 
  • Emotional ideas 
  • Emotional thinking 
Floortime does not target speech, motor or cognitive skills in isolation. Rather, it addresses these areas through its focus on emotional development.

How does Floortime work?

Ideally, Floortime takes place in a calm environment. This can be at home or in a professional setting. Formal treatment sessions range from two to five hours a day. They include training for parents and caregivers as well as interaction with the child. Therapists encourage families to use Floortime principals in their daily lives. 

Floortime sessions emphasize back-and-forth play interactions. This establishes the foundation for shared attention, engagement and problem solving. Parents and therapists help the child maintain focus to sharpen interactions and abstract, logical thinking.

For example, if the child is tapping a toy truck, the parent might tap a toy car in the same way. To encourage interaction, the parent might then put the car in front of the child’s truck or add language to the game.

As children mature, therapists and parents tailor the strategies to match a child’s developing interests and higher levels of interaction. For example, instead of playing with toy trucks, parents can engage with model airplanes or even ideas and academic fields of special interest to their child.

What is the history of Floortime?

In the 1980s, Dr. Greenspan developed his DIR model  as therapy for children with a variety of developmental delays and issues. In practice, he called DIR “Floortime.”

In 1998, Dr. Greenspan and clinical psychologist Serena Wieder, Ph.D., published The Child with Special Needs. The book explains and adapts the Floorplay approach for parents and caregivers. By exciting a child’s interests, Floortime creates parent-child connections and brings out a child’s creativity and curiosity, Dr. Greenspan said.

In a 2003 study, Dr. Greenspan and Dr. Weider studied Joey, a child on the autism spectrum who spent three years engaging in Floortime with his father. Over that time, Joey enjoyed six daily Floortime sessions. He continuously improved, and the two scientists concluded that Floortime helped Joey progress.

In 2007, a pilot study conducted by independent researchers likewise showed benefit for children with autism. Two other 2011 studies—one conducted in Thailand and one in Canada—further supported Floortime as significantly improving emotional development and reducing autism’s core symptoms.

How can I learn more?

Many child psychologists, special education teachers, speech therapists and occupational therapists have formal training in Floortime techniques. The Greenspan Floortime organization also offers parent workshops. Parents and caregivers can also learn Floortime techniques from books and websites. You can find more information on Floortime at Greenspan Floortime Approach and the Interdisciplinary Council on Developmental and Learning Disorders.

Autism Speaks continues to fund a wealth of research aimed at developing and improving behavioral interventions that enhance function, learning and quality of life. You can explore these studies using our Grant Search here.

For more information and resources related to autism, please see our Treatment overview, Video Glossary, FAQs and special sections on Asperger Syndrome and PDD-NOS. We also offer a number of resource-packed tool kits for free download (here and here). They include our 100 Day Kit for families who have a child recently diagnosed with autism. These resources are made possible through the generous support of our families, volunteers and donors.