Affect Autism: We chose play, joy every day

Photo by Gustavo Fring

This Week’s Guest

Kerri Ciskowski is a DIR-Expert Occupational Therapist in central New Jersey who does in-home support through her service Therapy Keeper for families who are typically raising autistic kids. She is a happily married mother of 3 boys age 12, 10 and almost 8. Today we’re talking about in-home DIR/Floortime coaching which supports parents in unpacking ‘behaviours’ and finding connection and joy with their neurodivergent children. 

This Week’s Topic

Parents learning about Floortime often say that they understand the theory, but are still unsure about how to handle their children’s ‘behaviours’. There is no ‘prescription’ in Floortime, though, as each child and family are so unique. We discuss how you can figure out what to do in a great follow-up to the recent podcasts on Intentionality, FEDC 4, and FEDC 4 into 5.

by Affect Autism

Bonus Insights

DIR Parent Network click HERE

We will never share your e-mail.

Setting the Stage

I set up a scenario that a family comes to Kerri’s service and she has to figure out how to support them. Kerri, I presume will be talking about that Floortime mindset where we look for the ‘why’ behind the behaviour, avoiding ‘teaching’ and ‘directing’, and looking at the sensory processing and individual profile of the child. Kerri says that what’s important when she meets a family is that she wants to set the stage before she even visits the home because it’s different than anything else they’ve experienced.

Kerri lets the family know that if the child is super interested in her when she arrives, and she establishes a great connection, she will run with it in the moment. She lets the parents know that they are a part of that process and if they have any questions, to write them all down because they’ll process it afterwards. The DIR model puts the child and family in the center. She’s never going to tell you what you need to do nor ask your child to perform. What she’s after–what families are always after–is the connection and the joy. This sets the stage for what the initial interactions are about, she assures us.

Appreciating Trauma

A lot of families are coming with so much trauma, including a lot of ‘icky’ experiences, Kerri says. She always wants it to look and feel like an environment where everyone is heard and loved. While this is typical for the Floortime community, Kerri continues, so few outside of it have experienced this. So when Kerri talks about the ‘I’, she wonders what that parent individually needs to have the capacity to even see the magic that’s unfolding in front of them.

The experience of trauma is as wide the individual differences can be, Kerri explains. I shared with Kerri how my son had a massive seizure and another 12 hours later, ending up in emergency, connected to so many contraptions that I didn’t know if he was going to die or if we’d be going home the next day. He was there for 3 weeks, then in a rehabilitation hospital for 3 more months. There, I saw children with very complex disabilities and felt guilty for feeling sad about what happened to my son.

It took me about four years to get over that post-traumatic stress without feeling guilty for feeling sad. I eventually realized that my son had many sensory differences from birth, and was born autistic. He is just like me. We have the same personality. Other parents face traumatic experiences with children who are banging their head or melting down a lot, and parents don’t know what to do to support them. Some children run off when in public, and sometimes you may lose your child, as discussed in this past podcast.

Meeting Families Where They’re At

Kerri concurs that when we realize that our child is not like other children we are overwhelmed. I shared that many find themselves in a behavioural setting like I did at the rehabilitation hospital where my 2-year-old was being strapped in a chair being asked to do menial tasks, and I hated it. It drove me to find Floortime.

Kerri says that Floortimers do an amazing job of holding space for this reality with parents. It’s such a big part of the story, she says. She loves working in homes to see the dynamics between the family members. It’s so organic in that way, she says. She prioritizes the individual profile, and often the conflicting profiles among family members, and she uses the word ‘trauma’ very carefully in a sensitive way, being sure not to project it on anyone.

Kerri and her team recently created two documents in Canva for families: Potential Triggers for a Parent of a Neurodivergent Child and Potential Triggers for a Neurodivergent Child which have both been very helpful for families to see because many people process things more visually. At Therapy Keeper, they are always meeting families where they’re at, but I asked what that looks like?

Wondering Together

If she has a mother who comes in with a fair amount of trauma and a child who is being triggered by something, Kerri looks at the ‘R’ (the Relationship) and the ‘I’ (Individual differences) of the Mom and why she’s feeling what she’s feeling, then separately looks at the child’s experience, the child’s individual differences and for patterns that often occur in autism, and then figures out in real time what’s happening.

If a Mom is saying, “Let’s go brush our teeth” and the child is in the middle of an activity, the child didn’t know they had to brush their teeth, they’re a Gestalt Language Processor (GLP), they don’t like brushing their teeth in the first place, or maybe their expressive language is very robust and they want to negotiate why they shouldn’t have to brush their teeth, this demand that the mother is putting on the child will not go well. It might be her childhood experience. She might be flooding the child with questions.

Kerri would say, “Here are the things that I’m wondering…” She says that her responsibility is to the family, wondering with them, about them, about the child, and getting the parents’ wheels turning as to why things might be falling apart. Kerri says that what might seem simple to a Floortime practitioner might be mind blowing to some parents, such as them asking a lot of questions when the child is dysregulated.

Kerri uses a lot of video footage in her practice without it feeling ‘icky’ or without parents feeling put on the spot. She also uses a lot of home cameras where behaviours might happen, such as during meal times, then they can go back and analyze it later. That shift–something that might feel so foreign to a family, yet is a standard tool for Floortimers who see it so clearly–might be something a parent has yet to see. When you make those simple shifts, Kerri emphasizes, it makes such a huge difference.

Without wanting to sound like a saleman, Kerri has literally seen this shift transform families. She tells people as one Mom to another Mom, whether you engage in her services or not, she needs you to know about Floortime!

Setting up for Success

I provided an example of what I do at home with my child who is verbal. We build structures into the day so every day is as predictable as possible. We get up, eat breakfast, go to school, come home, ‘relax’ on the iPad while I prepare dinner, eat dinner, play boardgame, have a bath, read a few books and then go to sleep. I shared that many families use visual schedules to show their child what’s happening which can help during transitions.

Kerri says that predictability affords a child the capacity for something else. They have a certain energy or battery capacity for the day. We’re making their day so predictable to reserve their capacity to problem solve things that come up that will challenge them, Kerri explains. Kerri aims to set a family up for success and finds that she can often see where minor shifts can help a family, such as the predictable routine. 

Schedules are critical components. But she’s also looking at how they handle transitions and she’s looking at the profiles of the parents. Many parents struggle with their child not wanting to leave their screen to come upstairs to brush their teeth, for example. Her team recently did a social media post on double standards that helps the parent take the child’s perspective.

Kerri asks parents if they’re watching TV would they want to stop watching mid-show? She also thinks about parents being on autopilot, always in a go-go-go mode. Often families have something planned out in their head, but haven’t conveyed that to their child, she explains. In the brushing teeth example, she says, the plan wasn’t shared with the child, and the mother had beautiful reflections about it afterwards. 

Parents’ plans aren’t transparent. She encourages them to share them in a clear and kind manner. Floortime is relationship-based. There’s nothing more than having solid relationships, including your relationship with yourself, Kerri says. She likes to help parents with having a schedule, visuals, and doing a lot of reflection about how transitions are being managed every day. Kerri created a document of 20 different transitions that parents may not even think of that she used with one client (some of which are documented here).

People moving into your space is a transition, for example. A child might find someone coming into their space to be very disruptive. Kerri continues that in standardized testing, the number one executive functioning challenge that comes up is shifting from one activity to another.

Kerri looks at all of the intricacies–which is what Floortime is, she adds–wondering about it together, and helping a family move away from the medical model, cookie cutter version of things. She instead gets them to think about where their child is getting caught up and struggling.

Kerri aims to figure out why parents are showing up the way they show up and what experiences brought them to where they are. She helps parents hold space for not judging that and empowering them. She says that we can all make a conscious decision to how we show up for ourselves and to others.

Tips for Parents

I asked Kerri that I can still hear parents asking, “What if I shared the plan with my child and they just won’t go along with it?” Kerri asks if it is a child who is aversive to demands (i.e., a PDA profile, aka Pathological Demand Avoidance, aka Pervasive Drive for Autonomy)? Kerri says that that can be an entire different case, but try to infuse a bit of humor, which can be hard at the end of the day as a parent.

She suggests giving autonomy to the child by asking things with tons of affect like, “Should we fly to the bathroom sink or march like soldiers?” Always gear this to the child’s interests so if they’re into sharks, ask, “Should be go like a hammerhead shark or fly like a great white?” Some kids might like a race to the bathroom, but it might trigger others. The child might prefer using one bathroom versus another. Think of what will peak their interest.

It might be sequencing that helps, Kerri continues. You might have to say that first we’ll brush teeth and then race cars to the bedroom. If kids are interested in books, she’ll suggest social stories. In a social story, she’ll start with a positive thing, then the experience of the child’s experience, such as “I might feel frustrated“. Next, you give them options like, “If I feel frustrated when mom asks me to brush my teeth, I can…” 

I shared that Dr. Karen Levine said that the part where the child is scared is always left out of typical social stories! Educator Jackie Bartell always says we have to set the expectation, for example, “We have to brush our teeth.” In social story, Kerri says that what it’s doing is giving meaning to the social experience. Having meaning behind why the expectation is important then they might be more willing to do it.

You could also watch YouTube videos of what you want your child to be able to do. Dr. Karen Levine suggested doing this with my son around clipping his toenails, and he absolutely loved the video and asked to watch it repeatedly. Kerri asks who is the favourite aunt or uncle? Get a picture of them brushing their teeth, she said. I said you could also brush teeth together with your siblings or parents. Kerri said they also use dolls and brush their teeth.

Regarding giving agency, Kerri says that if they like the cartoon Paw Patrol, get them a Paw Patrol toothbrush. Also, beware of the flavours in case they don’t like mint, Kerri adds. The message here is to stay hopeful, Kerri encourages parents. Stay curious and you will find something that works. Sit in the space of “I’m going to figure it out“, she urges.

What to do about Screentime

Parents continually share that they struggle to get their child off the screen. Kerri first tries to understand the family’s opinion around technology. Some say it’s ok and it’s regulating, so there’s no limit. Other families see that the more screentime the child has, they have less opportunities for play and their instinct as parents is to get the child off the device. Kerri wonders how polarized it is between the different caregivers and wonders about what that looks like.

Research supports the claim that screens are wildly addictive, Kerri adds, and quotes Dr. Stuart Shanker who says that you can’t have self-control if you don’t have self regulation. She says that also Dr. Stanley Greenspan talked about the developing mind pointing out the importance of whether or not the child has the capacity to easily move away from a screen. Kerri reframes what that could feel like for a child.

For some kids, she explains, it’s a certain amount of time they’re allowed to use their screen. For some, the limit is one show. For others, it’s the type of show. A YouTube clip has a new screen cut every two to five seconds, but if you can find a show that stays with a plot, maybe that’s a better fit and can make for an easier transition away from it. Maybe you only make screentime available on the big television so the parent has control of the remote, she suggests.

Kerri has worked with bridging where she’ll have a picture to colour from the show they watch so when it ends she’ll stick with the content of what they watched by transitioning to colouring the picture. You can also use a step-away process where first a sound or a timer goes off, then you lose the picture. Next, you lose the sound. She says that you have to know your child and be willing to try things.

What is a brilliant game-changer strategy for one child can cause another child to melt down, Kerri emphasizes. Doubling down on outdoor time is an underutilized strategy, as well. Get out in nature with the sun on you, moving your body, away from constant stimulation inside walls with a lot of sounds and music. Sometimes our kids need to experience that. Kerri adds that if a child starts to understand what it feels like to be outside on a trampoline, on a scooter on a nature walk, or in the pool, and those neurochemicals start to feel really good, they might be more willing to put the screen down.

I also suggested making the screen a shared experience where you’re watching a show together and connecting around it, when you have time, but once you’re in the meltdown or struggle, it’s too hard to figure it out. Kerri likes the idea of stepping back and reflecting on it and how to make changes going forward. I’ve also heard that when a child has visual-spatial challenges, sometimes screentime can make it worse because we want them to see things in three dimensions, interactively in movement.

Being Prepared

Our brains are very nuanced, Kerri says, so let’s refer to the Floortime concept of attunement and look to our child’s cues to attune to them to figure out what feels like you’re moving in the right direction. And just like a child uses scripts, parents have to have their scripts, too, Kerri says, like a bank of things to say in that heated moment. 

Your child might have a hard time to do some things spontaneous. Kerri has a Commonly Used Phrases document that parents can put on their phone and inside their kitchen cabinet or where they keep their glasses, to have it handy when you need to use it. These are things parents can say instead of asking a lot of questions, Kerri shares.

Kerri likes to talk about a sensory lifestyle where families are prepared, knowing the things everyone’s body needs to stay regulated. Kerri has tools to up- or down-regulate. To down-regulated an overstimulated child, she suggests reducing your pacing, anchoring yourself in space, and lowering your volume.

I shared that for transitions my son’s preschool had a soothing song “Tidy up… tidy up… everybody tidy up, let’s go” clapping to the slow rhythm that helped keep the children regulated. Kerri says that we always want to start the transition saying something the child likes in a calming way in the regulation and pacing in a way that works for your child.

Non Speaking Children

I asked Kerri how she works with families who have non speaking children who may have apraxia of speech and motor challenges. Kerri will demonstrate herself how to be with the child to take the pressure off of the parents for a moment. She wants to show how you get that shared social engagement and connection in a way that you presume competence and build beautiful reciprocity–a fundamental thing in early communication.

Kerri says that some families said to her that she came in and didn’t bombard them with a million questions and just connected with their child so they got to see her do it in real time. This is one of the best ways she says that they can support a family. She also notices another theme that comes up when a child isn’t talking. The family stops talking back, especially if there’s a verbal sibling. There’s not an intentional ignoring happening, but it ends up being that the non speaking child is ignored.

Kerri says that you have to think about creating opportunities for communication. Build reciprocity even if there isn’t a verbal output. I shared that the podcast on Preverbal Affective Signalling I did and the podcast on nurturing intentionality might be helpful where we discussed how holding that space with your child to see what the child does is so important, versus feeling the pressure to do something. Kerri stresses that a child can get used to nobody responding them so give up trying. Keep persisting and trying.

Floortime is about Shared joy

Kerri says that you are the toy for your child, and there are some toys that change the chemistry between you, such as blowing up a balloon or spinning toys. Sometimes having a ‘thing’ helps when parents say the child isn’t responding or initiating and they are stuck. The toy isn’t the answer, but it might be the spark, Kerri explains. When the parent sees the interaction, it ignites a bit of hope and less defeat and you can build from there.

When parents aren’t using a Floortime lens, they’re looking at things differently. I talk about looking at the strengths in the We chose play documentary. We were in the Hanen program and I’m blowing up a balloon and letting it go. My son had these beautiful strengths in his early Functional Emotional Developmental Capacities (FEDCs), but I didn’t have the DIR lens yet and only saw what he wasn’t doing. Since discovering Floortime, I’ve watched these FEDCs bloom in my son.

Look at your child’s strengths. Kerri often tells families to measure backwards. For families who really need to see that evidence, you can then see that in November the child wasn’t doing x, y, and z, but in July they are. They wouldn’t have believed it back in November. It’s powerful in the reflective process to look at how far you’ve come. You always want your child to be seen, heard, and loved at their fullest potential. It’s ok to want more, but celebrate where you are at.

This week let’s think about the points Kerri shared with us and reflect on minor shifts we could make to help our connection with our child. 

For example: Are you sometimes in too much of a rush and directing your child when your child has ‘behaviour’? Let’s think about how we can slow down, share our plan, use a visual schedule, and/or incorporate something your child likes into the transition using fun affect.

Thank you to Kerri for sharing her resources and telling us how she works with families in such great detail. Please visit her blog, her fabulous Instagram page, and resources at her website. I hope you found it as helpful as I did and will consider sharing this post on social media.

Until next time, here’s to choosing play and experiencing joy everyday!

The post DIR/Floortime In-Home Coaching Supports Families appeared first on Affect Autism: We chose play, joy every day.

Photo by Tima Miroshnichenko

This Week’s Episode

ToniAnn Loftus is DIR Expert and Speech-Language Pathologist. She trained at the Rebecca School and now owns and operates Seaport Speech and Feeding, a clinic in Manhattan. Today we are discussing inclusion in schools with a specific focus on speech and language and how she can bring the Developmental, Individual differences, and Relationship (DIR) Model into the classroom to make it accommodating for all students. This is a nice follow-up to my podcast with Kim Kredich who, along with her family, was a keynote speaker at the March DIR conference in New York City.

by Affect Autism

Bonus Insights

DIR Parent Network click HERE

We will never share your e-mail.

Seaport Speech and Feeding

ToniAnn’s practice includes children from age 1 to 10. Depending on their needs, ToniAnn works with neurodivergent and neurotypical children at home and communicates with the school on their behalf. Sometimes does in-service work at the school where she’ll talk about what communication looks like, what development looks like, what sensory looks like, and how different communications come out, which can be through behaviour.

ToniAnn also sees children in her local community within the classroom. She’ll work with their Special Education Itinerant Teacher (SEIT 1:1 aids) and Occupational Therapists (OTs) to make sure their day is enriched with speech and language, such as joining their morning meeting or a cooking activity, and bring visuals for the classroom. She finds that the teachers will use the visuals for all of the kids in the classroom and continue to use them when her in-service is done.

Buy In from Classroom Teachers

I asked ToniAnn if she does a follow-up with the teachers. She finds that 99% of the teachers do follow-up and ask for more because maybe they have a child in their class who is on the quieter side and because of the changes they made after ToniAnn’s training, that child now feels like they have a voice using a visual aid in the classroom. She can also help the teacher take any book and help make it a Floortime experience for any class.

Many teachers and directors request learning more about sensory systems and Floortime after ToniAnn’s coaching and ask how to incorporate moving in their preschool. I commented that she must be thinking about movement so much due to her interdisciplinary work at the Rebecca School where she learned so much about the sensory system. Indeed, she says. She points out that you get a lot of buy-in from teachers when they recognize behaviours of children as sensory challenges or communication.

Movement and Meaning Making

After my DIR 202- The DIRFloortime Certificate of Proficiency Course, I had mentoring with an OT in Hawaii named Kiegan Blake who drilled that point into me about bringing what you’re playing into three dimensions. When my son was sliding down into the ‘water’, I used our blue lycra sheet as the water. It really helps with regulation at the first Functional Emotional Developmental Capacity (FEDC 1) and following the child’s interests if they like water.

Bringing the play into movement helps to solidify the concepts so the learning sinks in and motivates the child to communicate more since you’re using multiple parts of your brain, ToniAnn explains. Kids are more motivated to talk and communicate because they feel more successful, she says. They feel like they can point and gesture to communicate, even if their voice is failing them or they can’t get their words out due to apraxia of speech, for instance.

Toni Ann will ask children to show her what they want and if it’s a cup she’ll say the word ‘cup’, smiling. The child then gets to hold the cup to get the touch and feel of it and they’ll smile feeling understood. This motivates them to communicate more because they were understood.  That joy at the second  Functional Emotional Developmental Capacity (FEDC 2) makes them want to communicate more, ToniAnn explains, because you’re helping them form meaning.

Holding up a cue card of an apple doesn’t teach you about an apple as much as biting into an apple does, tasting it and feeling its weight, as Dr. Stanley Greenspan would describe. ToniAnn said that Dr. Gil Tippy explained to her when she first started working at the Rebecca School that if you haven’t heard the roar of the crowds, tasted the hotdog and felt the ketchup drip down on your chin, how can you be a Yankees fan?

When I joked that this is a very American example and that I didn’t like hotdogs nor ketchup, ToniAnn pointed out that even tasting the hotdog and not liking it is an emotional experience! ToniAnn added that many toddlers will eat something and make a yucky face while saying, “Yummy“. She will comment that it doesn’t look like it’s yummy. I shared that my son does the opposite. He says he doesn’t like it but then tastes it and wants more.

What about AAC?

Many parents in ICDL’s parent support group that I facilitate use Alternative and Augmentative Communication (AAC) devices with their non speaking children. ToniAnn said that she will introduce AAC to classrooms as many teachers are not trained to use AAC. She will often use visuals in classrooms for teachers first. It only helps communication. She will typically just observe the classroom for the first day to see how they’re phrasing what they’re saying. Are they making demands or just inviting comments?

ToniAnn tries to have them wonder how they can pay attention to everyone using AAC rather than centering out that one child who uses it. Everyone can use AAC in a functional way. I brought up how Andrew Klein brought up in our recent podcast on Reflective Practice about modelling and how this also came up in my Parent Perspectives podcast with Cass Griffin Bennett, who modelled both low and high tech AAC with her daughters.

I wondered how receptive teachers are to using AAC devices. ToniAnn explained that it’s tough on the teachers if they’re not supported. Most of the teachers have a general education background, but not working with special education needs. ToniAnn would rather they tell her that they have no knowledge about it upfront so she can support them. Getting the kids excited and involved in it helps them understand that it works for everyone, she shared. 

Many of the students feel excited that there’s opportunities to learn within the context of their classroom when they can use AAC. Teachers see ToniAnn use it during morning meeting then are excited to use it the next day themselves. It’s like learning a new motor plan, ToniAnn explains. Having someone model it for you makes it easier and as they do it more and more, it becomes a new part of their day and doesn’t feel like a daunting new task.

Speech is a Fine Motor Skill

Speech is the finest motor task there is, ToniAnn explains. When we think about learning something new for the first time, speech is like a motor plan. We have an idea in our head, we want to execute the idea, and move our mouth in a coordinated way to produce speech, she continues. If we learn the word ‘cup’, for instance, we want to be able to say ‘cup’ every time. Joleen and Lynn’s course on praxis and motor planning for speech is one ToniAnn recommends to practitioners.

ToniAnn talked about how when you start with gross motor movements so kids have to think less about their movements, their fine motor will eventually improve. Let’s teach kids how to use words while they run and jump first, ToniAnn suggests. We want to think about how you can break it down and make it easier. If you work more on gross motor, kids feel more successful, then eventually you move on to the fine motor skills, she says.

It’s not just about the sensory system and vestibular on the swing and then their sensory systems are awake you talk more, ToniAnn said. It’s about the mechanics of their mouth, how they move, and how your brain works, she explained. I shared how we had worked with Occupational Therapist Maude Le Roux going to her clinic’s intensives and my son had a phase where he started licking everything, starting with licking his dad’s face, then his friends at school.

Maude’s theory was that because he had gone through a round of Tomatis listening therapy to effect auditory processing, she believed his mouth was starting to awaken and feel new sensations to clarify how he spoke. Although I could mostly understand him, others couldn’t. Toni Ann said that it’s all interconnected. It’s all the brain processing information. His brain was trying to gain more information Licking felt good and gave him more information. Every child is different.

Development Doesn’t Skip Steps

When our kids are developing and not on a neurotypical pathway, they do things that neurotypical kids do years later, such as mouthing objects that babies do. My son did that when he was 3 or 4. Gene Christian talked about children grabbing parents’ glasses. Babies reach for their parents’ face and our kids are doing it later. My son started pointing at things about four or so years after they were asking me at appointments if he was pointing.

Development doesn’t skip steps, Toni Ann, says. Everything builds on everything else. That’s why she loves Floortime. Everyone follows a developmental plan and everyone will go at different rates. Toni Ann’s 4-year-old son burnt his tongue on hot soup and couldn’t tell her, so he looked at her and licked her hand. He was trying to get whatever was going on with his tongue off. It clued Toni Ann in to the reason and she realized he burnt his tongue and was able to tell him what happened to him.

A Focus on Communication

There are children on the autism spectrum who don’t start speaking at all sometimes until they are 6 or 7. ICDL’s board president Emile Gouws did not speak until he was 15. People didn’t think he would ever talk. There will be some autistic individuals who will never speak. They will use AAC devices to communicate. Dr. Joleen Fernald said that she’ll never make a prediction again about which children will or won’t speak after being wrong about it in the past.

I asked ToniAnn how we approach this with parents or teachers. She asks them how they feel when they are given a question in a crowd. Would it make them more or less likely to be able to respond? They maybe never thought of it as feeling like a quiz, she says. There’s talking versus communication. ToniAnn focuses on communication and how we can enhance it. After a few sessions with her, she can say, “Look how much better they are motor planning and letting us know what they want.“

We are always looking to improve a little bit more, ToniAnn says. We want to think about how we can support our child to feel heard. Let’s give the child space to show us how they feel most comfortable communicating. This will be a lifelong process, ToniAnn stresses, figuring out how they want to communicate. She has met kids who are poets, but don’t use verbal speech. Let’s celebrate each child as an individual, she emphasizes again.

Things are Slowly Changing

The world is slowly starting to understand that different children communicate differently, ToniAnn believes. Now people understand that each individual is different and the way we each learn is different, which makes it harder for teachers, but it’s starting to be recognized. Ideally we want teachers to notice “That’s different. Let’s celebrate it and support it” versus saying “I can’t do that!“

At the Rebecca School, ToniAnn shares, they would take the students out into the community and one time at Trader Joe’s a student started throwing apples. Her regulation plummeted along with the child’s. A worker there recognized them and introduced himself to the child and asked his name. He explained that we can’t throw the apples and asked him to help pick them up. It was so kind and supportive, letting the child have the time he needed to pick up the apples and put them back.

Process over product, ToniAnn says. That person could have been angry at Toni Ann or the child, but was instead supportive. Toni Ann taught a DIR 101 Introduction to DIR and DIRFloortime course in Heber Springs, AK where people from the entire town came to learn: the Walmart greeter, a police officer, teachers, parents, the librarian–they all came to learn how to interact with autistic kids in a way that’s productive for families versus being punitive and were there to learn how to support each other.

How do we have a sensory space in the library to support the children during storytime, for instance, was a wondering. A bunch of them then took the Basic Certificate Course, DIR 201 with ToniAnn and a few went on to the next course, DIR 202, as well, with another trainer. It was such a great experience for ToniAnn to see this community’s dedication.

Promoting Communication

Autistic self-advocates advise providing AAC as early as possible while children are learning, even if they do end up speaking. Even if they do end up speaking, some individuals will prefer texting over speaking verbally. ToniAnn says she, herself, prefers texting so she can think about her response. By asking adults how they communicate, it gives them insight into how their child might communicate.

Toni Ann shared her use of low tech AAC with her son on her Instagram account. She put pictures of the snacks that were in the cupboard. Her son would point to what he wanted, then open the cupboard and get it. It helped solidify the meaning of what each picture meant until he could speak, ToniAnn explained. If she had drilled him to say that he wanted a ‘bar’, it would have made him feel anxious. She is more interested in overall communication. The nonverbal comes before the verbal.

We talked about recognizing cues our children provide which is their way of communicating if they can’t make their body or mouth work how they want. ToniAnn shared that Dr. Gil Tippy presented a talk called, “What are you doing?” to the Rebecca School staff about how you walk into a room and read the cues of everyone to figure out how to enter the space just ‘being’ versus ‘doing’, gauging the environment before engaging in big affective communication.

ToniAnn will observe how a parent is interacting with their child and see if it’s a match. Video recording is so helpful so you can see how far a child has come, but also so you can see how you are at reading their cues. The way a child reacts might tell you that you’re giving them too much information with your face, affect, and volume, for instance, ToniAnn explains.

Too Much Communication

I asked ToniAnn about kids who talk a lot. Toni Ann says it’s serving a purpose. It could have to do with liking the auditory input. If you are in a home where the TV is always on in the background and people are talking, that input feels good to you. If the classroom is quiet, maybe they are talking to get that feeling. It ‘could’ be a reason why. How can we give that child more input to make them feel more comfortable?

Maybe you can start with every child having a chance to give a shout out to start the day, ToniAnn offers. Reframing is always helpful. You can reframe what a student is doing. They’re seeking auditory input or more movement, so think about how we can help them get that in different ways.

More Helpful Tips

Use visuals, ToniAnn stresses. Visuals are simple. You can use your mobile phone to take photos of places you go, your child’s school, and things they do around the house so they can visualize what’s happening. Having a red circle on the floor where they sit during morning meeting can support them going to morning meeting. Having a rolodex of things in their classroom that can help, ToniAnn suggests.

ToniAnn also suggests using picture boards on the back of their IDs for when they’re out in the community. It’s one thing to say we’re going to a new park today versus showing a photo of where you’re going and saying that it’s a new park. Take the time to explain and show the visuals because it is very helpful, she says.

Working with the deaf and blind community, ToniAnn has also learned about backgrounds. A black background with white print is easier to see than black type on a white background. You can label pictures with words. Think about things as a whole in the classroom that we can then use for everybody, ToniAnn suggests.

At Seaport Therapy, ToniAnn can help parents wherever they are, virtually. Sometimes it just takes a tiny little tweak to make a big difference. She learned so much at Rebecca School working with Dr. Gil Tippy, Toni Tortora, Andrew Klein and so many more. She is grateful for all of the training that lead her to where she is today.

Floortime is for Everyone

Floortime is for everyone, ToniAnn shares. It helps understand how we are learners. Getting DIR into more schools and to more teachers will open doors. Floortime is not just for kids with specific challenges and support needs. ToniAnn is excited to share that with others. They’ll start to think about things they can ask Occupational Therapists (OTs) and bring them into the classrooms. They’ll consider how to support kids on the patio and kids jumping all over each other. OTs should be in every school. If we start looking through this DIR lens, schools could be more inclusive, ToniAnn concludes.

This week let’s use visuals with our child, if we don’t already, to provide alternatives to communicating and be mindful of not being too demanding with questions. 

For example: Take photos of places you go to regularly and/or items around the home that you use, and show them to your child to inform them of where you’ll go frequently before you go, and/or giving them choices between items you have in the home–whether toys, food, clothes, or something else.

Thank you to Toni Ann Loftus for taking the time to record this episode with me about promoting communication for all in the classroom. I hope you found it helpful and insightful, and will consider sharing this post on social media.

Until next time, here’s to choosing play and experiencing joy everyday!

The post Bringing DIR Into the Classroom to Accommodate Communication for All appeared first on Affect Autism: We chose play, joy every day.

Photo by NEOSiAM 2024+

This Week’s Topic

The topic of this episode is trauma through a DIR/Floortime lens. Maude Le Roux recently did a course on this topic through the International Council on Development and Learning and here she covers how to work with trauma clients through the Functional Emotional Developmental Capacities (FEDCs). This complements the previous trauma-related podcasts I’ve done with Galina Itskovich and Erin Forward and Taylor Anderson and focuses on the DIR/Floortime aspect of the work.

This Week’s Guest

Our returning guest, DIR Expert and Training Leader and Occupational Therapist Maude Le Roux has a DIR/Floortime clinic, A Total Approach, just outside Philadelphia, and a satellite location just outside Allentown, PA. She is an international trainer in many other modalities as well.

by Affect Autism

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Trauma and Autism

Everybody’s talking about trauma and there are so many podcasts, blogs and articles about it. I haven’t felt worthy of covering this topic for a long time in a head-on way, but Maude is joining me this episode to take a DIR lens to the topic. My son’s medical trauma and the trauma I still face when I think about what happened to him, being in the hospital for four months following severe brain inflammation at the age of two, is one type of trauma. Autistic self-advocates talk about the trauma they face from attempts at being normalized by adults throughout their childhood.

Maude begins from the platform of an autistic individual having trauma. She points out that there are a lot of pieces to consider. Trauma is housed in the brain, even if we don’t recall it everyday. Trauma in an autistic’s life can be very different from other types of trauma, she says. They might be going through trauma, but because somebody says to them, “This is our secret“, they keep the secret. It will come out behaviourally, perhaps through stimming, and it’s just labelled as autistic behaviour. We may be missing the cues when autistic individuals are going through trauma, which is very tough.

In trauma you have the same structures that may be enhanced, like in the amygdala, that are enhanced in autism as well. Then, the biggest intervention in trauma is talk therapy. How can you do talk therapy with someone who doesn’t understand how to describe the emotions they are feeling? There are so many things to think about, Maude continues. The experience of trauma is very real. The numbers of trauma and anxiety are staggering, Maude says. Exponentially, autistic individuals are four times more likely than the neurotypical population to experience trauma when looking at the ACES data (Adverse Childhood Experiences).

At FEDC 1

Since the beginning of being asked to work with teams around trauma, Maude has used DIR/Floortime because it just fits her and the way she likes to work with anyone. It’s respectful and makes sure you are harnessing the individual differences. When considering the first Functional Emotional Developmental Capacity (FEDC 1), Self-Regulation and Interest in the World, we want to think about what self-regulation means and what having a regulated system means, Maude asserts. It’s a safety system.

FEDC 1: Self-Regulation and Interest in the World

FEDC 2: Engaging and Relating

FEDC 3: Intentionality and Two-Way Communication

FEDC 4: Complex Communication and Shared Problem Solving

FEDC 5: Using Symbols and Creating Emotional Ideas

FEDC 6: Logical Thinking and Building Bridges between Ideas

FEDC 7: Multiple Perspectives

FEDC 8: Gray Area Thinking

FEDC 9: Reflective Thinking and an Internal Standard of Self

When you’re looking at trauma and FEDC 1, regulation is about getting into that safe zone so you can comply to the rigor of everyday life and meet performance expectations, Maude explains. When you’re looking at regulation in trauma-informed care, you’re looking at how to create safety and providing that container within which the individual can find a ‘place of landing’, having an anchor to co-regulate and pivot around to create this order of safety.

When you’re working with trauma in autism, Maude continues, you have to know that the regulatory system will keep resurfacing even more when you’re doing the trauma work. If you’re talking not autism, every single FEDC capacity that you’re climbing is going to be a place where dysregulation can happen at a much more rapid rate. The trigger of the super vigilance of the sympathetic arousal is so high in individuals who are trauma survivors, Maude explains.

So when you’re looking at FEDC 1, you may see in a non-autistic population, that they’re highly verbal and in the emotional phases at FEDC 5, but needing the safety of FEDC 1 throughout the entire process. You’re not looking at them as ‘levels’ of a step ladder. Regulation is always a consideration. The concepts of Floortime (co-regulation, wait-watch-wonder, pacing at their pace, joining them where they are at)–all of these wonderful, golden techniques–are so instrumental for trauma survivors.

The Safety Principle

The first thing that came to my mind as Maude and I were talking was an autistic child whose parents put their child in an intervention that tries to normalize them and every time the child sees that person, they’re going to get dysregulated. It may take them hours to calm down and feel safe again after being with that person who is making them do things that are unnatural to who they are.

Maude says that’s why it is so critical with the lens we are operating from. Yes, there’s the trauma lens, but what are our own biases and frames of reference, Maude wonders. It doesn’t matter what population we are serving. Safety becomes the therapy she insists. We have to beware of violating that safety principle. 

If you look at the work of Dr. Stephen Porges on social engagement and the ladder that’s climbed from the ventral vagal, dorsal vagal to sympathetic arousal and the beautiful work of Deb Dana, Maude continues, we know about that co-regulation response from that neuroceptive “am I safe here or not” feeling. When you add in these components, Maude says, you can realize that you might be working at FEDC 5 to 9, but you still need to be working on safety with trauma clients.

If the safety is violated by a particular technique, Maude continues, that will add on to what has already happened to them, she asserts. In trauma-informed care, besides creating that safe ‘container’, thinking of the use of self in co-regulation, looking at not only the individual differences as the profile is now, you also have to remember that the trauma is never over when it’s over. The trauma trigger can be just as alive and real even if it’s years later, Maude states. The past becomes the present. You are re-triggering and re-traumatizing the individual. 

Talk therapists are shifting in their dialogue from wanting survivors to talk through their trauma, and focusing more on working on the body and how it’s holding and keeping the score, as Bessel Van Der Kolk says. As therapists, it’s a serious consideration: Am I adding to the trauma, or am I allowing the person to be who they need to be in this moment? So, in therapy, Maude says, it’s essential what kind of a framework you choose.

Lingering trauma

A few thoughts came to me. We can think about a child or pet who was abused by a man and they are then scared of all males. The trauma stays alive and comes back when they see men. When my son had brain inflammation, I was an emotional wreck and my husband said to me, “Do you like being depressed? Why are you watching all of these stories of people who went through what we did?” while I was wondering why I never saw him cry about what happened to our son. 

Then my mother-in-law had a conversation with me saying that everyone processes these experiences differently. When she is sad, she likes to watch a sad movie to cry to so it comes out. At some point days later, I came home to my husband telling me he watched a sad movie about a man who cared for an autistic son then found out he was dying and he said that he balled his eyes out. I realized that this was his way of letting out the grief of what happened to our son. 

Trauma doesn’t have to be physical or sexual abuse or something super horrific. There are so many types of trauma. When we moved out of downtown Toronto to be closer to our son’s school, I was out for a run and saw young boys playing baseball and was struck with sadness from out of the blue, realizing that my son would never play little league baseball like my brother and I did growing up. 

Trauma can hit us when we don’t expect it. Many parents of autistic kids have these experiences, and this gets into the concept of Ambiguous Loss that I discussed with Dr. Robert Naseef.

The Traffic Circle of Frustration 

Another thought I had about what Maude said was that Dr. Gordon Neufeld talks about emotional playgrounds. One thing he finds astounding is that people avoiding emotional healing, which is the way around everything: to soften the heart and feel these emotions, which means feeling that sadness about things you can’t control. That emotional release is what helps your brain adapt and move forward with resilience, he states.

His whole definition of resilience is to have the tears (physically crying, which contain cortisol the stress hormone), or sadness about realizing that there’s nothing more you can do versus being stuck in that traffic circle of frustration and anger where you circle around and around trying to change stuff that you have no control over. In his work he talks about that shift from being in that traffic circle to adaptation.

Think about how frustrating and traumatic it must be to be in a body that doesn’t do what you want it to do when you have severe co-occurrences with autism. We are hearing now from autistic adults who have learned to spell or communicate in other ways that they understood everything happening in their childhood but couldn’t communicate that.

Feeling ‘Felt’

As a therapist in the room, Maude says, we are resonators of feeling felt, heard, and seen because when you’re a trauma survivor you feel like you don’t have a rightful place and feel unworthy. Any trauma is not chosen. It happens to you and you have to wonder why it happened, Maude says, and everybody struggles with that. This changes the way you build your self-identity.

All of us wish to get around these struggles versus going through them. This is not the talk for today, though, Maude insists. The issue is that every experience that we have depends on our own temperament and resilience that we have, and as Neufeld says, we are too focused on the end product in which we lose the process of how we get there. 

The truth of all the empathy research is that we need to have empathy for ourself as a trauma survivor, Maude explains, and then empathy that we can then shape to feel for someone else, too, so the community at large can have compassion for each other. This is a very different animal. That comes only from that processed orientation to emotion. 

The DIR Way

Maude often says to families when someone important passes away that you should bring the child to the funeral. You need to find a way for the child to express the fear and anxiety, rather than avoiding it to ‘protect’ the child. A lot of the work in trauma, too, lies in FEDC 5 when we’re trying to get some symbolic understanding of what the trauma means to my life, how do I embody what has happened to me, how do I figure out where I stop and where someone else starts, and that I have an identity and it’s not broken.

Something happened, and it’s hard, but I’m not broken. I’m here. When we, as therapists, Maude continues, in DIR/Floortime show the client that I’m here for you and you matter, that my time with you is a worthy time spent, and that I find myself valuing our time together–when we give that message–the client gets it, Maude says. That’s the Floortime way. We’re going to be together. We have this time where we can value each other. At the end of the day, we know that being with each other matters, Maude stresses.

At FEDC 2

This is where the Floortime perspective and the use of self comes in so much, Maude insists. When we look at FEDC 2 (Engaging and Relating), it’s a crucial place for a trauma survivor because what they want to do is disengage or dissociate. They want to go through the motions, but don’t really want to be in the moment because ‘in the moment’ may bring them too close to feeling what they don’t want to be feeling–the triggering, the flashbacks, or that the therapist is going to expect more of me than I’m prepared to give.

Maude specifies that we’re not talking about the same engagement challenges from an autistic individual that is avoiding because of individual differences or not understanding the moment in a fragmented moment of time. It’s a different flavour when you’re working with trauma, Maude says, and the combination of trauma and autism can be really hard. When you’re working with a trauma survivor on engagement, you’re working on messaging. Whether the client shares the details or not, we’re stressing that you matter enough for me to engage with, Maude explains.

Maude says that we can say to parents, “This was hard.” There’s nothing we can do to change it. It is what it is, but we can say that we want to spend time with you and make it happen for you and take this journey with you, together. When you do this, in the DIR way, the family feels at home. It opens up and enlarges the picture. It’s not just a bubble around them that’s feeling so hard. As a therapist, you can expand the bubble to include one more in the family’s village to take this journey forward. It is powerful.

The Safety is the Therapy

If I think about my son’s experience, as I mentioned in the podcast about medically complex children, whenever my son sees someone with a band aid on, he gets triggered. He had numerous IV changes and blood tests in the hospital when he was 2 years old. He is so concerned when he sees a band aid or ‘boo boo’ on others. In a Floortime way, we can explore that. 

Maude says that there’s so many things about fear and in psychotherapy they can do exposure therapy. But what we often see, Maude explains, is that when you create the safe space, children know themselves what they need to work on. In trauma, she’s seen it over and over. When a band aid is an issue, it will come up. She doesn’t even have to initiate it. 

When the safety is there, they will face their fears, but without the safety, there’s no holding them because they can’t face it alone. This is why she says that safety is the therapy, and the playful approach is the approach that provides the safety. Maude gave an example of a child who played with having predators in a jungle, with all of them facing towards the middle of the scene. The child played, talking herself through it, making the animals come closer then go back. 

Then, the child took a little toy toilet and put it in the middle of the play. The child wants to do a sleepover so badly, but wets the bed. The toilet went in the middle of the scene and she didn’t touch it as she played with the predator animals around her, representing the threat of the bed-wetting issue. The therapist didn’t say anything about the toilet. The child needed to face the threat and be the animals and also be the victim. 

Two weeks later, the child stopped bed wetting. They didn’t even talk about it. It’s the beauty of the Floortime method, Maude says. The child knows where they need to go. Some of it is hard stuff, Maude says, but when you create this safe container, the healing starts from within. And it’s their process. I mentioned that in Maude’s trauma course, the example was a child who had experienced intense trauma and Maude showed how they went through the FEDCs in their play with the child.

The Brain Doesn’t Forget

It makes me think that that’s why my son is so interested in people getting hurt in shows he watches and playing with figures having broken limbs, putting a cast on them, and going to the hospital after all of his fears around having been in the hospital when he was two that are probably subconscious at this point. Even going to the dentist can be traumatic when strangers come at you wearing a mask and gloves, carrying tools, for a child who’s had medical trauma.

Maude brought up another complex case she worked on where a girl seemed completely fine except that she could not handle buttons of any kind. They had to do a lot of hard digging. They found that the child was in and out of the hospital as an infant and the nurses would lay her against their chest where there were buttons on their shirts. That feeling of buttons brought back the trauma and was part of the trauma trigger. It was such a learning curve to figure out what it was because there was no tactile defensiveness. The brain doesn’t forget, Maude says.

At FEDC 3

The way memories are laid down is through the sensations of the moment and the emotions associated to those sensations, Maude explains. Anyone working with sensory or emotional trauma clients could trigger them, Maude says. That’s why DIR is such a safe method, with regulation, engagement, then working on the two-way discourse providing a medium of safety. 

The activity doesn’t matter. There’s a rhythm of back-and-forth. Eventually up pops the thought from the client, Maude shares. In trauma, you have to be careful with that because in Floortime you’d usually say, “Hmm… I’m confused” whereas in trauma, you don’t, Maude asserts. Maude explains that if the client is already at FEDC 5 and 6, her and her team are just adding the foundation at FEDC 3 and 4 to give the client a better time at FEDC 5 and 6. 

In trauma, they’d just keep the back-and-forth going at FEDC 3 because you know the memories are coming up in fragments. When you dream at night, it’s not really sequential, Maude says. It’s fragmented. It’s also what happens when these fragments of memories come through in therapy, she explains. You just accept it. If you said, “Wait, I’m confused” they’d shut down. So you just go with it in trauma, which is different than working at FEDC 3 with autism, Maude explains.

At FEDC 4

Maude continues that at FEDC 4, having the structure is as important as with anyone. Depending on when the trauma occurred, the client may struggle with the stages of structure–building enough of the amygdala, the praxis, and motor planning in getting there. The client’s nervous system got stuck at the time that the trauma occurred. 

Then the development that had to come after that which is still part of myelinating the brain, Maude says, doesn’t happen at the stage or age that you want it to be, so you have to re-structure FEDC 4 and spend a lot of good time there to help them find a place where the emotion can land, Maude explains. They create many, many stories. 

Another thing that’s different from autism, Maude continues, is that when a client is building their structures of stories in FEDC 4 in Floortime, we tend to put playful obstruction in there to get the sequences out in that problem-solving, but in trauma you don’t. You will do the whole thing about role play and make sure they’re taking in your role, as well as their role, and you don’t challenge as you might in FEDC 4 in autism. 

Instead, you work on constructive problem-solving from their notion and their perceived reality, Maude stresses, because their perception of the reality is going to be very skewed, based on what they’ve experienced, and a lot of that reality distinction doesn’t happen until FEDC 6. But in FEDC 4, you’re putting down the structure on which that reality base can land later to improve their perception that this present moment is the present moment and the past is the past, Maude offers. 

At FEDC 5 and 6

You are creating experiences in FEDC 5 and 6 where the client is having many more positive experiences around the same emotions that, over time, can replace the bad memories associated with the same triggers, sensations, and emotions, Maude continues. The more you’re building those positive experiences with the same emotions and sensations, the further away you can move away from being triggered, even though you can’t forget. It’s about decreasing the impact of the trigger, Maude shares.

I shared that if anyone hasn’t yet listened to the previous three podcasts, and especially the last podcast where Maude talked about building the structure at FEDC 4 for FEDC 5, please go back and look at it so you can better grasp what Maude is talking about.

Parent Regret

What I heard Maude say answered the question I had in my mind. Parents often regret giving their child an intervention that may have caused their child trauma thinking that their child will never forget and be triggered by them. Maude just said that we can work through those experiences in play and work through the FEDCs to recreate a new, safe environment that can slowly overshadow the old experiences.

Maude says that you only know what to do at the time you know how to do it. What you did at the time is what you thought was best, so be kind to yourself. Our brain is plastic until the day we leave this earth, Maude states. You can change any brain, despite the child’s age. Can we say perfection? Nobody’s perfect. But we can make it functional and we can decrease the triggers over time when we apply safety and security, she says. 

This is where we need to know who is in the village around you. Are they speaking the same language? One thing that DIR/Floortime gives us is that the social worker can do it, the speech therapist can do it, the educator can do it, the occupational therapist can do it. They all talk the same language, which is so much less confusing for the child.

When we all do that, one is not doing exposure therapy while another is doing injection therapy and vagus nerve stimulation, another is doing DBT, and another CBT. Is the team all using the same sense of safety? Maude has had sessions where she simply sat on the couch watching YouTube videos with a client. She’s seeking a sense of connection because the child isn’t willing to give. She’s trying to enter the child’s world to be able to bring them into her world to show the child it can be safe.

Parents, let the bus of the past go by, Maude suggests. She knows it’s not easy. You did the best you could at the time. Every decision you made, you made because you thought it was good for your child, and that must be ok. Maude hopes that families choose DIR.

Magnitude of the Trauma

Trauma is such a loaded word. When you talk about the ACES (Adverse Childhood Experiences) such as poverty, war, divorce, abuse, etc., these can all be labelled as trauma and everyone experiences trauma differently. But, there is a feeling out there that some traumas are worse than others, so I asked Maude what the idea of little ‘t’ is where there’s a bunch of little traumas that add up over time (versus being raped or watching your parents getting murdered or some horrendous trauma).

Maude says that it’s only the perception of the child at the time. What might look to us as a little ‘t’ trauma, may have been big in the child’s perception and that memory stays big until they get through it which is until we can get through it in a way that can transpose of the magnitude of the event. The perception of the trauma survivor at the age and stage that it happened is what is the magnitude of the trauma, not how we as adults look at it, Maude says.

The parent or adult can think that the child is being overly sensitive. It may be a little ‘t’ for us, but in the child’s perception, if it was a huge piece for them, then we better take it seriously, Maude cautions. If the perception is the bigger piece of it, we need to really consider that even the small ‘t’ can linger for a very long time, and it does in Maude’s experience. It therefore behooves her to really look at it without regard to how big or small the event was in our, the adult, perception.

Stimming and Trauma

I asked Maude about what she meant when she said earlier that some autistics who have been through trauma might stim more. She said that you need to pay very close attention to stimming if there has been trauma. Most Floortime therapists don’t call on stimming. We know the client’s individual differences and that their vestibular system needs support, and perhaps they’re trying to access vestibular input through their visual system, for instance. There is a reason for it. Always give space for the stimming. 

Maude says that she is trying to figure out why the individual needs to stim right now. What happened just before this? Maybe this was a release after a hard activity. She will allow them to release the tension then redirect to a movement activity to allow them to release it through the movement. Maude starts to see that the client gets relief from the movement activity, such as going on a swing, for instance. Where there is stimming from trauma or a sensory need, it’s the same, Maude says, but she might give it a bit more time, depending on the individual’s profile.

DIR is a Valid Approach for Trauma

DIR is a valid method for trauma in many ways, Maude says. The DIR/Floortime approach is a respectful, warm, embracing way of helping somebody feel that they’re worthy and that “I want to be with you and I want you to be with me and I want you to feel felt and feel me. I want you to see my kind eyes and voice so you can reach within and bring yourself in the moment.” Maude hasn’t found another method that works as well. 

Plus DIR is developmental. Plus it’s respectful to the unique individual differences. Plus it enhances the family and brings the parent to a place where they can connect with the child. Floortime just gives you this fullness that can reach out at so many different levels and bring peace, Maude shares. If we do this, tomorrow will always be there. Maude always says that today is the scaffold for tomorrow.

If I harness this moment today, Maude continues, then tomorrow already looks brighter because I use what I have. This is what I have. I can’t control what happened in the past, but I can work on what I have now. Making today count is so helpful to decrease the anxiety about tomorrow. I added that all of this is through the power of relationships and through connection with each other.

This week let’s practice creating and/or maintaining that place of safety for our child.

For example: Are we putting extra demands on our child that we need not be doing? Let’s attune to our child’s emotional state to make sure they are not shutting down in response to us by ‘collecting before directing’, joining them in their interests and sharing joy together at their pace for as many moments of the day as we can–especially on the weekends.

Thank you to Maude for this informative podcast that really was helpful for me in understanding how to use the DIR lens in thinking about trauma. I hope that you found it as helpful as I did and will consider sharing this post on social media.

Until next time, here’s to choosing play and experiencing joy everyday!

The post Trauma through a DIR Lens appeared first on Affect Autism: We chose play, joy every day.

Photo by cottonbro studio

This Week’s Topic

The topic of this episode is to give an overview and review of the fourth Functional Emotional Developmental Capacity (FEDC 4) of the Developmental, Individual differences, and Relationship (DIR) Model from last episode, an overview of the fifth FEDC, and to discuss how one moves through FEDC 4 into FEDC 5. 

This Week’s Guest

Our returning guest, DIR Expert and Training Leader and Occupational Therapist Maude Le Roux has a DIR/Floortime clinic, A Total Approach, in Glen Mills, PA, just outside Philadelphia and a satellite location just outside Allentown, PA. She is an international trainer in many other modalities as well.

by Affect Autism

Bonus Insights

DIR Parent Network click HERE

We will never share your e-mail.

The Fourth Functional Emotional Developmental Capacity (FEDC 4)

Two episodes ago, we talked about the third Functional Emotional Developmental Capacity (FEDC 3) and moving into FEDC 4. Last episode we dove into FEDC 4, and this week we are recapping FEDC 4 and bridging to FEDC 5 in the Developmental, Individual differences, Relationship-based (DIR) Model. Maude says that everyone always asks if their child is there yet, about FEDC 4, and the bridge between FEDC 3 and FEDC 4 is a huge bridge to climb.

FEDC 1: Self-Regulation and Interest in the World

FEDC 2: Engaging and Relating

FEDC 3: Intentionality and Two-Way Communication

FEDC 4: Complex Communication and Shared Problem Solving

FEDC 5: Using Symbols and Creating Emotional Ideas

FEDC 6: Logical Thinking and Building Bridges between Ideas

FEDC 7: Multiple Perspectives

FEDC 8: Gray Area Thinking

FEDC 9: Reflective Thinking and an Internal Standard of Self

FEDC 4 is the structure on which everything lands, Maude explains. It’s the whole social-emotional understanding of having a social discourse and problem solving around a social-emotional level of being. If I want you to understand my thoughts without me always explaining them, then we need to have FEDC 4 in place, Maude explains. Theory of Mind–understanding another’s perspective–is where we get that ‘shared’ part of problem solving. The important word there is ‘shared’, Maude continues. 

It’s not cognitive problem solving. How do we help each other to understand my thoughts versus your thoughts, and my opinion versus yours? How do we negotiate now that I will pretend to be Captain Hook and you’ll be the pirate, and then we’ll switch around? When we understand standing in another’s shoes, the beautiful work of empathy starts, which is the food of shared problem solving, Maude says. Maude says it’s emotional. It’s cognitive. It’s language. It’s practical on a praxis level. That’s where the depth of FEDC 4 really lies, she says.

We can construct what the jail will look like, how many bars it will have, that it will have a key, and we figure out how to build and structure it from our mind. We have to negotiate if we now have the praxis piece of the sequence of the structure, then how do we lay the sequence of pragmatic speech on top of that, then how do we take both of those constructs and put the story onto it that develops from the beginning, middle, and end, that contains visualization, ideation, imagination, and creativity.

When we then bridge into FEDC 5, Maude continues, the sympathetic arousal that comes with emotions has a place to land. If FEDC 4 is not in place, there’s no place for the emotions to land, and there’s no construct to hold them, and no container to understand them. There’s only a fear that the emotions will be overwhelming. When we have FEDC 4, then when we get into the true depth of the plot and understand what each emotion is, then we have to be sure that the child has the capacity to hold and contain it and not feel overwhelmed, Maude explains.

Bridging into FEDC 5

When I started learning about Floortime, Dr. Gil Tippy told me the biggest leap is that jump from the concrete world to the abstract world, which he felt happened at FEDC 5, whereas Dr. Greenspan thought that happened at FEDC 4. Once you can co-regulate off of another person, you no longer need to have catastrophic emotional reactions. I like the way Maude described that the emotions have nowhere to land without FEDC 4.

I couldn’t wait for imaginary play to start in my son and many starting out place imaginary play in FEDC 5, but it actually starts in FEDC 4. Maude says that at a rudimentary level, which is representational–the child represents what they see people in their life do and put that into some frame of understanding for themselves in their play, or imitate scenes they see in a movie–imaginary play starts in FEDC 4. A child will stay with what they’ve seen.

It’s only when you start expanding away from that, by adding more complexity with more emotionality that you bridge into FEDC 5, Maude says. There is an emotional component in FEDC 4, for sure. Dr. Stanley Greenspan used to say that the only way you get to FEDC 5 is if you have 60 or more ideas in one session, Maude recalls.

That ideation doesn’t mean it has to be full-blown emotional recognition. It means there’s a bridge that collapsed, and I can make a plan to fix it, Maude explains. I don’t have an airplane right now, but I can make this cell phone look like one in my mind.

A ‘Container’ to Fall Back Onto In FEDC 4, Maude continues, you start to visualize and put things to the concrete in front of you that don’t have to be completely concrete. Visualization is a structure from visual-spatial skills and FEDC 4 is where that happens, she says.

When you have an emotion, you get a sympathetic arousal. How do you discern the emotion so you don’t become overwhelmed if you don’t understand what’s happening when you get the physical response from it and don’t have anywhere to place it? Social becomes a scary world here, Maude cautions.

In FEDC 4, when things come a bit more contained for you, you can start to make sense of why Mommy is giving the soother to your sibling and you want her to spend more time with you. You can wonder what the limits in this preschool class are. If you don’t have a structure, it remains scary and something to be avoided, Maude explains.

If kids can’t bridge into FEDC 4, they want to skip FEDC 5, and use cognitive logic and cognitive ways of becoming more left-brain, systemizing problems into certain categories, and if it doesn’t fit, they’ll avoid it, because the emotional grayness that we need in FEDC 5 is not available. There’s not enough structure for it to land, so they pull away cognitive skill from their structured executive, praxis ability. 

As it pulls away more and more, the disconnect between mind and body grows, Maude explains. The big piece we need to take that executive function to a place where the emotion can feel safe enough to explore is FEDC 4, so it’s crucial. Don’t rush it. Stay with it. The sturdier it is, the more we can do in FEDC 5, Maude encourages.

Staying at FEDC 4

I remembered my son being at Maude’s clinic wanting to build a big wall out of the firm, colourful pillow gym blocks. Maude said he had the ideas, but didn’t have the motor planning to build it himself, so he’d tell others to do it. He would place a triangle piece down on the tip so it would fall over. Motor planning comes in FEDC 4.

Maude also talked about beginning, middle, and end, and having timing and sequencing in FEDC 4. There’s so many aspects in FEDC 4. My son’s been in FEDC 4 for the better part of 7 years. Maude says that for some kids it does take longer. This is often where they see a lot of compassion and empathy for their families at A Total Approach, Maude shares, because things aren’t happening in the time frame parents expect because of how society tells parents that their child is delayed. It’s so important to support parents through these phases where it looks like their child isn’t developing.

There are many nuances to FEDC 4, but in it, an individual is working on praxis, language, visualization, and ideation, so it’s very important for clinicians to let parents know and help them understand that ‘FEDC 4’ is only the category of a wide range of things to be explored. Autistic exploration often lands up in single files, Maude believes, so it can take awhile for the single files (of praxis, language, etc.) to come together, then be translated into play.

It’s not that the child is not moving forward, Maude reassures us. It’s simply that FEDC 4 is a complex capacity so they have to focus on the different components of the capacity. It can feel like the child is plateauing and it can feel like you need to change therapists, but Relationship is so important, and we don’t want to send the message that relationships are not permanent and not to be trusted.

If you feel like a child is staying at the same place for too long, remember that if the child has a good relationship with a therapist, this is such an important piece. Maude talked about how going slower is how we move faster in a previous podcast. Maude says that without FEDC 4, it’s impossible to get to FEDC 5.

What FEDC 4 Imaginary Play Looks Like

I explained how my son’s play went from enacting a PJ Masks scene with PJ Masks characters years ago to now watching Curious George and enacting the scenes from it with Super Mario characters, or using a LEGO cart to be an ambulance in representational play, which is more complex than before. We can’t force our kids’ development. It comes from them when it comes. We can just provide ideal conditions, Maude stresses.

Maude says that the complexity is increasing. If your child takes the characters they like–whatever has foundation for them and their curiosity and what is comfortable to them–and if these characters start completing different scenes from what he has seen before–creating a novel storyline or creating a calamity that they have to solve, which is completely unique to that story–this is when FEDC 5 is emerging.

Maude continues that this is why Floortimers say to expand the play, along with promoting circles of communication. When you start seeing scenes like my son is doing–crossing over from one character series to another–then you can say, “I’m so scared…what am I going to do?” Once he starts putting his own story line with those characters with a production of a beginning, middle, and end, he’s emerging into FEDC 5. 

When he is facing me with an emotion, he has structure–visualization and imagination in order to say, “It’s going to be ok!” Then you can reply, “I don’t know… I’m really scared“. Then he can say, “Come under this pillow!“, figuring out that when I’m scared, I can feel safe under the pillow and that safety will feel better. I get safety and now I get my play partner’s part, and now we’re negotiating both.

See ICDL’s Newsflash entitled 6 Ways to Help Untangle FEDCs 4 and 5

Bringing Reality into the Play

I found rainbow colours of painter’s tape and made a spider web across the banister at home for my son. My son grabbed his plastic Super Mario figures and stuck them to the tape. Then, I put a piece of tape joining two of the pieces of tape, from the higher one to the lower one, and my son made one of the characters slide down it yelling, “Whoo hoo!” I thought this was a bit more novel than other things he’s done in play.

I shared with Maude, though, that I haven’t seen him enact scenes from his typical day with parents, with friends, or at school. There could be a variety of reasons for that, Maude responded. She’d encourage him to take his characters to school and also add a piece of reality into his current play. If you went to the museum, for example, enact going to the museum with his characters. Bring in those pieces of reality so it becomes part of the fantasy play, she urged.

Maude wouldn’t push the fantasy in the play, she said, because that comes later. It’s not really FEDC 4. Instead, bring reality into the fantasy play so there’s more material of things your child has to make sense of, that they have to generalize from one thing to another. This brings the visualization to life, which is really important, she asserts. This ‘practice’ is essential for solidifying the foundation for the next capacity.

There’s still work in FEDC 4 with my son, Maude explained, because in FEDC 5 we have to start making emotional sense of things, which is the integration that FEDC 4 creates for us to build the material where we can land emotions and thoughts on later in FEDC 5.

What is FEDC 5?

The fifth Functional Emotional Developmental Capacity (FEDC 5) is called Using Symbols and Creating Emotional Ideas (earliest emergence 18 to 48 months). We’ve already said that the emotional piece must land on the structure of FEDC 4. This emotional piece is a crucial place where the sense of self comes into a place where one can understand interoceptively, cognitively, and emotionally what their emotions feel like, what they’re going to label them, and how they’re going to be dealing with them, Maude explains.

You can label emotions cognitively in FEDC 4, Maude says, but if my Mom is playing sad in FEDC 4, I want to go make my Mom smile by putting my fingers on her mouth to make her smile. At the end of FEDC 4 where they have cognitive empathy, they can start to handle you being sad, Maude continues. You can say, “I’m so sad. My doggy is sick.” They might kiss you to start, but when they are doing that real empathy, they can suggest putting a blanket over the doggy so he’ll feel all better. Then you can problem solve how to put the blanket on the dog because you’re out on the street, for instance. 

The more you’re sad, the child tries to figure out how they can help your sadness and solve it in FEDC 5. Deeper in FEDC 5, they’ll come sit beside you and just hold your hand saying something like, “I know you’re sad” like when Sadness from the movie Inside Out put her hand on BingBong‘s knee when he lost his van. Empathy shines thorugh. Empathy feeds that sense of self in who we are, and our productivity and capability of actually dealing with someone’s emotion and leaving it separate from our own emotion is the depth and breadth of FEDC 5, Maude explains.

What about Empathy?

A lot of autistics say they have more empathy than others because they feel so much. Some autistic kids seem to be more overwhelmed by emotion than neurotypical kids. If you see sad things on TV, neurotypical people tend to think it’s cognitively sad, but it’s not the same as their own family. However, many autistics feel as affected as if it were their own family. What I hear Maude saying is that it’s not that the empathy isn’t there. It’s that there’s so much feeling that they don’t know what to do with it until they get to FEDC 5, whether you’re neurotypical or autistic.

Maude points out that in FEDC 1 we feel emotion, but you’re not able to label it, understand it, or be anywhere close to dealing with it. You’re just feeling dysregulated by it. You’re a victim of the environment. So it’s not that emotions aren’t there from the get-go. Empathy is built from the minute you are born when your mother ‘coos’ with you, Maude asserts. It used to be said that there were no mirror neurons in autism, but this is not true, however, they might be underdeveloped or underutilized, Maude says.

This is why we love to sit across from the child in Floortime, which makes the mirror neurons four times more active, Maude says. Iacoboni’s research on empathy says imitation is the place where empathy starts in our brain. Maude continues that you build the type of parent you’re going to be from the way that you were parented. It’s not what you say with kids, it’s what you do. As they pick up your response and empathy, that’s where empathy will land. 

It is not true that autistics don’t have empathy, Maude stresses. Empathy, as it lands on interoception in the body, she says, can overwhelm the interoceptive system, and can lead us to shut down the interoceptive system if we don’t know what to do with it. This can then also lead to other problems, Maude explains. There’s a lot of adults who still struggle in FEDC 4 when you’re under stress, I pointed out, but we’re talking about the development of these capacities.

The Development of Self

Maude says that there’s a line that walks through the Functional Emotional Developmental Capacities (FEDCs) and that’s the personality. We’re born with different temperaments. Maude gravitates toward the nature-nurture theories that nurture shapes the personality. As we go through these capacities, a little ego is developing and becoming autonomous. Feeling that sense of “I can” is developing through these capacities. 

All of us need to know that the moment you’re an entity as a baby, you have the full capacity in your nervous system to have the things in place you need to have, Maude asserts. Your nervous system is hard-wired to develop. You don’t tell a baby when to crawl. They naturally do that because we are pushed towards development. But when one part of development isn’t happening the way it needs to, then we turn into avoidance, she explains. We avoid the things that make me feel out of control, which is what causes the delay.

The experiences you need to become praxis-oriented, to build vocabulary for language, to put your language to what you’re doing, and applying yourself to it in play gets missing, so you don’t build the constructs that you need to. A model like the DIR model is one model of explaining how these things have to follow on each other, but it doesn’t mean the availability isn’t there from the beginning, Maude insists. 

From the moment you see your mother’s eyes or hear her voice, you are feeling something, but being able to capitalize, understand, and organize those feelings comes with time, support, and containment, Maude continues. Any developmental model provides the timeline, but it’s not about one step at a time. In the podcast conversation, Maude says, her and I are doing the first six FEDCs at once, thinking of what we’ll say next to help others understand.

In DIR the ‘I’ is for Individual differences, and we like to focus on the individual profile over a diagnosis because everyone is unique in their development based on their unique profile. The whole emotional piece that is such a big piece in this developmental model is what we focus on, Maude says.

Final Thoughts

The fifth Functional Emotional Developmental Capacity is where we can work against polarized thinking, Maude says. If an individual can understand the range of emotion in themself and where it lands, and understand that another goes through something too–that is, if I can get you and you can get me–then we actually have a place where we can have a debate. 

It’s an organizational structure on which I can trust you and where you’re coming from, and you can respect me and where I’m coming from, and the fact that we may differ in opinion doesn’t make it wrong or right. That ultimate respect lies in this model. It brings about so much healing that our world needs right now, Maude reflects. FEDC 5 provides the room in which me and you can be in a space that corresponds and keeps us co-regulating each other so we can both grow, Maude concludes.

This week let’s practice meeting our child where they’re at, and fully working on making that capacity robust.

For example: Are they having robust circles of communication? If not, go back to watch this podcast from last month. If they are, let’s start enacting their favourite scenes with their favourite characters or stuffed animals. If they are fully doing representational play, start playing the role of one of the characters and have those emotions like Maude talked about. Let’s be a part of the drama they create.

I thank Maude for taking the time to record this podcast and I hope that you found it as helpful as I did in really getting a deeper understanding of FEDCs 4 and 5! Please consider sharing this post on social media.

Until next time, here’s to choosing play and experiencing joy everyday!

The post Developing Through FEDC 4 into FEDC 5 appeared first on Affect Autism: We chose play, joy every day.

Photo by Mikhail Nilov

This Week’s Topic

The topic of this episode is the fourth Functional Emotional Developmental Capacity (FEDC 4) of the Developmental, Individual differences, and Relationship (DIR) Model based on the presentation our guests in March at the New York City DIR/Floortime conference called, The Spectrum of FEDC 4.

This Week’s Guests

Katie Shepherd is a DIR Expert and Training Leader with the International Council on Development and Learning (ICDL) and a Speech-Language Pathologist in Chapel Hill, North Carolina. Sanette Louwrens is also a DIR Expert and Training Leader with ICDL and owner of Sensorium Therapy Inc., a DIR Occupational Therapy practice in Redding, California. Sanette completed the Napa/UC Davis Infant Parent Mental Health fellowship in 2022. Reflective practice development in DIR is one of her passions.

by Affect Autism

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The Spectrum of FEDC 4

I asked what made Sanette and Katie choose this topic to present at the DIR conference in March. Sanette says that Katie and her taught DIR 201- The DIRFloortime Basic Certificate Course together, and had such a wonderful synchrony, that they wanted to present together. They chose FEDC 4 because it is so complex. It’s called Complex Communication and Shared Problem Solving. It is such a shift in the child’s affective development and the development of ‘self’, Sanette says. It’s an incredibly foundational shift.

They called their presentation The Spectrum of FEDC 4 because you have an imagery of a white light lighting a prism and then radiating the colours of the rainbow. That is how FEDC 4 is. Everything is stepping up. The regulation is stepping up, the communication is getting more complex, and there’s more nuances. They were trying to capture this complexity in the title. They want this to be a resource for people so they can dig in and have more wonderings about FEDC 4.

You have an imagery of a white light lighting a prism and then radiating the colours of the rainbow. That is how FEDC 4 is.

When Katie and Sanette teach DIR 201, it covers the first four Functional Emotional Developmental Capacities (FEDC 1 through 4), and then in the Certificate of Proficiency course, DIR 202, they cover FEDC 4 through 6, so FEDC 4 is visited twice. Then, as they did their literature research and also looked at what Drs. Greenspan and Wieder have written about FEDC 4, Sanette says that her and Katie both expressed awe and humility in the breadth and depth of this fourth capacity and how beautiful this DIR model is at meeting every child and family.

Diving in to the Fourth Capacity

I referred listeners to our last podcast on the third FEDC with Naomi Wong and Andrea Snyder and Katie said that she attended their presentation at the DIR conference right before presenting hers and Sanette’s, which really helped because you can’t really think about one capacity without considering the earlier ones. Katie added that in the DIR model, she doesn’t think Dr. Greenspan intended on any of us to only work on only one capacity at a time. We’re always thinking about all of them.

Complex Communication As an individual is moving from the third to the fourth capacity, their back-and-forth interactions are becoming longer and more complex. These long chains–affectively charged and continuous–of circles of communication create a flow of communication. As the interaction progresses, these circles of communication become more complex. It also involves the use of many communicative signals such as facial expressions, gestures, all forms of body language, vocalizations, and/or words to communicate increasingly more complex ideas.

An Interactive Experience As a DIR 201 instructor, Katie values and celebrates the preverbal experience. The non speaking communication is so important to promote and encourage communication, she emphasizes. Individuals express more complex ideas gesturally with vocalizations or sound effects as well. We also want to highlight how this is interactive, Katie says. You’re interactively solving problems with a sense of ‘we’ in the fourth capacity. We think of the development of these interactions in this capacity.

Maintaining Regulation Another component is that we need to maintain regulation while maintaining a broader range of emotions, which is something we really want to focus on, for longer periods of time, Katie continues. Through all of these rich interactions, we establish a sense of self and this understanding of a ‘you’ and a ‘me’. An individual can begin to advocate for themselves and say ‘no’ when you have a sense of self, Katie shares.

Motor Planning We want to support an individual’s pursuit to lead reciprocal interactions and sequence and execute action plans, Katie adds. This is where the recognition of patterns comes in. All of this is interactive with a communication partner, even under healthy levels of stress, Katie adds. I shared that in ICDL’s parent support meetings, parents are learning the FEDCs and it took me years to even remember what they are, even having read about them numerous times.

Continuous Flow I pointed out that the developmental capacities are like a spiral. They are not stages or steps where you master one and move on to the next one. We’re working on this all the time. I highlighted Katie’s point about the flow of communication being continuous. This is different than start-stop interactions where you may ask a question that your child answers, then ask another question, etc. Or your child asks you a question or sends communication to you, and you answer, then you change the topic.

Broader Range of Emotions I also wanted to highlight Katie’s mention of maintaining regulation through a broad range of emotions. In my Floortime series, ‘We chose play‘, you can see my son starting to demonstrate this when his father presents a symbolic idea of the train putting out the fire which my son protests, but he stays in the interaction and his distress lessens because he is so motivated to continue playing trains with Dad. 

Co-Regulation I didn’t realize at the time all the developmental capacities he was showing, even though he still had constrictions in his capacities. When he was younger than that, he would have got up and walked away, but he stayed in the interaction. I pointed out what Dr. Stanley Greenspan would say about reaching the point where one can co-regulate with another person using those affective signals versus having ‘catastrophic emotional reactions’. Getting to the point where your child feels safe enough so they can co-regulate with you through those dysregulating moments is a part of this fourth capacity.

The Genuine Relationship

Katie pointed out that the Relationship is so important in my example, and my son was motivated to continue being in that relationship with his Dad. She also wondered about the affective signalling Dad was providing in that interaction. I replied that Dad’s affect was pretty neutral and he was more focused on his agenda, as he was newer to Floortime then, but acknowledged Katie’s point that the child is affected by the parent’s affect and how I would have been much more reactive to my son being upset than his father was; he was always much more calm and chill.

I shared how important it is for parents to be able to find their genuine affect with their child because you have to be comfortable interacting with your child versus following how someone else is doing Floortime. Katie also highlighted that I said my son isn’t having catastrophic reactions much as he did when he was much younger. It’s because of the rich emotional interactions and emotional signalling, which helps a child learn to tame their own emotions.

Shared Problem Solving

Sanette added that in the train example, my son could stay in the interaction through distress. The individual’s regulation has more stability in the fourth capacity, whereas in the earlier capacities (FEDC 1 to 3) you have to work a lot harder at co-regulation, she explains. There was a ‘problem’ or ‘challenge’ created that had meaning to the child, so that was affect-mediated problem solving. Problem solving in FEDC 4 isn’t just having a problem in the play, Sanette continues. It’s about having meaning to the child, and in that meaning the child will negotiate and navigate through affect.

It’s interesting to reflect on how the circles of communication in the third capacity help the child realize they have an impact and influence through their initiation and gestures. It helps them figure out cause-and-effect, whereas in the fourth capacity, they realize the world is their oyster. This concept of signalling, negotiating, and navigating makes them realize they can resource the other in the problem, and the problem has meaning to the individual.

When you have the flow with interaction, you don’t have to do too much to regulate and bring a small challenge, Sanette continues. In order for this to be in the fourth capacity, we want to see that it’s affect-mediated and meaningful to the child, and the child resources you to solve the problem with them through their communication system, Sanette stresses again. 

Many times when we do playful obstruction, Sanette says that we’ll use ‘magical’ problem solving: “Whoops! The fire is out!” or when playing with cars, you’ll say, “Oops! My car stopped!” The child might come and pretend to put gas in the car and ‘magically’ solve the problem instead of seeing the sequence of needing to call a tow truck so you can figure out what happened to the car. When you do playful obstruction, make sure the challenge has meaning for the child, Sanette stresses.

I shared that Dr. Gil Tippy really stressed with me in the past that any so-called ‘intervention’ can bring a child to FEDC 3 but DIR/Floortime stands out because getting a child to those higher capacities is where we see thinking emerge. I added that this is where the praxis piece comes in, too, because if you aren’t yet capable of planning, initiating, and executing your ideas, it’s a struggle in this fourth capacity to problem solve with someone.

Katie points out that’s it’s so important to realize that problem solving is so much more than verbal negotiation. There are so many ways to communicate with your body language what to do with your car during playful obstruction, for instance. You are seeing if the child can make sense of the vocal and social action patterns of the play partner’s movements of looking, showing curiosity, and wondering together, without words, really leaning your body in there and make meaning of whatever the solution is going to be.

See ICDL’s Newsflash on this capacity HERE.

Promoting FEDC 4

I stated that in FEDC 3 we start by initiating circles of communication then eventually the child begins to initiate. In FEDC 4, we might suggest a solution first, such as going to get gas for the car that stopped, but I shared that perhaps the child will just repeat, “Go get gas” every time after that, without thinking of another idea. Sanette responds that we want to bring the thinking to meet the child’s ideation where it’s at. We want to support the child’s ideas.

One of the big components of FEDC 4, Sanette repeats, is that non verbal, gestural communication. That system is so foundational across the lifespan. It’s the glance of your eye, the way you place your head, or where your body is. It’s a mind-body system that is foundational on your interoceptive ability. The interoceptive system makes sense of what’s coming in from the outside. Sanette shares that her granddaughter had the raise of an eyebrow as a baby that had so much communication contained in it. As you develop this, you bring so much more of yourself into the play.

Let’s say that in play, Sanette explains, you make the noise of a car running out of gas (e.g., “putt, putt, putt…“) and gasp, this is way more inviting than asking, “What do I do now?” When you use these non verbal gestures in this way, you are giving the child feedback. The child has to use their eyes and ears to take your gestural system in, in a multi-system way. It’s a feedback loop that modulates and regulates the child. It provides the regulation to support ideation, Sanette explains.

Katie shared an example of playing with a little girl who loved to play firefighters. They were putting out fires together. For one of the fires, they were too late, and the house was full of soot. They were trying to get the soot out. The girl was doing a lot of imitation of Katie. Katie had a sponge and ‘by accident’ got a hole in her sponge. The girl was magically fixing it. Then, the girl had a hole in hers. There was a lot of back-and-forth in capacity 3.

Next, Katie was standing, and the girl asked her to come over to her, but Katie asked if the floor was stable because she was scared the floor was going to fall. The girl said that it was fine, but Katie hesitated and showed on her face that she was afraid, without words. The girl lifted up her toe to test the floor without saying anything, and together they were figuring out this problem. Katie and her together put their toes down hesitantly to see if the floor was stable.

There was social referencing as they looked at each other, there was affective signal exchange with their facial expressions, and they were sharing the emotion of being nervous. Then, they tried it together and there was a sense of relief that the floor didn’t collapse. That moment of shared, social problem solving was done with their body language, Katie explains. It’s just about figuring out what to do next. It doesn’t have to be a grand, elaborate problem to solve.

One mistake I made early on was creating too many problems too quickly, instead of staying in the moment and using that affective signalling. Katie adds that it’s also important to support the child’s pursuit to lead. They will tell us what to do next. Follow their lead. I added to slow down as well. Slow down, then slow down more, then when you think you can’t go any slower, slow down ten times more than that. When you watch videos of yourself, you realize you didn’t wait at all for the child to jump in with an idea.

Sanette added that as Katie was recalling that experience, in her FEDC 4 example above, she was glowing. To bring in reflection as a source of information, we can think about the warmth, pleasure, and joy in the second FEDC. There’s a quality, too, of the collaboration as the ‘I’ and ‘me’ become a ‘we’. The quality of engagement and collaboration of doing something together is something you can sense, which is just beautiful.

Katie adds that this goes to the ‘R’: the relationship. Katie adores this little girl and has a wonderful relationship with her and her family. There’s a trust and co-regulation because of the relationship. The pacing and engagement also supported the interaction. It had so much to do with the relationship, though, Katie stresses!

Those Individual Differences

I highlighted paying attention to the child’s Individual differences. I shared an insight that my son’s speech-language pathologist had about how, despite him not having seemed to be a Gestalt language processor, she noticed that when she altered the way in which she spoke with him–the way she would with a Gestalt language processor–she could see him move up in his developmental capacities. 

She was supporting him by taking into account this individual difference. Katie agrees that communication is such an important individual difference, and perhaps we are noticing that my son might be a bit of both an analytical and a Gestalt language processor, which many people are. Sanette continues on another individual difference–that of ideation. She said that we want to figure out how to support ideation so the idea can come into the individual’s body and they can express it in the sequencing and timing, then watching how it’s getting executed, and the feedback it gives to the body. 

In thinking about how we support this in the interaction through the relationship, Sanette reflects on Katie’s example. The child had a dyspraxic profile, and the way Katie positioned her body, the way they were referencing one another, and the minimal language and use of affect, it gave the child feedback and scaffolded the child’s interaction. It goes back to how important it is to hone this skill as a Floortime play partner, Sanette says, when you are supporting the fourth capacity.

Even just the breath is a gestural signal, Sanette continues. You’re signalling to the child in an interoceptive, affective way, embodying emotion with that non verbal gestural system. It enables the child to truly feel the emotion, and helps the transition from emotion, into ideation, into symbol formation into FEDC 5, which is what we want. It’s the feedback they get through the eyes and ears–a multi-system feedback–in that continuous flow that is paced. Yes, you’re in the moment, but you’re also in an analytical place thinking about how you do all of this, Sanette insists.

Limit Setting 

A huge topic in this fourth capacity is limit setting. Katie gave an example of a little boy who could climb across the monkey bars, but was not allowed to go up the ladder in a Floortime session. They used humour and affect to communicate the limit setting. They would sing, “No climbing on the ladder!” The child would test the limits to see what they would do.

Through the interaction that they stretched out about not climbing on the ladder, the child loved the affective exchanges they were having and understood the limit, while being silly and hinting to test it. They’d say, “I know you want to go on that ladder!” and if they used a firmer tone, the child understood and followed the limit.

Using the humour and through the relationship and affective cues, the child made a game of it, so they gave the child time and space and stretched it out as much as they could to get that continuous flow, and made meaning of what was happening. Sanette comments that there’s regulation that has a stable quality so the child could be more flexible in his ideation and engagement, which allowed a reciprocal interaction that had flow.

Sanette added that the affect was what the child needed to process and understand the limit. The child was developing and fortifying his sense of self by testing the limits, as kids do in FEDC 3 and 4. You have to understand that someone has an idea that’s different than yours. You have to have the capacity to receive and hold the space that someone has ideas different than theirs, but instead of it being a threat, it becomes a resource. The child was working on this in a very engaging, multi-system, supportive way.

I asked what to do when the child makes a repetitive game of testing those limits to get that reaction out of the parent that is so gratifying–the emotion-seeking–such as dropping things from the top of the stairs that they’re not supposed to do, to see what you do. They might be doing that cause-and-effect ‘object’ play that comes after ‘sensory’ play. 

Once it becomes a pattern, our kids will often stick with the new ‘game’ or pattern that then is very difficult for the parents if they are more mischievous or dangerous, and in school, might be disruptive. Sanette says that they are many aspects to limit-setting. There are different qualities and needs to limit-setting and there’s definitely a requirement to set limits when there’s danger and risks, for instance. We want to be able to set safe limits. 

As we are putting down our limits, we don’t always have the time to do playfulness around the limit, so we should set aside time to do this so children explore when an adult says ‘no’ and understand what it feels like. It’s important that they experience emotions in their body in a shared environment. But hearing ‘no’ puts them in a negative range of emotions. They might get frustrated and angry, which is so hard. 

You need to play through how we are ‘together’ during these negative emotions. Sanette also adds that DIR is a developmental model. Limit setting is a threat for some children, depending on your developmental capacities, she explains. When you are threatened, you become dysregulated and it’s a matter of survival in terms of a physiological response. 

There is a place for limit setting, but Sanette says let’s look at the shared world and look at what the interaction looks like. Sanette is saying that we should bring it into playful setting where we can act these limits out so the individual gets practice with them, when we aren’t rushed and have time. Katie adds to also connect before redirecting. ‘Connect before you correct’. 

In play, when exploring a broad range of emotions, sometimes mischief and aggression come out, Katie adds. The more comfortable we, as care providers can feel playing with those emotions, the better children will understand the broad range of emotions and the limits we set.

In Summary

Besides strengthening the third capacity, which is always the answer, Katie says to create extra steps in your pretend play. Be animated, and use your affect through your facial expressions, gestures, and vocalizations. Deepen the plot rather than entertain the child, like it says in The Child with Special Needs. Stretch out those gestural exchanges, she encourages.

Sanette adds that when you’re working on problem solving, sequencing is involved, so think about how you can scaffold and support the child, looking at breaking down the solution into parts to figure out what part you can do so the child can do the next step. Use a variety of gestures because that is the feedback system for the child. Pair your gestures with your vocalizations and actions, and adding vocalizations and gestures to the child’s actions to strengthen the feedback loop. 

We also want to be aware of counterbalancing the child’s regulation, Sanette adds. If the individual is more agitated, we’re more soothing. If they’re lethargic, we’re more energizing. If they’re impulsive, we’re more containing for them. If they’re fragmented–especially if the problem becomes dysregulating–think about how to scaffold and support their organization. That counter response is a way to build their range of emotion, Sanette explains.

This week let’s practice focus on what Sanette stressed so much: strengthening the feedback loop to our child through our gestural, affective signalling. 

For example: Position your body close to the child in their range of vision and at their eye level, use facial expressions, vocal intonations and gestures to indicate that you are eager to be a part of the interaction, and hold that space where they see you are waiting for them to initiate.

This podcast was long overdue, and I want to thank Sanette and Katie for taking the time to cover this vast fourth capacity with us! I hope you found it as helpful and will consider sharing this post on social media.

Until next time, here’s to choosing play and experiencing joy everyday!

The post FEDC 4: Complex Communication and Shared Problem Solving appeared first on Affect Autism: We chose play, joy every day.

Photo by Anna Shvets

This Week’s Topic

This episode we are discussing intentionality in the third Functional Emotional Developmental Capacity (FEDC 3), which is Intentionality and Two-Way Communication in the Developmental, Individual differences, and Relationship (DIR) Model, and moving from FEDC 3 into FEDC 4, Complex Communication and Shared Problem Solving. Our guests presented on Intentionality and FEDC 3 at the ICDL DIR Conference in March and you can watch that presentation here as an introduction to this podcast episode.

This Week’s Guests

I have two first-time guests today. Andrea Snyder is an Occupational Therapist and DIR Expert and Training Leader in Colorado Springs who sees clients in the home setting and teaches certificate courses for the International Council on Development and Learning. Naomi Wong is a Speech-Language Pathologist and DIR Expert and Training Leader in Singapore who owns a clinic called Speech Therapy Adventures helping parents and children navigate their developmental adventure together.

by Affect Autism

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The Early Social-Emotional Capacities

To begin, I asked Naomi to describe the first three Functional Emotional Developmental Capacities in the DIR Model, even starting with what Colette Ryan called ‘FEDC 0’ last episode, or that ‘felt’ sense of safety. Naomi shared that in the first FEDC, Self-Regulation and Interest in the World, we transit from a sensory realm into an emotional realm and experience sensory integration. If you can integrate your senses well, she explains, you then have the emotional availability to attend to someone and communicate and interact with them. 

In the 2nd FEDC, Engaging and Relating, we think of the ‘gleam in the eye’, or the capacity to have a simple back-and-forth circle of communication with someone. Picture a baby who coos at their caregiver, the caregiver smiles, then the baby smiles back. These first two capacities after that sense of ‘safety’ are about feeling regulated and ok in your body so you can attend to others in a social sense, Naomi explains.

I complimented Naomi on her eloquent description of FEDC 1 and she said that she started using this definition because when she would refer clients to Occupational Therapy, parents would ask why their child needed it? All they wanted to work on was the communication bit. Once Naomi explains it, they are happy to go for the sensory integration component of their child’s program.

The third capacity is about having that idea to want to communicate. Naomi and Andrea themed their New York City ICDL DIR conference presentation, ‘Intentionality’ because they wanted to think about the child having to take the initiative to communicate. To do this, you have to give the child a purpose, because having a purpose and having something to share is the very first step to meaningful communication, Naomi explains. So, if you want intentionality to come on board, you want to ‘woo’ the child to have something to really want to communicate with us.

Mismatched Communication-Action-Affect

Sometimes the children we work with have mismatched words, gestures, and affect. Naomi shares an example of a client who would jump on the sofa at her clinic saying, “You cannot jump after you eat“, but he would keep jumping. That is what his parents have been saying to him, and he repeats that script whenever he jumps on the couch. Conversely, Naomi continues, he was then taking a transparent bottle of Naomi’s, shaking it intently and staring at it, fascinated by it. He wanted to get the beads out of it. He said, “This is not a real bottle. It’s a fake bottle.“

If you compare both sentences, the shorter sentence, “This is a fake bottle“, it makes a lot more sense, with intentionality, and conveys a lot more than the longer sentence about jumping on the couch, Naomi explains. There are also examples of mismatched gestures where a child might be pointing to something, but their eyes are looking at something else. You have to watch their eyes to see where their intentionality is.

Sometimes parents get really frustrated because they are keen to listen to the words, but not read the body language. In Floortime, we used to talk about W-A-A (Words, Action, Affect) which we now refer to as Communication-Action-Affect where we can watch how they communicate, whether it be with an AAC device, with words, or with gestures and affect.

I highlighted what Naomi said about how parents can miss cues children send, such as their eyes looking in a different direction. I gave the example of my son playing Monopoly with Mario characters as the game pieces. He loves to change his character between each turn, so as he begins counting spaces to move his character after his dice roll, he counts corresponding to the spaces for a few spaces, and then miscounts as he moves his character forward. 

Another player noticed and pointed out to me that his eyes wander to the pile of characters when he loses his counting correspondence, so I now alert him to watch where he’s moving his character, or to start over. Some parents are better at picking up their child’s cues than others. Naomi says that it is natural for us to tune in to what is verbal, and not look and listen to the body language. Most of our communication is non verbal rather than verbal. We are not cueing into the non verbal language sometimes.

Nurturing Intentionality

Andrea highlighted that my example speaks to my son’s intentionality when he is so excited to change his Monopoly character when his turn ends. He’s going through the actions, but his true intrinsic intentionality is what he’s focusing on with his eyes and body–not his motor actions that he’s passively going through in order to get to what it is that he’s intentionally interested in interacting with. I said that his intentionality has been strong in him for years; it’s the sustained back-and-forth that is still challenging to maintain.

I shared how in my Floortime documentary series ‘We chose play‘, I talked about how when my son was much younger, it didn’t seem like there was intentionality, which can be hard for parents. You’re trying to get that engagement. You might have to initiate the circles for the child to respond before the child starts initiating. Getting this going is really strengthened, Naomi says, when that engagement is more robust. As Dr. Kathy Platzman has said, when you work really hard on FEDC 1, you get FEDC 2 for free. When you work really hard on FEDC 2, you eventually get FEDC 3 for free, and so on.

The Transition into FEDC 4

When our children are entering the fourth capacity of Complex Communication and Shared Problem Solving, we begin to see representational play come out, Andrea says. An individual starts playing different themes that they experience on a day-to-day basis: of going to school, of caregivers going to work, or of caregivers making dinner. One of the big shifts we see moving from FEDC 3 to 4, she continues, is that emotional quality.

This is where we really see emotions come into their interactions–different feelings and experiences–contrasted from the third capacity where we’re getting that robust back-and-forth together and are emotionally connected, but are not emotionally expressing our internal feelings like when we move into the fourth capacity.

Naomi says that in their presentation on Intentionality at the ICDL conference in March, her and Andrea spoke a lot to taking into account the Individual differences of the child. In Naomi’s example of the child with the bottle, the child loves music. Anytime there’s a musical instrument and they’re singing, you see the gleam in his eye, so Naomi uses that through the first two capacities and then, using support, moves in to the third capacity. 

This support helps the child navigate into the third capacity and stay there, Naomi explains. It’s about following the child’s interests, whereas in FEDC 4, you might not need as much support to keep the circles of communication going, and you might not need to follow their interests as much as you need to in FEDC 3.

Following the Child’s Lead

Considering the individual’s differences includes honing in on what is intrinsically motivating to the child, so practitioners should have materials out that support their play preferences, their sensory preferences, and their motor preferences, Andrea explains. By supporting these, it allows the child to have the intrinsic freedom to fully express with us what it is that they want to play with and how they want to play with it. 

With Naomi’s client, Andrea continues, Naomi will have toys or items to support that music desire/motivator, since she knows he loves music, and through that, it allows him that intrinsic freedom to open up that intentionality of interaction and communication with Naomi. So let’s talk about how to do this.

I shared that when we read the descriptions of the capacities, it’s describing neurotypical development and what ‘the baby’ does, but parents say, “My kid isn’t a baby. He’s 8.” They don’t know how to interpret it. I want to see that my child is intentionally communicating with me and responding to whatever communication I’m sending back. 

So in Naomi’s example, she might hold up the ‘fake’ bottle, for instance, in anticipation, and the child looks. Then, Naomi can make a noise such as “Ahhh!” and the child smiles back. Right there, that’s two circles of communication. When we get more and more of these ‘circles’ and have this robust back-and-forth, with dozens of ideas, you approach the fourth capacity.

Naomi continues that when you are holding up the bottle, she is looking at the quality of the child’s communication, affect, and gestures and if they are intentional. She wants to see that all three align nicely for that communication purpose. As the communication goes back-and-forth, she might drop the bottle and it might roll somewhere else and she can use affect, saying “Whoops! Where did it go?“

When is it Time to Challenge?

In a good Floortime session, Naomi continues, there’s always the engagement, and there’s also a little challenge that creeps in. Will they go look for it? We want to challenge a little to know if the individual is ready to move forward, or if they would lose that interaction because it’s too difficult for them to continue.

I shared that when I visited Jake Greenspan some years ago, he saw all six capacities in my son, but said that the tree trunk (referencing The Learning Tree) was very narrow and we want to work on widening that tree trunk by making the third capacity more robust across situations, environments, and caregivers. This is what we’re talking about.

Andrea said that it is part of the challenge of parents when we really do want to see our children move from capacity 3 to 4. We want to move to that next step, but it’s so important to sit in capacity 3, Andrea stresses. We want it to be robust. It’s so tempting to throw in some playful obstruction when we get a few circles. We want to see that intention with a variety of toys, in a variety of settings, with a variety of people. 

It’s hard not to want to jump into capacity four, Andrea continues, but we want to sit and hold capacity 3 for as long as we can which will set up our child for success to move into capacity 4 so they can have that intentionality when there’s a challenge. If they don’t have that robust intentionality yet, the child will just walk away. 

You could say, “Uh-oh! Where did the bottle go?” as a little test to see if the child is ready for us to stretch a little bit because it’s a small challenge. We want to start with that super small challenge, Andrea asserts. That’s how we know when our children are ready. When they take our small little shift, they figure out what comes next with us, their play partner.

Stick with a Small Challenge

Naomi stresses that it is a very small shift. In her example, the bottle might roll slowly towards the couch so the child sees it and can track where it has gone. It’s a simple challenge. If they are not ready and their eyes don’t follow the bottle, it is our queue to stay with FEDC 3. Andrea repeats that the small shift still includes the play partner. We want the child to figure out where they bottle went jointly with the caregiver, not on their own. 

In DIR, it’s all about the Relationship. We don’t want to lose that relational quality of finding that bottle together. We want to see the child maintaining their intentionality with their play partner in that little shift. It’s about that relational-conversational-interactional quality versus solving a problem by yourself. It’s about doing it all together. It’s a shared experience.

If you make the challenge too big and the child walks away, that behaviour is the clue that the challenge was too hard. I shared that in my Floortime documentary series ‘We chose play‘, I shared a clip of a consultation I did with Dr. Gil Tippy where we watched a clip of my son playing trains with his Dad, but then Dad uses a crane in a symbolic way and our son throws his hands up in the air and leaves the interaction with a scream.

Dr. Tippy asked me why my son left the interaction. I replied that he didn’t like what Dad did. Dr. Tippy said it wasn’t just that; it was also that the play was functionally, emotionally, developmentally too far ahead of where he was at that time for where he was developmentally in that moment. Many times, parents don’t know what to do when the child walks away. They think the child isn’t interested in playing with them. 

Sometimes, the child walks away and comes back. My son would do that to regulate and then return to the interaction. And sometimes we challenge too much. In Season 1, Episode 6 of ‘We chose play‘, Colette Ryan is coaching me retrospectively about a 7-year-old Floortime video where my son was 5 years old and I was challenging my child way too much and trying to teach my child. 

What stood out for me was Dr. Tippy saying to me once that if you change one little thing, stay with it for three months. In the video with Colette, I stayed with a change for about 3 seconds! Dr. Tippy said 3 months! When you’re teaching and challenging, you’re forgetting about keeping the back-and-forth interaction going.

Holding that Space

Andrea says that we feel stuck in the play as parents, feeling like we’re doing the same thing over and over, and that we should be doing more. But with the DIR Model, Andrea asserts that we’re intrinsically giving our child that freedom to want to continue through these developmental capacities, and our children show us when they’re ready for us to give them that expansion. We’re doing everything we should by following the lead of our child and waiting for their cue that they’re ready. 

We might take it too far and challenge too much, and that’s ok because we can always repair the broken interaction, Andrea assures us. When there’s a rupture, we re-initiate that interaction, which sets up our child for future experiences where they might experience a rupture in the classroom, and now they know how to repair it. By returning to that interaction by re-joining and re-following, we are strengthening their intentionality in FEDC 3 and waiting a couple more weeks to try that little shift or challenge again.

I used to find myself in ‘performance’ mode when doing Floortime and I didn’t know how to self-regulate when I was frustrated in the interaction. Waiting in that moment is so important. We want to focus on ‘being’ over ‘doing’. It can be uncomfortable to sit and wait on the child’s cues. It’s a real art, and it’s always changing as our child continues to grow and develop. Naomi says that when we are able to wait with our child and engage them in a relaxed interaction, having that just-right challenge and having fun, without having to push for another goal, this interaction can be very regulating for both the parent and child. 

When we talk about co-regulating, Naomi continues, the interaction is rejuvenating for both the parent and child. This is the sense of ‘being’ together. This helps build the relationship and keeps us together over time in our bond and intimacy, which is what we want for parent and child, versus a parent taking on too many hats being a teacher and a therapist, too. Know when is the time to just ‘be’ with your child, and when you are playing and doing Floortime, still ‘be’ the parent in that interaction. 

Inserting the Pause

Andrea adds that parents can keep in mind the power of ‘the pause’ to actively be in the interaction while our worlds are moving so quickly. We tend to constantly think about what’s next, but the pause allows our child the opportunity to show us what’s next because they have that idea, but sometimes they need that extra time from that processing, from a motor planning, or from an initiation standpoint.

Being in that connection with our child gives our child so much power to figure out the next opportunity, Andrea adds. They feel that intrinsic, “I got this” versus them needing to respond to what the caregiver gives next. It allows that true active ‘being’ in the interaction. Naomi says that in a course her and Andrea taught, there was a parent who just sighed, breathing out, as a pause, and after that the interaction was so much better.

Dr. Gil Tippy did a video series during Covid called For on the Floor about waiting, and how when we’re rushing, the child ends up thinking there’s a right answer and that there’s a demand on them. They’re eager to please so they don’t think but just respond, so I love what our guests said about taking that pause. We so naturally direct our children all day long and at school they’re always being directed. We want to give them the time together to just sit back and let them show us their ideas. 

I gave an example that parents can do with their child on the weekend when there’s no rush to go anywhere. Say that it’s time to get dressed and then wait. See what they do. Then you might say, “shirt?” and wait, or “pants?” and wait. It might take two hours to get dressed. You give subtle hints to see if they take the initiative. When you have a sock see if they know what to do with it. You could even put it on their hand and see if they protest that it doesn’t belong on their hand.

Andrea says it’s so easy for us to say that it’s time to get dressed and disengage. In my example, she said, we are holding the space affectively, being curious and wondering, sending that emotional experience of anticipation with the child. It’s holding the emotional space, which is so powerful. Andrea might affectively say, “What are we going to play today?” and look around the room with anticipation. If they’re stuck, she’ll give them a nudge to see if they come up with the next step. 

Slowing Down to Go Faster

She’ll affectively hold that emotional space in excitement and wonder, which motivates the individual to have that space to figure it out. I reiterated how important it is to slow down, and when you think you’re going slow, slow down even more. When you think you can’t go any slower, slow down even more. If you film yourself doing Floortime and watch it back, you can see how quickly we tend to go, leaving our children lost in the interaction.

Naomi said that the paradox is that we are slowing down to speed things up. When we slow down we give our child the chance to make a choice, and to be intentional and initiate. If we are rushing and entertaining them and not giving them that space, we rob them of the time for them to think and figure out and process the next step. I shared how Mike Fields called that being an ‘opportunity thief’. We are robbing them of their third capacity, Naomi says.

This week let’s practice sitting in the moment with our child and holding the space for them to initiate their ideas with us. 

For example: Find an activity your child loves to play, such as blowing bubbles, and just enjoy being with them holding the bubbles, waiting for them to initiate that they want you to blow the next bubble.

I am so grateful for Andrea and Naomi’s podcast this week! I really learned so much about supporting my child at FEDC 3 to strengthen it in order to strengthen FEDC 4. I hope you found it as helpful and will consider sharing this post on social media.

Until next time, here’s to choosing play and experiencing joy everyday!

The post Nurturing Intentionality as a Bridge to FEDC 4 appeared first on Affect Autism: We chose play, joy every day.

Photo by Ketut Subiyanto

This Week’s Podcast

This week our topic is one that is a top request by parents: sleep. I covered it a bit with Dr. Joshua Feder in a previous podcast. Although neither this episode’s guest nor I are sleep experts, we want to come at the topic from a Floortime lens and present some helpful information. My guest is Colette Ryan, an Infant Mental Health Specialist, who is finishing up her PhD with Fielding University on the topic of parent self-efficacy–which we will podcast about in a few months. She is a DIR Expert and Training Leader with The International Council on Development and Learning and has just accepted a new position starting a new Floortime Reggio Emilia school with a group in Tokyo, Japan!

by Affect Autism

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Which part of sleep are we struggling with?

From ICDL’s parent support meetings that I facilitate, parents come with all of these struggles: My child has difficulty falling asleep, staying asleep, or waking too early. I shared how my son breast fed every 2 hours until he was in the hospital at age 28 months and then continued to nurse until age 5 and a half, because it was the one sure way I could help him stay regulated. Even though it was no longer every 2 hours, I did not get a full night of sleep that entire time, and he didn’t sleep through the night until at least a few years after that. It was exhausting!

Colette added that 50 to 80 percent of autistic individuals have sleep challenges. Is it that the problem is falling asleep? Colette wonders if it’s the person’s sensory system? Is it difficult for that individual’s sensory system to calm down? What about staying asleep? Is it that the person is going through the sleep cycles and waking in the middle of the sleep states? And if an individual has a hard time waking in the morning, at what point in their sleep cycle are they? There are four points in the sleep cycle and we need the restorative sleep for our cognitive and mental health, Colette says.

Colette continues that there are other children who wake up much earlier than we want them to, and this is many children–not just those with a diagnosis. Their body doesn’t allow them to know that if it’s still dark, they should go back to sleep. This logical thinking is a higher capacity of ‘if…then‘. “If my caregivers aren’t awake yet, I shouldn’t get out of bed.” Sense of time is also in the sixth Functional Emotional Developmental Capacity (FEDC), so if you wake up and it’s 4:30AM, that might not mean much to the individual who has not yet mastered this capacity.

The ‘I’ impacts sleep

Individual differences will impact a child’s ability to fall asleep, stay asleep, and wake too early. These include arousal level, and their tactile, proprioception, and/or vestibular systems. Colette says we don’t need to be an Occupational Therapist to see how these factors can affect our child’s sleep. Colette says that some children need to move to stay regulated and by attuning to the child in front of us, we can figure out if our child maybe does need to run and jump or move around in order to be regulated enough to settle in order to go to sleep. Even with sleep, we need to attune to what the child needs. Use aromatherapy–if that’s what your child likes. Dim the lights–if that’s what your child needs.

Screen Time

Screen time needs to stop fairly early before bedtime, too, Colette states, because using screens activates that pleasure centre of the brain, and if you don’t know when to stop, you get over-aroused. I mentioned that I had heard that screentime stimulates the visual system, and that makes you crave more visual input. This is hard for parents because screens are what give us a break to do the dishes or other things. And we know from my podcasts with Occupational Therapist, Maude Le Roux, that the visual and vestibular systems are very much connected.

And screens aren’t going away, Colette says. When is it appropriate to watch the screen? What are we watching on the screen? How long are we watching the screen? And there’s passive and active screen watching, as well. If we can do active watching with our children, we’re still using the relationship piece to comment and use our affect about what we’re watching together.

Sensory considerations, Regulation, and Attachment

Next, we talked about tactile input. Perhaps our child doesn’t like the texture of their pajamas if they’re picky, or a tag is bothering them. Maybe the sheets or blanket don’t feel good against them. Maybe it’s their pillow. I shared that my son always kicked off his blankets and still kicks them around in his sleep today. Colette says it could be the feel of these things, the smell of them, or the type of pillow.

What we know about sleep is that we need restorative sleep, Colette repeats. If we don’t get that, we see more dysregulation the following day. We could have behavioural issues because of not getting that sleep. Dr. Gordon Neufeld talks a lot about the need for a sense of safety and the attachment piece as the pre-eminent need, even before hunger. Colette says that we are wired for it. You could also put Mom or Dad’s shirt next to the child when they sleep so they feel safe when they wake between their sleep cycles to help them fall back asleep. 

Colette brought up secondary altriciality and how we come into the world needing someone to take care of us, so those first relationships are about survival and are born with attachment-promoting behaviours. After that, it’s about really liking the feeling of being with the person. We talked about separation anxiety that our children can go through in transitions, and sleep is a transition from being in the comfort of our caregiver to having to regulate ourselves to sleep, which we may not be developmentally ready to do.

How do you perceive the world that you are in when it’s time for sleep and does it feel safe for you?

Colette also stresses that we’re talking about a perceived sense of safety rather than physical safety. It could be that the sheets feel funny, so I don’t feel safe, or it’s too dark, or not dark enough, or I can still hear people talking, but can’t process what they’re saying, so I don’t feel safe, and can’t fall asleep by myself. This makes Colette think about Dr. Stephen Porges’ Polyvagal Theory.

Sleeping next to our children

Next, we talked about how many parents of autistic children find themselves needing to sleep with their children in order for the child to fall asleep. This was true for me for many years. I recall hearing a presentation at the DIR conference in New York in 2020 by two staff members of Threshold Community Program in Atlanta when a staff member of the Rebecca School asked about how to help parents who are sleeping next to a child who is already in puberty.

I cautioned parents listening who still sleep with their children to start the process of getting them used to sleeping in their own bed earlier than I did. We need to set firm limits with our children and when we don’t, our children feel unsafe because they don’t know what the limit is. Dr. Neufeld talks about this, and Colette says that Dr. Greenspan has a great radio show about limit-setting (discipline) on ICDL’s website where he stresses that you can’t set a limit on somebody who you don’t have a relationship with.

With sleep, Colette continues, we get into patterns. We get into patterns with everything we do. Sleep is something that both parents and children need, though, so many parents are doing whatever needs to be done in order to get a good night sleep. But for some people it’s not a good sleep because they’re sleeping on the floor or in a twin bed with a ten-year-old. When you set a limit of sleeping in your own bed, it will be difficult for several days, until the individual finally realizes that this is a new pattern of behaviour. The parent will then continue to let the child know that they will provide what the child needs to feel safe.

Setting Limits

I shared that Dr. Gil Tippy gave me a reality check when he told me that if I wanted my son to sleep in his own bed, I should prepare to set the limit when I can plan to go 3-4 days or up to a week with no sleep. You set the limit and you let the child have the tantrum and stay firm that this is the parents’ bed and that is your bed. This brought up the topic of tantrum versus meltdown where I brought the example of my son as a baby crying and escalating to the point of vomiting if I left him in his crib to sleep. I wouldn’t do that to a baby.

Colette points out that as a baby, he wasn’t there yet, developmentally–the ‘D’ in the DIR Model. We would want the child to be developmentally ready to have that limit of staying in their own bed. It is a trial and error because if it is a meltdown with an older child, you would have to know if it’s a tactile issue that is causing it, for instance (or something else). There is no prescription. It really is an individual journey that is trial and error to determine what works best for your unique family circumstances.

I confessed that I just didn’t have the energy and just gave up and would lay next to my son until he fell asleep. But sure enough, exactly what Colette described would happen: he’d fall asleep and I’d be awake. As soon as I fall asleep, he squirms and wakes me out of my sleep cycle. Colette mentioned that not getting a good night’s sleep impacts our self-efficacy as parents. Do we feel successful if we did not get our restorative sleep and are overly tired, finding it hard to regulate and co-regulate?

Interoception

When we think about Individual differences, we also have to think about Interoception Colette wonders if there is a constipation issue? Is there a reflux issue? Laying down to sleep when you have reflux is painful, she says. What about headaches–especially during allergy season? You might need to have a pillow that raises the child’s head higher. Another thing that effects autistic children is seizures. My son has an irregular EEG and is at risk for seizures, which he has had in the past, and there are parents in ICDL’s parent support group have children who have seizures. This is something that is really out of our control as parents, and can make us feel so helpless, I tell Colette.

Colette says that this is another thing we have to attune to. We figure out what our child needs to feel safe which includes their sensory system and that interoception piece. I talked about that interoception piece of feeling when you have to have a bowel movement that can also impact the ability to fall asleep. Colette brought up children who may not feel when their body is tired and requires sleep. If you don’t understand that signal, the idea that you need sleep escapes you.

In the long run, it’s so much benefit for everyone in the family if you take those difficult 4 or 5 days, or weeks, to make that new routine of everyone sleeping in their own bed, so that everyone can get that restorative sleep and be able to function at their best each day. Colette also talked about research that suggests many with an autism diagnosis may not have that memory piece that helps them recall what it feels like when they were tired last night and went to bed. It’s like it’s a novel task each night to go to sleep (Neil et al., 2016; Pellicano & Burr, 2012).

Regulation

Amy Lewis and Heather Spann teach us through Powerfully You about regulation, breath control, and staying regulated within your window of tolerance, Colette says. If you’re not in that window, you might not be able to fall asleep. It made me think of the frantic nature of bedtime and how we use a lot of words and a more firm tone, which can throw our children out of their ideal regulation window. We always say that we want to slow things down with our kids who may struggle with processing things quickly in real time. In addition, some children may need to move a lot in order to get to a calm and quiet state.

I brought up having structure and predictability for bedtime, and setting expectations. A predictable schedule really helps children, then within that structure we can expand and stretch through play. Even if our kids are not yet interoceptively aware of the sense of time, knowing what’s coming up in a schedule supports their regulation. At my house, we have bath be at bedtime, which gives a lot of proprioceptive input, having water around the body, which supports calming down before sleeping.

Following bathtime, we will look at a few books, then do lights out. Proprioception is very organizing, Colette says. By attuning to our kids and helping them organize–using the relationship that creates a routine with the favourite books–it forms a nice pattern for bedtime, she adds. Dr. Gerry Costa talks about needing ‘A.G.I.L.E.’ (Affect Gestures Intonation Latency Engagement). We can use our affect to support the regulation that’s needed to fall asleep. The ‘L’ is for ‘latency’ and Colette says that Dr. Costa says “Less language, longer latency“. That is, let’s use our affect rather than our language. Affect is a great motivator.  

Follow the Child’s Lead

This discussion around affect made me think about how we follow the child’s interests. Recently in the ViSPA podcast, with the free, 150-page PDF download, my son and I started doing the ‘Magic buttons’ game Toni Tortora described at bedtime, as well. My son really looks forward to doing this activity. We can figure out what works for our child based on their developmental capacities, their interests, and their individual differences.

In Functional Emotional Developmental Capacity 3 and 4, this is where play is about playing out what a child has seen on a show, for example, Colette explains. Getting into a pattern of acting out a bedtime scene from the show ‘Peppa Pig’, for example, might be an idea that supports a child’s sleep. There’s a lot we can suggest, but think about what they like. What helps them relax? 

There’s the Qigong massage that works well to support sleep in some individuals, Colette continues. I shared that Occupational Therapist, Maude Le Roux, talks about giving deep pressure massage when they wake up and when they go to bed and I did that instinctually with my son when he was a baby, and he still enjoys leg and foot massages at bedtime. Colette adds that maybe you do olfactory support before bed. Colette is confident that parents can figure that out. 

Nightmares

When our children get symbolic, they may begin to have nightmares. Colette says that a Floortimer is the only person who will cheer when you tell them this, because they are excited that the child is becoming symbolic. Your brain will have storylines in your head when you get into a certain cycle of sleep. When kids wake up and don’t know what to do about it because they had a storyline and are suddenly awake, Colette prefers to talk about it.

Colette suggests asking your child about what was happening in their storyline. Suggest writing it down or drawing it out. It helps them make sense of them. If they had a dream about Marshall and Chase from the show Paw Patrol, Colette suggests playing it out. Even if it’s a negative storyline, she continues, you can say, “Wow, that must have been hard for you. Do you want to tell me about it?” Or, you can simply say, “That is a big feeling!” We address storylines differently depending on where your child is developmentally, and Colette gives an example for FEDC 4, 5, and 6.

Other Concerns or Setbacks

I mentioned how there’s always something that comes along, and a new routine that’s working may not last forever. Things change. Routines change. T. Barry Brazelton’s work on TouchPoints where he talks about things falling apart for a little while and building up resiliency before things come back together again, is helpful, Colette says. I mentioned my podcast about Developmental Growth Spurts that talks about this, as well.

Is the individual having ‘bad’ dreams or do they have bedtime separation fear? Fears from being alone or doing the hard thing of going to sleep by yourself can be overwhelming, Colette says. She sometimes has parents put one of their worn (and unwashed) shirts on the child’s pillow, so as the child is going from sleep state to sleep state, they can sooth with the scent of a caregiver rather than waking up with the fear and alarm of being alone. 

Sleep cycles can become disrupted for many reasons, and Colette prefers melatonin to medication if possible. Many times the individual needs to get back into a cycle that fits the family’s needs and the melatonin can support getting into a better cycle, she suggests. 

Does the family have a bedtime routine with visuals? It really does not matter if the time changes for when a child goes to bed, Colette says, as long as the routine is the same. Remember that some kids have decreased meaning making for words, so just talking about the routine is not always enough. The visual representation can be really helpful, Colette adds.

Check out this sleep podcast from Toronto’s Holland Bloorview Kids Rehabilitation Hospital on autistic teenagers and sleep.

This week let’s think about our child’s sleep and wonder about their individual differences and their impact on the child’s sleep. 

For example: Does your child have a hard time calming down to fall asleep? Do they have sensory considerations that impact their ability to feel safe in bed?

Thank you to Colette for our candid discussion about DIR considerations around sleep. We hope you found it very enlightening and will consider sharing this post on social media.

Until next time, here’s to choosing play and experiencing joy everyday!

The post A DIR Lens on Sleeping appeared first on Affect Autism: We chose play, joy every day.

Photo credit: Giant Steps Autism Centre

This Week’s Podcast

I’m speaking with Marla Cable, the Assistant Director of the Resource and Training Centre at Giant Steps Interdisciplinary Autism Centre in Montreal, Quebec, which houses the developmental approach, individualized private school in the public interest with both English and French instruction, serving students aged 4 to 21 with an autism diagnosis. We heard about the school just over a year ago, but they have now moved into their new facility and Marla is here to tell us about the new Autism Centre.

by Affect Autism

The New Location

The new Giant Steps Autism Centre opened in August of 2023 after being a project in the making for over 5 years, Marla shares. It’s located in the Angus area of Montreal, which is in the Rosemont neighborhood–a neighborhood that’s very pro-inclusion, so they were really welcomed with open arms, Marla says and they’re no longer just a school. Giant Steps has been around for about over 40 years, but now in the new Centre they also have a Resource and Training Centre, adult education, and a research pillar as well.

I commented how it must be great to finally be in the new location. Marla says that just having air conditioning has been wonderful. Giant Steps is a private school, but they’re publicly funded by the Minister of Education in Quebec, so there is no tuition fee for parents to send their children to their school, Marla says. If you watch the YouTube video of our podcast, above, you will see the photos of the neighbourhood, with a lot of construction, and the incredible backyard with the splash pad. 

Marla says that the difference they see here in the new large outdoor space where students can run around and play is that the kids are occupied. They’re busy doing things now, whereas, in the old building there was a little bit more pacing and just being off in a corner. Now, Marla continues, there’s so much more for them to do and explore, so it’s really lovely to see them outside in the playground. 

There’s a garden and different music instruments, including a xylophone, chimes, drums, and all sorts of things they can play with. There’s stairs that lead up to a slide and various climbing structures, swings, and areas where they can go. Marla says that the photos don’t show it, but on the back fence there are sensory walls all along there and a communication board. In addition there’s an outdoor classroom area with a blackboard and logs to sit on. 

A Tour of the Centre

Next, Marla showed us one of the 15 classrooms, of which 11 are open right now. They’re opening the 12th next year. The other 3 classrooms are currently used for overflow. There’s a nice reading nook that’s in the wall in the very back, and large windows that bring in natural lighting. The building doesn’t have any fluorescent lighting because it can be often challenging for autistic individuals. All the cabinetry is built-in, so they can reduce a lot of visual stimuli, as well, Marla says.

Next, Marla showed us another example of a classroom from a different angle. Each classroom has a communication device, kind of like a newer version of a PA system, so they can communicate with departments, or floors, or specific people, and each department also has a smart board. Next we saw the art classroom that all the students in the art pillar attend. Then Marla shared the incredible sensory gym, which is the large occupational therapy room, or the gross motor room. They have another room that’s somewhat similar to this, but on a much smaller scale for kids who may get a little bit overwhelmed by the size of the gross motor room. 

The school has in-house occupational therapy and speech-language therapy. Marla says that they really want to recognize the whole student, not just academics. They have a computer class, a social skills class, art class, and a gym class. They’re really looking at the whole person and making sure that they’re supporting the individual so that they’re ready to go once they move into adulthood. 

Next, we saw a picture of music therapy which is about your relationship to music as there’s a lot of sequencing and patterning in music which leads to the basis of math skills. Music therapy also touches on our emotions and emotional regulation, Marla explains.

Next, Marla shows us the computer lab, not only learning how to use a computer but also about their relationship to technology, including teaching them how to navigate the internet and keep themselves safe. They’re also looking at finding different programming to support students in their IEP goals. They have academic  objectives, but they’re also looking at what they’re interested in and how they can explore that through technology to help them blossom in their interest, Marla explains.

Next, on the main floor they have a kitchen that the school uses to learn cooking skills, which helps with learning math skills right with all the fractions and measuring everything, language arts by reading a recipe, and life skills activities as well. The photo Marla shared is of their industrial kitchen, used in the adult pillar for adults over 21 and replicates a kitchen you would see in a restaurant. 

The Centre has several partnerships with different restaurants and their hope is that their adults will learn the skill sets and then hopefully go off and do internships, then get jobs in different kitchens, based on the skills that they’ve managed to learn at Giant Steps.

For instance, they have a partnership with the chicken restaurant chain St-Hubert. In the beginning, Marla explains, it was more about the client experience in the restaurant, so through the Resource and Training Centre, they were really helping and supporting them, making sure that the restaurants are welcoming and are inclusive to all individuals, so that they can go to a restaurant. They went through and did an audit of the restaurants and suggested perhaps the music needs to be a little bit lower. Maybe the lighting needs to be a little bit stronger or softer here and have more natural lighting there, etc. 

Marla’s team helped them support customers with sensory bags and communication boards so the restaurant can lend them out to people coming to the restaurant. St-Hubert also had sensory-friendly periods on Sundays. They also provided training for the management staff and created online videos they can use for their personnel to learn a little bit more about autism and how they can support autistic individuals in the restaurant. Now they’re working with St-Hubert on hiring autistic individuals. Marla says they have been really on board with all of the steps.

Giant Steps also has a grocery store in the school. Giant Steps did work with the city of Laval who had named themselves the first city in Canada to be inclusive and they’ve been doing a lot of work with the city of Montreal. Giant Steps is very open to working with anyone who wants to become more inclusive. Marla says that in the beginning of her career in the resource centre, it was more about just sensitizing people to autism, but now it’s much more than that; it’s making sure that they are fully inclusive and a lot of organizations are coming forward with this.

Marla shared the photo of the Center’s mini Maxi which would be known in other provinces as Loblaws. Giant Steps has been working with them for a very long time helping autistic adults learn the skill sets to work at the grocery store, whether it’s managing the stocking of the items or working in the back warehouse. Giant Steps actually has a functioning cash register so they can learn how to do the whole cash process right at the Centre. 

Across Canada, Loblaws has hired just over 200 autistic individuals, so that’s a huge success. And that’s with regular pay and regular benefits, which is what they’re really pushing organizations to do, because they’re able to do the work. 

I commented that I hear Marla saying that she’s noticed this trend from having to really educate people on how to make sure that they’re accepting of autistic people to really embracing inclusion. Marla says that yes, it’s what’s happened.

Next, we see a picture of the new gym facility which is also an event room. In 40 years, Giant Steps has never had a gym, so Marla says that they’re very excited about the gym and that it was kind of the big reason for building the new Centre, and so they can use the gym for events as well. It has all the facilities so that they can hold banquets. They have tables and chairs and there’s a kitchen nearby, so if someone wanted to cater an event, they could do that as well, Marla says.

At the beginning, there were a lot of inaugural events and the premier of Quebec came to do a big celebration of the new Centre. They also had a couple of conferences and some people from the outside have rented out the room for parties and events as well, Marla shares. For the students, they have a gym teacher who is actually able to help and support them in their physical education.

Next, we see the Resource and Training Centre, which we talked about in the first podcast, Marla’s mandate is to help and support organizations, and individual businesses on the outside of Giant Steps. They have a lending library with lots of different books and teaching materials, so anyone from a school to a parent can come and borrow any items or they can come just to search for ideas if they need help and support creating visuals or social stories or anything like that, Marla explains.

The Resource and Training Centre

The Resource and Training Centre also offers workshops, conferences, and trainings and invites the public to attend, or a group can contact Marla directly and ask for a training for their group. They also offer consultations so that if a school that has tried to help support a child and they just need a little bit more help, Marla will go in and observe and help their team find strategies to better help support that child in that environment.

They can do this consultation outside of Quebec as well as they want to spread their knowledge and help in any way they can. The other big part of the Resource and Training Centre is to help different organizations. They have a partnership with the Montreal Canadians NHL (National Hockey League) team in the Bell Centre in Montreal exploring ways in which they can become more inclusive. Marla’s team has helped them create communication boards and sensory bags that they can loan out during games.

They’ve trained all of the heads of the department so they can help their workers understand autism and how they can support autistic individuals who come to the game. As an exchange, the Canadiens hockey team has given them tickets for some of their families to go and watch a game on International Autism Day this year, and they actually provided a skate day where students could go and skate on on the ice with the mascot, Youppi!, so that was fun.

They do a project with the Pierre Elliott Trudeau airport where families go through the whole process of flying to learn about what areas their child or the autistic individual may have a harder time dealing with, so they can be better prepared for the actual travel date. Another great project that they are really proud of is working with the police force and the new police chief for Montreal that is a 5-week immersion program where he requires all of his new recruits to do this program before they actually start working on the streets. 

The police recruits go into a whole bunch of different organizations to learn about all sorts of differences about vulnerable people so they can be better skilled and knowledgeable about how to support all sorts of differences in the community. Most of their recruits come and spend a day at Giant Steps to learn about autism. Marla has heard nothing but great things from their recruits. They say they’re really well empowered that they had these tools and strategies that they could use to help and support the person. 

Reception to the New Centre

I asked Marla how the reception has been since they opened. It’s a process, Marla says. They have had a lot of media so that many people have learned about who they are, so it’s been very busy. Of course, they have a ways to go and they still need to educate people and they still need to get out there and help with support, Marla says.

Adult Education Pillar

In terms of the adult pillar, Marla says they did have classrooms for the past few years at another center and now they’re at Giant Steps, which is a department that’s growing, so they’re still figuring that out. The adult pillar is through a partnership with the English School Board in Montreal, and it’s really education-based. They teach work skills, but it really is an adult education department and is offered in both French and English, and in Quebec, when you’re an adult, you don’t have to belong to a certain school board to go to the Centre.

The Research Centre

The Research Centre is focused on how to do research that will improve the quality of education and life for the students and is mainly through McGill, called TACC (Transforming Autism Care Consortium) that has many different researchers so they can apply if they are interested in doing research with Giant Steps, and then there’s a team that will read their file and decide if it’s accepted or not. Marla said that they do accept researchers from all the major universities within Montreal so if they want to do research that will help their staff in their ability to help and support the students, they can apply.

Adjustment of the Students

I asked what it was like for the students moving from their old school to the new Centre? Marla said there were lots of social stories, lots of calendars to count down, and their neighbour next door allowed them to put a live camera on their balcony, so they had live feeds where they could actually watch the building as it was being built. Then, in the summertime they had several days where the building was open, so families could actually come and visit with their child just to get a feel for it. 

Marla said they also always recommended to the families to drive by, go for a walk in the neighborhood to show the kids that this was going to be their new school. The students really didn’t have any difficulty making the switch over to this new building, Marla said, and after all, it’s tailored for them.

Input from Autistic Self-Advocates

Giant Steps also had input from autistic self-advocates as much as possible to always include the autistic voice in anything they do, including any training, any workshop, or project. Marla has given several tours of the new Centre and several with autistic individuals and they all love it.

Floortime at Giant Steps

Giant Steps school uses a developmental approach, taking input from different approaches, and one of those approaches is DIRFloortime. We were fortunate to have Richard Pare, an educator at the school who has training in Floortime and he shared how Floortime is incorporated at Giant Steps.

Richard is doing a pilot project with one class, picking 5 students and seeing how they can implement Floortime into the school environment. He does one-on-one sessions for 45-minute periods once each week with each student, working with the behaviour success team. It’s part of the prevention approach. They figure out what’s going on, taking the DIR philosophy to try to figure out what the student is experiencing and if there is some sort of difficulty.

They contact the parents and have a specific protocol on how to assess where they’re at, asking about what’s going on at home and if there’s certain things that can be causing them to be having a hard time at school. Richard develops a relationship, sharing and communicating everything that he’s learned with the team.

Richard aims to bring the Floortime perspective by using the children’s interests in the classroom and in his sessions. Beginning with the team and with the families, he wants to meet them where they are at, developmentally, and get on the floor with them to play, developing that relationship, and scaffolding from there.

Richard has learned the value of reflective practice and videotaping sessions, so he tries to do that as much as possible because they’re lucky enough to get the permission from families to share it with the school and their classroom team, as well as with all the staff members of Giant Steps for professional development so he can do workshops on Floortime, talking about what he’s doing, why he’s doing it, and why they should be doing it in the classroom.

Floortime Sessions

Richard says that the students love the area near the window, so he has a big mat to play on. He has toys and items to make an obstacle course to give the kids movement, taking into account their individual differences and what they might be needing in that moment from a sensory perspective. They also play in the hallway because there’s a couple of things students love to do in the hallway where they have seats and areas for the students to relax.

With one student, Richard continues, he had that gleam in his eye as they began to play. Richard went on the floor with him and imitated him and the child seemed to feel that Richard understood him. He was running and jumping then sliding on his knees to get that proprioceptive feedback. He would look back at Richard and Richard started getting that back-and-forth as the student was looking at him and laughing. He took Richard’s hand and brought him to do the same, which was just incredible to have that moment with him, Richard shared.

I told Richard that he made the student feel comfortable enough where he was comfortable initiating, which is what we see once the circles of communication get flowing. They start their initiation, and then you can start to work into the fourth Functional Emotional Developmental Capacity.

Richard continues that they go in the hallways, in the schoolyard, and in different environments that really set the children up for success. He shows us the sensory bin with fun toys and talks about how he will get lots of fun back-and-forth around these toys, such as when they fall, which creates a problem. They’ll look and sometimes it falls underneath the tables and then they have to wonder where they went. 

Richard says that they will have fun closing the blinds to make the room darker with the light-up today and he’ll put in a little bit of a playful obstruction by taking out the batteries and wonder what they’re going to do together. And of course, he says, that they have sensory play, including balloons. Different children will communicate in different ways wanting him to blow up the balloons for them. Some will bring it to him, and another signs to him. 

Implementing Floortime

Richard also tries to implement AAC as much as possible. One student has an iPad. At Giant Steps they use TD Snap and have been able to get donations and grants to give iPads to students and teach how to use it in the classrooms. They’ve seen really great outcomes from this, as it’s so important to be able to communicate, Richard says. And for the younger children, they’re not teaching or expecting them to use the AAC yet, but they are just modeling it to have them get used to it.

Looking and reflecting, as well as communicating and sharing with the school, Richard’s been figuring out the best way to implement Floortime in the school environment as working one-on-one is tricky. They’re trying to think outside the box to have it in the school system, such as thinking about how they’re interacting and setting up the environment, and how to include families.

Richard says that a big learning experience for him is really thinking about what we’re saying that we’re doing, including how to present ourselves. The self-reflection helps him think about how he’s feeling and if he’s able to attune to the students rather than thinking about all of the responsibilities and everything else he forgot to do. If you’re in your head, Richard says, you’re not in the moment with the students.

Richard is really enjoying the constant progression and the new centre which is meeting a lot of the students’ needs. It’s a lot more spacious. The gymnasium is incredible so when it’s very cold in Montreal, it doesn’t mean just staying in the classroom anymore. They can have fun and run around in the gym to get that energy our. Then, the students are more prepared to learn in the classroom afterwards.

Thank you to Marla and Richard for sharing the story of this incredible new centre and how they do Floortime with us. We hope you found it interesting and will consider sharing this post on social media.

Until next time, here’s to choosing play and experiencing joy everyday!

The post Giant Steps Interdisciplinary Autism Centre appeared first on Affect Autism: We chose play, joy every day.

Photo by Christina Morillo

This Week’s Podcast

Andrew Klein is a DIR Expert and Training Leader and a pediatric Occupational Therapist at Emerge Pediatric Therapy in Durham, North Carolina where he has a specialized role in facilitating reflective supervision with his colleagues. He is also a certified trauma professional through PESI. He started his career at the Rebecca School in Manhattan where his Floortime journey began and he is the father or two active young girls. The topic for today is Reflective Practice in DIR.

I’ll refer listeners to the podcast I did with Dr. Gerry Costa on Formation and training practitioners in this field, which included a discussion around reflective practice.