When a child receives a diagnosis of autism spectrum disorder (ASD), a number of services may be recommended, including speech therapy, occupational therapy, a social skills group, or play therapy. Among the various approaches to play therapy, DIR/Floortime stands out as a developmentally grounded, relationship-based model designed to support children’s emotional, social, and cognitive growth. This approach emphasizes engaging children through play while addressing their unique developmental and sensory needs.
Research indicates that DIR/Floortime has been associated with improvements in social-emotional functioning and communication skills in children with ASD. For example, a controlled study¹ found significant gains in social interaction and emotional regulation in children participating in DIR/Floortime interventions. Another study² reported that DIR/Floortime therapy led to improvements in adaptive behavior and parent-child interaction quality, further supporting its effectiveness.
What Is DIR/Floortime?
DIR/Floortime is an acronym for Developmental, Individual-differences, Relationship-based therapy. It consists of the following core components:
Developmental: Recognizing the natural stages of development and tailoring interventions to where the child is developmentally.
Individual Differences: Respecting each child’s unique profile, including sensory preferences, strengths, and challenges, to create personalized strategies.
Relationship-Based: Building strong, emotionally meaningful connections between the child and caregivers or therapists to foster trust and growth.
The “Floortime” aspect encourages adults to meet children on their level, literally and figuratively, by engaging the child through activities that captivate their interest. For instance, an adult may get down on the floor to play next to the child and begin to engage in the child’s preferred activities.
Therapists and caregivers implementing DIR/Floortime focus on several key practices:
Following the Child’s Interest: Joining the child in an activity that they are interested in or are already engaged in to create a positive interaction.
Scaffolding Learning: Providing the right level of support to help children succeed in tasks just beyond their current abilities.
Fostering Emotional Connections: Building trust through consistent and predictable interactions.
Expanding Symbolic Thinking: Encouraging play that promotes imagination and abstract reasoning.
Why Use DIR/Floortime with Children with ASD?
Children with ASD often need support in areas such as communication, social interaction, sensory processing, and emotion regulation. DIR/Floortime has been shown to help by:
Enhancing Social Skills: Supporting children as they navigate social interactions and participate in cooperative activities. For instance, the adult might guide the child to share their toy’s meal with another toy who has shown up at the table.
Encouraging Communication: Expanding “circles of communication” by encouraging gestures, words, and other means of expression. For example, a therapist may place a roadblock in front of the child’s car prompting the child to utilize their words or gestures to ask for the roadblock to be removed.
Improving Emotional Regulation: Helping children manage intense emotions and build resilience through structured yet flexible interventions. For example, if a child is upset by a noise the therapist is using during play, the therapist might acknowledge their feelings by saying, “It’s a little annoying to you when I make that noise. Would you like to ask me to stop?” This validates the child’s emotions while encouraging self-advocacy and emotional regulation.
Developing Symbolic Thinking: Nurturing creativity and imagination, which are critical for abstract thinking and problem-solving. For example, when a child is playing with blocks, the adult may take a block and use it as a pretend telephone to call the child.
Practical Applications
DIR/Floortime is versatile and can be incorporated into therapy sessions by a range of professionals, including psychologists, speech therapists, and occupational therapists. Parents can also use its principles at home. The effectiveness of DIR/Floortime can be maximized when it is used consistently across settings by both professionals and caregivers.
Conclusion
DIR/Floortime is a developmentally grounded play therapy technique where an adult gets down on the child’s level, joins them in their play and encourages the child to expand their play, communication and imagination through interactions and modeling. Research has shown that DIR/Floortime can lead to measurable improvements in social-emotional development, communication, and adaptive functioning in children with ASD. This technique is versatile and can be utilized in professional settings as well as at home by parents and caregivers. If you would like to learn more about DIR/Floortime you can visit the home of DIR/Floortime at https://www.icdl.com/home.
References
² Casenhiser, D. M., Shanker, S. G., & Stieben, J. (2013). Learning through interaction in children with autism: Preliminary data from a social-communication-based intervention. Autism, 17(2), 220-241. https://doi.org/10.1177/1362361311422052
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Elbeltagi, R., Al-Beltagi, M., Saeed, N. K., & Alhawamdeh, R. (2023). Play therapy in children with autism: Its role, implications, and limitations. World Journal of Clinical Pediatrics, 12(1), 1–22. https://doi.org/10.5409/wjcp.v12.i1.1
Effectiveness of DIR/Floortime play therapy in social skills and emotion regulation of children with autism spectrum disorder. (2024). Middle East Journal of Rehabilitation and Health Studies. https://doi.org/10.5812/mejrh-138491
Home of dirfloortime® (Floortime). Home of DIRFloortime® (Floortime). (n.d.). https://www.icdl.com/home
Johnson, A. G. (2018). The role of play in the treatment of autism spectrum disorders, and the experiences of practitioners using DIR/Floortime (Publication No. 10750811) [Doctoral dissertation, ProQuest Dissertations & Theses].
¹ Lal, R., & Chhabria, R. (2013). “DIR/Floortime”™ intervention model for children with autism spectrum disorders: Developmental individual-difference relationship-based model. Open Journal of Psychiatry, 3(3), 344-348. https://doi.org/10.4236/ojpsych.2013.33034
Pajareya, K., & Nopmaneejumruslers, K. (2011). A pilot randomized controlled trial of DIR/Floortime™ parent training intervention for preschool children with autistic spectrum disorders. Autism: The International Journal of Research and Practice, 15(5), 563-577. https://doi.org/10.1177/1362361310386502
Solomon, R., Van Egeren, L. A., Mahoney, G., Huber, M. S. Q., & Zimmerman, P. (2014). PLAY Project Home Consultation intervention program for young children with autism spectrum disorders: A randomized controlled trial. Journal of Developmental & Behavioral Pediatrics, 35(8), 475-485. https://doi.org/10.1097/DBP.0000000000000096
TherapyWorks. (2024, January 9). What is DIR/Floortime? https://therapyworks.com/blog/autism/dir-floortime/
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Acknowledgements
This blog post was prepared with the help of Rachel Beck, a second year graduate student at Tufts University’s Eliot-Pearson Department of Child Study and Human Development. Rachel is passionate about child development and supporting children and their families. This has manifested itself in all of her professional work, including her experiences in Early Intervention and Healthy Families Massachusetts.