Floor Time is a therapeutic treatment methodology and philosophy developed by child psychiatrist Stanley Greenspan, M.D. for interacting with children with autism. The basic approach or premise of this treatment strategy is to determine the child’s current level of functioning and build a larger circle of interaction by taking that current developmental level, and building on the child’s particular strengths. Maintaining activities at the child’s developmental level, and enticing the child towards the next developmental levels and constantly looking for ways to turn the child’s actions into interactions are specific strategies to effectively use Floor Time principles.

Dr. Greenspan’s methodology suggests that intervention time with the child include three types of experiences in both the home and school settings; 1. Floor Time – follow the child’s natural interests and let the child lead the adult to the activity of choice and then let the activity gradually become interactive. 2. Semi-Structured Play – Interact with the child to create a highly motivating situation in which problem solving engagement occurs as a part of the natural learning situation. 3. Motor, Sensory, Spatial Play – Arrange activities to include numerous physical activities (spinning, running, jumping, etc) that include opportunities for the child to cross the mid-line with motor programming.

In Floor Time, the parent or teacher, through mutually shared engagement in activities the child enjoys, moves the child towards increasingly more complex interactions. Floor Time does not focus on individual skills (speech, motor, or cognitive), but rather addresses these areas through a synthesized emphasis on emotional development.

Reported Strengths/Benefits of Floor Time:

1. Floor time involves meeting the child at his/her current developmental level, and building upon his/her particular set of strengths.
2. Floor time uses the child’s interests and desires as the means for motivation; following the child’s lead, the adult entices him/her to engage in interactions and learn to relate in meaningful ways by tuning in to his/her interests and entering into the child’s world.
3.  Floor time provides a framework that can guide various daily interactions with children such as bath time, meal time, and play time.
4. Floor time’s general philosophy works for any child with developmental deficits. (Down syndrome, mental retardation, and other developmental disorders)
5. Children in the milder end of the autistic spectrum are more likely to respond positively to Floor time methodology.
6. Floor time is good for teaching parents how to actively engage with their children. Parents are responding to their child in a relaxed, natural matter which helps reduce frustration and the feelings of being overwhelmed.
7. Floor time is not based only on membership in a large and varied group, such as autism or PDD. Instead, it is based on an analysis of where in the normal sequence of development the individual child went off the track and on crafting a strategy for getting development back on track based on the child's individual development.
8. This approach is consistent with recent research that shows that when children with autism are compared to children without developmental challenges and matched for IQ scores, what separates them is their ability for abstract, reflective thinking, including making inferences; engaging in reciprocal affect interactions as part of a continuous flow of interactive problem-solving; and evidencing high levels of relatedness and empathy ( Minshew & Goldstein, 2000).

Reported Weaknesses/Concerns of Floor Time:

1. Floor time is an indirect stimulation approach and does not directly address specific skills that may be identified as deficits.
2. Floor time presumes that children are aware of other people attempting to interact with them. Sometimes, children with autism require a more direct, focused intervention approach.
3. The treatment techniques of Floor time still need further research within the autism disorder to establish efficacy.
4. Floor time can be very time intensive for both parents and therapists. For working parents the time requirement may be burdensome.
5. Because the child takes the lead in Floor time, caregivers and therapists may have a difficult time if they are trying to train specific treatment targets.

Cost:

The price of workshops may vary, but overall floor time is a cost-effective treatment approach. Parents can attend a workshop for as low as $135 per couple or $75 per person. Professionals can attend a workshop for as low as $95 per person. Floor time does not require therapists or family members to purchase materials or kits.

References:

Greenspan, S. and Lewis, D. (2002). The affect-based language curriculum (ABLC): an intensive program for families therapists and teachers.
Greenspan, S., DeGangi, G. and Wieder, S. (2001). The functional emotional assessment scalefor infancy and early childhood: clinical and research applications.
Greenspan, S, and Wieder, S. (1997). The child with special needs: encouraging intellectual and emotional growth.
The Floortime Foundation <http://www.floortime.org/>
Stanley Greenspan. <http://www.stanleygreenspan.com>