Floortime/DIR - 2012-05-29
The Floortime/DIR (Developmental, Individual Differences based, Relationship based ) approach is a developmental intervention to autism developed by Stanley Greenspan and Serena Weider. Its core precept is to understand the child's sensory differences, follow the child's lead and use these to encourage children with ASD to climb up the developmental ladder. This approach is based on the idea that the core deficits in autism are individual differences in the sensory system, motor planning problems, the inability to relate and the inability to connect ones desire to intentional action and communication. When addressed through a combination of sensory support and DIR/Floortime techniques, the facilitator is playfully obstructive to redirect the child to play and relate to their therapist. As a result, children can become more social, less repetitive and also develop symbolic abilities.[unreliable medical source?][60]
The DIR model is based on the idea that due to individual processing differences children with ASD do not master the early developmental milestones that are the foundations of learning. DIR outlines six core developmental stages that children with ASD have often missed or not mastered:
 Stage One: Regulation and Interest in the World: Being calm and feeling well enough to attend to a caregiver and surroundings. Have shared attention.
 Stage Two: Engagement and Relating: Interest in another person and in the world, developing a special bond with preferred caregivers. Distinguishing inanimate objects from people.
 Stage Three: Two way intentional communication: Simple back and forth interactions between child and caregiver. Smiles, tickles, anticipatory play.
 Stage Four: Social Problem solving: Using gestures, interaction, babble to indicate needs, wants, pleasure, upset. Get a caregiver to help with a problem. Using pre-language skills to show intention.
 Stage Five: Symbolic Play: Using words, pictures, symbols to communicate an intention, idea. Communicate ideas and thoughts, not just wants and needs.
 Stage Six: Bridging Ideas: This stage is the foundation of logic, reasoning, emotional thinking and a sense of reality.
Most typically developing children have mastered these stages by age 5 years. However, children with ASD struggle with or have missed some of these vital developmental stages. When these foundational abilities are strengthened through the child's lead and through meaningful play with a caregiver, children begin to climb up the developmental ladder. An introduction to DIR/Floortime can be found in the book - Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate, and Think, by Stanley Greenspan, M.D. and Serena Wieder, PhD.