Parents and caregivers of a child with autism spectrum disorder or other developmental delay seek effective ways to connect and better understand their child’s needs and motivations. Through a developmental therapy method called DIR Floortime (DIR), therapists at Easterseals DuPage & Fox Valley work with families to build healthy social, emotional and intellectual interactions between a caregiver and their child. But what is DIR, exactly?
At Easterseals, DIR — also called DIRFloortime — can be included when children take part in occupational therapy, speech language or social work services as part of the Autism Collective at Easterseals. The services are tailored to best reach a child’s needs and their family’s goals to improve relationships and abilities at home, at school and in their community. With 1,000 children receiving services each week, Easterseals therapists best understand how to empower each caregiver to help their child thrive today and in the future.
“As an occupational therapist, the first thing I will look at is where a child is developmentally,” says Maureen Karwowski, OTR/L, Vice President of Clinical Services at Easterseals. To do that, she observes the child’s self-regulation, their gesturing and how engaged they are with their caregiver. “All are social-emotional markers specific to that child.”
An important component to DIR is parent involvement. Rather than simply drop their child off, parents or caregivers are an active part of the therapy session.
“We work through the most primary relationships in a child’s life, which is a parent, grandparent or caregiver,” she says. “And, because DIR is about relationships, we build a triad of therapist, child and caregiver working together.” Strong relationships help the child and caregiver reach a better outcome through DIR — and, during therapy, parents learn how best to connect with their child and meet their needs.
What DIR can look like, and what it can achieve
When a child with autism recently arrived for DIR therapy with his mom, Karwowski immediately recognized the child was on high alert. Through the principles of DIR, Karwowski offered some sensory activities to help him feel more comfortable. “At the end of the session, the child readily climbed the ladder, waited for his mother to count to three, then slid down the slide on his stomach, into his mom’s arms for a hug,” Karwowski explains.
By using DIR and occupational therapy principles to assess the child’s developmental stage, his need to engage in sensory activities and his mother’s connection, the triad determined what steps were needed at the onset of the session to help the child feel calm, and work toward a play-based experience that the mom and child both enjoyed.
“What we often find is that the most calming thing for a child is a connection with a parent, so we work to make the connection robust and frequent,” Karwowski says, adding that a strong bond is helpful to the parent — especially when it is tricky to figure out their child’s needs.
“One mom said to me so authentically that her child was a puzzle to her. That can make parents feel incompetent and cause a lack of confidence, so we want everyone to be supported,” she says. “As parents, we need to understand our children in order to have a relationship with them and it’s part of my job to help parents learn how to understand their child’s behavior and connect with them. Sometimes our clients’ cues are limited and hard to read and a family may not recognize those cues.”
As children grow along the social-emotional developmental ladder, they build skills to help maintain a sense of calm, build warm and trusting attachments, initiate communication and eventually learn problem-solving skills.
“As your child moves up this scale, your work changes as they develop, and with DIR, the parent is always an integral part of that,” Karwowski says.
Play based and relationship focused
DIR honors a child’s own intentions, and to the casual observer, DIR looks a lot like play. “Oftentimes, parents will have in mind that therapy happens seated at a table with flashcards, but for all children, not just those with developmental challenges, play is the avenue for learning and it’s how they learn small concepts and huge concepts,” says Karwowski, adding that because play is fun for a child, they’re more likely to engage with and enjoy play-based therapy.
Families can learn more about DIR through a couple of nonprofit organizations recommended by Karwowski: Profectum Foundation and the Interdisciplinary Council on Development and Learning (ICDL).
Parents who are interested in an evaluation for their child can contact Easterseals DuPage & Fox Valley and talk with an intake supervisor to learn more about services through tele-therapy, or at their centers in Naperville, Elgin or Villa Park.
Discover the many supportive services of Easterseals DuPage & Fox Valley at eastersealsdfvr.org.
