DIR/Floortime, ABA......How Best to Teach?

There's a number of methodologies out there for teaching students on the autism spectrum. One that Jim and I have thought less appropriate for Charlie is DIR/Floortime. "DIR" stands for "Developmental, Individual Difference, Relationship-based" and is based on the work of Dr. Stanley Greenspan, Clinical Professor Psychiatry and Behavioral Sciences and Pediatrics at George Washington University Medical School.

DIR is said to start with "child’s natural emotions and interests" and then "follow the child’s natural emotional interests (lead) and at the same time challenge the child towards greater and greater mastery of the social, emotional and intellectual capacities." Having read a couple of Dr. Greenspan's books, Jim and I felt that, while there is plenty to be said about following one's child's "lead," the techniques discussed in the books did not address Charlie's learning needs and challenges.

So I was interested to read about the Oconomowoc Developmental Training Center in Wisconsin, in the February 21st Journal-Sentinel. The center's Innovative Care for Autism and Related Disorders (ICARE) is described as for "kids with behavioral problems and mental disabilities that schools and families were no longer equipped to serve"; the article describes it as a "program of last resort." The center uses DIR/Floortime:

Kara Stevenson, the director of residential services at ICARE, said they see their goal as helping autistic kids gain as many developmental skills as possible.

While some methods suggest that kids with severe autism need to be given specific skills to do over and over until they master each one, Stevenson disagrees. Instead, her staff has adopted the philosophy of clinical psychiatrist Stanley Greenspan, who advocates treating autistic kids through individualized, developmental and relationship-based therapy.

"As common sense as (building relationships with kids) sounds, it's actually fairly innovative when it comes to autism," Stevenson said.

12-year-old Hannah Rose started at the program having 900 tantrums a month, it's noted, and now has some 500. Also, she is able to "interact with an adult for short periods of time, and she's made more gains since her learning environment allows her to get up and walk, run around or play on the swings when she's feeling caged in and stressed." (Though, as she is non-verbal, it's not specified how it's known that Hannah feels "caged in and stressed"---perhaps these are what are intuited by teachers and staff.)

My own son has benefited primarily from teaching based on Applied Behavior Analysis (ABA). While there's a tendency to see this kind of teaching, based as it in behavioral science, to be somewhat clinical, ABA has been most successful with my son precisely when he's developed, even as a sort of side-product, real relationships with his teachers; when his teachers have not seen him simply as a child with "problems" and "tantrums" and "behaviors," but as the affectionate, well-meaning, student he is. There is an emphasis on keeping data and looking at "behaviors" in an ABA program; as a parent, I've found these helpful as looking at these help me to see what Charlie is doing and learning, without things getting so muddied by my emotions.

At the end of the day, it's not the methodology or teaching philosophy that matters, but the efforts and attitudes of the people doing the teaching, and the satisfaction in my son.

Photo from Help Your Autistic Child Blog.