Developmental interventions are based on research into typical child development and focus on the child’s ability to form positive, meaningful relationships with other people.
The Developmental, Individual Difference, Relationship-Based Model (DIR) is commonly referred to as the ‘Floortime’ approach.
Floortime does not target speech, motor or cognitive skills in isolation, but addresses these through its focus on emotional development.
The program aims to help children reach six developmental milestones crucial for emotional and intellectual growth:
- Self-regulation and interest in the world
- Intimacy, or engagement in human relations
- Two-way communication
- Complex communication
- Emotional ideas
- Emotional thinking
Each child is first assessed and provided with a program tailored to their skills, challenges and interests. Around 2-5 hours a day are then spent in child-directed play sessions. These sessions are referred to as ‘Floortime’ as the adult and child often play together on the floor. According to the theories underpinning the DIR method, interactive play, in which the adult follows the child’s lead, will encourage the child to ‘want’ to relate to the outside world.
The DIR Method is usually delivered by parents and facilitated by a consultant, who develops and oversees the child’s individualised program. The home-program is therefore often combined with occupational therapy, physiotherapy and/or speech therapy sessions as required.
The DIR/Floortime method is supported by some research, although experts believe more is needed to confirm its effectiveness.
Relationship Development Intervention (RDI)
RDI was developed by psychologist Dr Steven Gutstein as a parent-based treatment aimed at developing ‘dynamic intelligence’. The goal of RDI is to improve the individual’s long-term quality of life by helping them improve their social skills, adaptability and self-awareness. The six objectives of RDI are:
- Emotional referencing: The ability to ‘read’ emotions to learn from subjective experiences of others.
- Social coordination: The ability to observe and regulate behaviour to successfully participate in social situations.
- Declarative language: Using language and non-verbal communication to express curiosity, invite others to interact, share perceptions and feelings and coordinate your actions with others.
- Flexible thinking: The ability to rapidly adapt, change strategies and alter plans based upon changing circumstances.
- Relational information processing: The ability to see the ‘big picture’ and solve problems that have no clear right or wrong solutions.
- Foresight and hindsight: The ability to anticipate future possibilities based on past experiences.
The program involves a systematic approach to working on building motivation and teaching skills, focusing on the child’s current level of functioning. Children begin work in a one-on-one setting with a parent. After an initial assessment, a consultant develops an individualised program for the child and trains parents to implement it. Progress is assessed through videotape review and meetings with consultants.
While RDI is based on sound theory and research, like with DIR/Floortime, more research is needed to confirm its effectiveness as an autism intervention.