Importance of Floor Play Strategies – NIEPMD – By Cibi Siddarth

Hi All,

sharing the details of another presentation I have attended recently. Below are the details of the session:

Topic – Importance of Floor Play Strategies
Date – 25th April 2022 3:00 pm to 3:30 pm IST
Mode of Presentation – Online Webinar
Speaker – Cibi Siddarth , Clinical Therapist – NIEPMD

This session was organized by NIEPMD ( National Institute of Empowerment of Persons with Multiple Disabilities)

Below are the points shared in the presentation:

What is Floor Time

Floor Time Play Therapy (FTP) is a type of intervention for autistic kids that addresses specific areas of weakness. However, there are very few studies that look at its effectiveness for these children. Floor time is meant to entice children to interact joyfully. Through structured interaction, they build behavioral, cognitive and social skills. At the time, this approach was philosophically distinct from any other therapeutic methods. For many parents and therapists, it remains extremely appealing.
Contrast to ABA – Rather than teaching children appropriate behaviors and rewarding them to “reinforce” the lesson, Floor time engages with children through emotional connection.

History

Over 40 years ago, child psychiatrist Dr. Stanley Greenspan recognized the importance of meeting children on their level both developmentally and physically – In order to maximize communicating, interacting and learning. This meant getting on the floor to engage the child’s attention. Ultimately, Dr. Greenspan developed The Greenspan Floor time Approach to make his techniques, tips and tools available to parents and those who work with children.

Professionals who can use Floor time

• Child Psychologists
• Special education teachers
• speech therapists
• Occupational therapists
• Parents and caregivers can also learn Floor time techniques through workshops, books and websites.

Goals

Capacity 1 – Self Regulation and Interest in the World
Capacity 2 – Engaging and Relating
Capacity 3 – Purposeful Two Way Communication
Capacity 4 – Complex Communication and Shared Problem Solving
Capacity 5 – Using Symbols and Creating Emotional Ideas
Capacity 6 – Logical Thinking and Building Bridges between Ideas
Capacity 7 – Multiple Perspectives
Capacity 8 – Gray Area Thinking
Capacity 9 – Reflective Thinking and Internal Standard of Self

(There are 16 Capacities in total, but in the presentation only 9 were shared)

Implementation of Floor Time

Its important that the adult engages with the child based on the childs interests and actions, even if those actions have no obvious content or purpose. For many young children with autism (even those who are verbal), the first step is simply to get the Childs attention focused outside themselves and to encourage any type of engagement with another person.

How to get Started with Floor Time

• Video Tape your first session
• Find a space where you and the child can sit comfortably.
• Observe what your child is doing and then join in
• Be Patient
• Set a timer for 20 minutes.

Examples

One example of this is a child who is opening and closing a door with no obvious purpose. Their guardian hides behind the door and when it opens, says “Boo”. The child laughs and does it again to get the same response.
Or a child is lining up trucks on the floor. A Guardian rolls one truck backward and forward, making vrooming noises. The child reaches for the truck, but a guardian playfully hides the truck under one of their hands. The child lifts the guardians hand to get the truck and puts it back in the line.

Benefits

Floortime does not work on speech, motor or cognitive skills in isolation. It addresses these areas through its focus on emotional development.

Behavior – It strengthens processing abilities. Less overwhelmed and more tuned in, a child can improve relationships. It’s easier to be good.
Communication – It draws children into an exciting emotional world. Learning to communicate and interact with purpose, they can have impact on the world.
Thinking – It is build on a renowned model of how we learn to think. It shores up a child’s primary thinking skills. They can learn to think on their own.
Relationships – Its basis is emotions. Emotions create the desire to interact because they create the desire to be close. Children can become related and engaged.

As a therapist what can we do to a parent / caregiver who’s implementing Floor time at home

• Provide help in setting goals for a child
• Help you structure a program that will meet the child’s particular needs
• Review videos or observe you as you interact with the child to provide suggestions or guidance.
• Model techniques that may be helpful
• Suggest ways to help the child move forward
• Help you to troubleshoot if you run into roadblocks or challenges (as you almost certainly will from time to time)

Pros of Floor Time

• Parents can become Floor time therapists with Little Training
• Useful for relationship building
• Its portable – you can do Floor time play almost anywhere
• Helps kids develop meaningful human interaction
• Very Safe activity

Cons of Floor Time

• Not likely to be sufficient without behaviioral therapy for moderate to severe autism
• Few schools are willing to implement floortime
• Rarely paid for by insurance (hiring therapist can be pricey)
• Takes time, patience and energy to implement.

Research and Evidence

In a 2003 study, Dr. Greenspan and Dr. Weider studied joey, a child on the autism spectrum who spent 3 years engaging in floor time with his father. Over that time, Joey enjoyed six daily Floor time sessions. He continuously improved, and the two scientists concluded that Floor time helped Joey Progress.

In 2007, a pilot Study conducted by independent researches likewise showed a Floor time benefit for children with autism

Two other 2011 studies, – one conducted in Thailand and one in Canada – further supported Floor time as significantly improving emotional development and reducing autism’s core symptoms.

Personal Feedback:

This may be a technique or intervention from western side, but from an Indian perspective it is part of our Culture to perform many tasks Sitting down on the Floor. Majority of the children from earlier generation have done reading, writing, eating, watch TV, playing board games etc.. by sitting in Floor only. Furnitures were not affordable ( due to money or space) by everyone at that point of time.
The basic concept is that when you sit down at the Floor and play, all the items that are required for playing is at your reach (one arm reach radius), nothing can fall down, you and the child are looking at each other, you are at the eye level of the child building eye contact, and you as a parent look at the micro expressions of the child, you build sitting tolerance by modelling the behavior yourself, when you lock legs and sit in the floor and blood circulation happens effectively within the upper part of body, your posture gets better, no gravitational insecurity, less fidgeting as legs are locked in sitting posture, and many more ….

Still a decent amount of people still sit in the Floor for eating , writing, etc.. may be not a daily basis. The important aspect of Floor Time which was not mentioned in this session is that it is an DIR model i.e. Developmental, Individual Difference, Relationship-based, which means it is highly effective when done by a Family Member or Care taker.

My opinion is when we are adapting an methodology / Concept / Approach developed Outside India or your respective country, we have to review in detail to find out whether it is applicable to us or the child before proceeding further. It may be something we are already doing, but we did not name it or not aware that there is name available for it. Do not follow just because it is followed by people Outside India.

Also NIEPMD has to do something about the network, we are aware that they are located in Outskirts of the city so they do not get Signal most of the time. Streaming an audio itself is not great with the bandwidth they have, so video calls with slide shares is pushing the limits. The flow of session is interrupted a lot, the enthusiasm is lost. The basic pre-requisite for an online webinar is to have an decent Internet connection. (We were told that this time the interruption was due to a Cell Phone Signal Jammer installed as there were examinations are being conducted nearby). I hope the future sessions happen smoothly.

Regards,

Saranya and karthik

Karthiksaranyaparents@gmail.com