Jan 13, 2014  2 Comments

Climbing the symbolic ladder in the DIR model through floor time/interactive play

S E R E NA W I E D E R Interdisciplinary Council on Developmental and

Learning Disorders, Bethesda, USA

S TA N L E Y I . G R E E N S PAN George Washington

University Medical School,Washington, USA


A B S T R AC T The developmental, individual-difference, relationshipbased

model (DIR), a theoretical and applied framework for comprehensive

intervention, examines the functional developmental capacities

of children in the context of their unique biologically based processing

profile and their family relationships and interactive patterns. As a

functional approach, it uses the complex interactions between biology

and experience to understand behavior and articulates the developmental

capacities that provide the foundation for higher order symbolic

thinking and relating. During spontaneous ‘floor time’ play sessions,

adults follow the child’s lead utilizing affectively toned interactions

through gestures and words to move the child up the symbolic ladder

by first establishing a foundation of shared attention, engagement,

simple and complex gestures, and problem solving to usher the child

into the world of ideas and abstract thinking. This process is illustrated

by a case example of a young boy on the autism spectrum interacting

with his father during ‘floor time’ over a 3 year period.


Play is the most important enterprise of childhood. It ushers the child into

the world of symbolic thinking where symbols and images can represent

reality. We have constructed a model of symbolic elaboration (the functional

emotional developmental model) based on an integration of affect

and cognitive theory (Greenspan, 1979; 1989; Greenspan and Shanker,

2003). By elevating feelings and impulses to the level of ideas expressed

through gestures and words, ideas and feelings can be shared and expanded

through symbolic play and conversation. The gestures encompass the affect

cues that give meaning to the words, actions, use of figures and toys (i.e.

the tone of voice, facial expression or type of movement). These affect cues

convey what is coming, what is safe, and what things mean, providing the

support necessary for regulation and taking the risk to broaden feelings and

ideas to climb the symbolic ladder. Because symbolic play provides the

distance and safety from real life and the immediacy of needs, it offers

practice to differentiate one’s own and others’ experience and feelings as

well as to differentiate from the environment in order to prepare for abstract


Play is also the most important enterprise for children with special

needs where uneven development related to sensory processing and regulatory

challenges need not limit the potential and propensity to develop the

capacities for a symbolic life. In children with autistic spectrum disorders,

interactive play uniquely addresses the core deficits of relating and communicating

as no other approach can. Interaction is the key to facilitating

development, where long sequences of back and forth co-regulated affect

cues help the child focus, initiate and elaborate ideas. As early as 18 months

the absence of symbolic play has been identified as a critical indicator of

high risk for autism (Baron-Cohen et al., 1992). Yet, while various intervention

models include some form of play, symbolic processes are not given

the centrality necessary to reach abstract levels even though no other

activity encompasses the complexity and opportunity interactive play


Symbolic process is central to the developmental, individual-difference,

relationship-based model (DIR: Greenspan, 1992; Greenspan and Wieder,

1998; ICDL, 2000;Wieder and Greenspan, 2001). This is a theoretical and

applied framework for intervention which articulates the developmental

capacities that provide the foundation for higher order thinking and


The DIR model examines the functional developmental capacities of

children in the context of their unique biologically based processing profile

and their family relationships and interactive patterns. Three components

must be considered simultaneously in the DIR model. The ‘D’ represents

the developmental capacities (i.e. functional milestones) that emerge

during the child’s early years including: shared attention and engagement,

back and forth interactions, problem solving, creating play ideas and

abstract thinking. Through interactions during play and conversations

children expand and elaborate upon their ideas, thoughts and feelings as

well as learn to empathize with others as they put themselves in someone

else’s shoes. The ‘I’ represents individual differences in sensory motor processing

and regulation which need to be taken into account and treated to

support development (e.g. auditory or visual spatial processing deficits).

The ‘R’ represents the relationships and environment necessary to provide

the interactions through which the development of emotional, social and

cognitive capacities are nurtured, practiced and enhanced.

In the DIR model affectively toned interactions between child and

parent, teachers or peers, be they gestural or verbal, move the child up the

symbolic ladder. A case example of one child on the autistic spectrum

moving through the first six developmental stages within the ‘D’ component

of the model will illustrate the range this concept embraces. This

example will not describe the full range of comprehensive services the

child received but focuses on ‘floor time’, the component that is spontaneous

and led by the child, where the caregiver follows the child’s lead

and promotes the continuous flow of interactions utilizing affect cues that

entice, challenge, soothe and encourage the child further. Floor time does

not mean just following the child and commenting on what he or she is

doing, but is the active process of interacting in a continuous and rapid

back and forth manner at all the levels the child is capable of, from sensorymotor

pre-verbal interactions, to problem solving, to symbolic play and

abstract conversations. The purpose is to strengthen each of those functional

developmental capacities which together form the foundation for

higher order abilities. It is important to note that some children have

language and some limited interests, but lack the interactive capacities for

mutual attention, relationships, and the back and forth affect gesturing

necessary to expand feelings and themes. These gaps derail development of

symbolic and emotional abilities.

Key elements of ‘floor time’

The key elements of ‘floor time’ are described at each developmental stage.

Stage 1: self-regulation and shared attention (interest in the world)

This initial stage focuses on harnessing all senses and motor capacities, to

help the child stay calm and regulated in order to draw him or her into

shared attention. The adult involves the child in enjoyable interactions that

include looking (look at and examine faces), hearing (focus on voices),

touching (pleasurable tickles, stroking or sharing an object or a toy) and

movement. Constructive and playfully obstructive strategies are used with

affect cues to stretch the child’s capacity.

Stage 2: engagement and relating This stage involves encouraging the

child to engage with pleasure as seen when the child brightens, smiles,

references (looks), moves, vocalizes or reaches. The idea is to encourage

growth of intimacy and ‘falling in love’. As the child develops, the relationship

is deepened to include the full range of feelings such as assertiveness,

anger or sadness that can be incorporated into the quality and stability of

the child’s engagement (e.g. does he or she withdraw or become aimless

under stress, does he/she stay connected when angry or scared?). Relationships

are continually emphasized to develop a sense of security, intimacy,

caring and empathy. Relationships also support the hard work needed to

develop motor planning, language, and positive attitudes towards all new


Stage 3: two-way intentional communication This stage involves

following the child’s lead and challenging him or her to communicate

through exchanges of gestures and emotional signals about his or her

affects (interests, needs or intentions). The adult is animated and shows

affect through tone of voice and facial expressions. This begins with a

dialogue without words through subtle facial expressions, a gleam in the

eye, and other emotional signals or gestures, and progresses to a dialogue

with problem solving words. Affect cues (signals) are used to woo and wait

for the child’s purposeful social gestures (facial expressions, making

sounds, reaching, pointing, throwing, movement, etc.) to express desires,

objections or other feelings. Reciprocity is established by challenging the

child to do things to the adult, by helping the child achieve his or her goal

and later build obstacles to add steps. A continuous flow is encouraged by

opening and closing multiple circles of communication. A circle is opened

when the child exhibits some interest or initiates a behavior – e.g. the child

looks at a toy, and the parent or caregiver follows the child’s lead by picking up

the toy and showing it to the child. The child closes the circle by reaching

for the toy, while acknowledging (looking, smiling at) the parent.

Stage 4: purposeful complex problem solving communication At this

stage the adult and child work up to a continuous flow of 30 or more back

and forth circles of communication – e.g. the child takes a parent by the

hand, walks her to the door, points to indicate that he/she wants to go out,

and perhaps vocalizes a sound or word to further signify intentions. The

adult expands the conversation by asking where the child wants to go, what

he/she needs, who else will come, what they will get, what else, how come,

etc. These conversations negotiate the most important emotional needs of

life (e.g. being close to others, exploring and being assertive, limiting

aggression, negotiating safety, etc.).

Stage 5: creating and elaborating symbols (ideas) This stage encourages

the child to relate to sensations, gestures and behaviors, to the world

of ideas which can be shared in pretend play. The adult lets the child initiate

the play idea and joins the child as a character through dramatization in

direct roles or using figures to elaborate themes and expand the range of

emotions (closeness, assertiveness, fear, anger, jealousy, aggression, etc.)

which the child can explore and express safely. When feelings and impulses

are elevated to the level of ideas, they can be expressed through words –

e.g. instead of hitting a friend, the child can say, ‘I’m mad’ without acting

out. Play provides the distance from real life and immediacy of needs to

differentiate self from others through empathic roles – e.g. the child

pretends to be a mommy, comforting her frustrated baby who broke his

toy. It is important to look out for polarizing or being dominated by one

or another feeling state (aggression and impulsivity, needy or dependent

behavior, fearful patterns, etc.). The adult engages the child in long conversations

to communicate interests, feelings, desires and objections

throughout the day.

Stage 6: building bridges between symbols (ideas) This stage involves

challenging the child to connect his ideas together by seeking his opinion,

enjoying his debates, and negotiating for things he wants using logical

reasons. The adult promotes pretend play, words, and/or visual symbols to

elaborate a partially planned pretend drama (theme or idea is identified in

advance), or engage in logical conversation dealing with causal, spatial,

and/or temporal relationships between themes. Recognizing when themes

or ideas are fragmented, the child is encouraged to ‘make sense’, with a

beginning, middle and end where elements in the drama logically fit

together, motives are understood, and the child can put himself in someone

else’s shoes. The child is challenged to create connections between differentiated

feeling states – e.g. ‘I feel happy when you are proud of me!’

Relationships (contingency) between feelings, thoughts and actions are

identified. Differentiation of more subtle feelings states (e.g. lonely, sad, disappointed,

annoyed, frustrated) are expanded. This capacity is essential for

separating reality from fantasy, modulating impulses and mood, and

learning how to concentrate and plan.

Case example of a child on the autism spectrum

The first stages of intervention

Joey was diagnosed on the autistic spectrum at 30 months of age. He was

withdrawn and self-absorbed, spending his time pushing a car back and

forth lying on the floor, examining it through his peripheral gaze, shuddering

and quickly covering his ears as he heard unexpected sirens or cries.

He did not respond to his name or appear to understand what was said to

him, typically looking away. But he recognized a few songs, turned the

pages of books, and loved jumping. There were times he smiled as he

enjoyed dancing and bouncing on the bed, but he did not point or wave,

or come to his parents except to take their hands to get a cookie or toy car.

At 2 he was still silent, with just a few guttural sounds. His parents decided

not to wait any longer as they experienced their child slip away and sought

evaluation. It took nearly 6 months to put a comprehensive program in

place (ICDL, 2000).

The following sections describe the authors’ interpretations of Joey’s

progress through a series of floor time interactions over 4 years of intensive

intervention which included: (1) six daily floor time sessions, (2) four

semi-structured and sensory-motor activities, (3) intensive speech and

occupational therapies, (4) three to five playdates weekly, (5) inclusion in

a preschool and (6) various music, gym, drama and sports activities.

Joey and Dad are rolling on the floor engaged in gleeful rough house play as

Joey bounces on his dad’s tummy, waiting to be lifted up once more onto his

dad’s knees to ‘fly into the sky’. He waits breathlessly anticipating his flight

and bumpy landing, his hands trembling, but to no avail. Their gazes meet

with joint excitement and Dad asks, ‘ Are you ready Joey? Ready for take-off

sweetheart?’, his voice wooing Joey into the next step which Joey must initiate

if his intent is to keep flying, both patient and reassuring. Joey finally takes his

dad by one hand and then the other. Pulling both towards him, he blurts out,

‘Eh, eh!’ With that the engine revs up as Dad stretches the moments of their

shared gaze and joint attention until Joey tugs once more, their pleasure

mounting as the plane soars into the ‘bumpy skies’. Joey is now the captain,

signaling his wish to go higher or faster as his dad waits for him to initiate

the next move by gesture or vocalization until they reach their ‘destination’

designated by nearby photos of Nanny and Pop-Pop or Disney World towards

which Joey first reaches and then points as his dad models pointing with an

energetic, ‘Over there or over here?’

Sometimes the plane ‘crashes’ and needs to be repaired with Joey’s hammer

(fist), sometimes it needs to be refueled with kisses, and sometimes it stalls

or gets lost before Joey arrives and he is met with tight squeezes and hugs.

Their journeys stretch from moments to minutes as Dad encourages Joey to

sustain a continuous flow of gestural interactions where Joey is in charge of

each next move, solving every problem as it arises unpredictably, closing circle

after circle of communication in a co-affect regulated state until they reach

their destination.

On this joyful journey many goals are accomplished for this 30-month-old

little boy diagnosed on the autistic spectrum only 6 months earlier. The

most important was the deepening of Joey’s relationship with his dad who

acts as his ‘toy’ and makes playing with people more compelling then

pushing his cars back and forth (which he relied on earlier because of poor

motor planning and sequencing) or spinning in his craving for movement

(because of his under-reactive vestibular system). While Joey always enjoyed

rough house play with his dad, it was Dad who always threw him around

and did all the work for his passive low muscle tone little boy. Building on

this one area where he could still reach the ‘little boy he lost’, Dad learned

how to help Joey develop critical functional developmental capacities

through play with his non-verbal pre-symbolic son.

Mutual attention and engagement were enhanced through affect cuing

to get Joey to initiate what he wanted and communicate this to his dad,

who wooed but waited for Joey to make the first move, knowing what Joey’s

intent or desire was. Their mutual pleasure deepened their relationship and

affection, expressed in deliberate smiles, hugs and kisses. By waiting and

being playfully obstructive, Dad was able to get Joey to elaborate on getting

more of a ride and also to woo him into more complex gestures, where

Joey not only had to tug at his hands but look, pull, figure out if the next

step or solution to the problem was to bang his hammer or give a kiss or

point to where he wanted to go, identifying the purpose of his flight. On

this two-way street, Joey became a better problem solver. Dad then challenged

him to find more complex solutions as they maintained a continuous

flow of interactions and Joey learned to get off the plane and get the

gas truck, or tool kit, or other passengers who could get on board (his

favorite teddy bear and figures). He developed more complex gestures as

he learned to ‘close his seat belt, pull up the throttle, and listen for the count

down (5, 4, 3, 2, 1)’ etc., until he could first point and then say ‘up’ and

‘go’. He mastered a sequence of actions (motor planning) necessary to take

his trip through interactions.

This was a bumpy ride that first just met his proprioceptive and vestibular

needs through rough house play where Dad ‘recaptured’ his son, ushered

Joey into the symbolic world. The countless times his parents had pointed

to the airplanes rumbling in the sky (which Joey was very sensitive to),

and the plane trips they had taken to visit his grandparents, prepared Joey

for the symbolization which now accompanied their lengthier and lengthier

interactions. Choosing symbols and actions which had personal

meaning based on experience, coupled with strengthened capacities for

mutual attention, engagement, communication and problem solving,

prepared Joey for the symbolic world.

Six to 18 months later

Six months later Joey and Dad continued to play on the floor (floor time),

but this time family figures were boarding a small airplane as Joey called

out ‘All aboard’ and told ‘Mommy, on!’, ‘Daddy, on!’, ‘Ready, set, go [to]

Nanny!’ His family figures had driven up to the airplane on a bus,

transferred their luggage, and were ready to board. Joey was still the captain

as Dad spoke for the various figures. Enveloped by strengthened basic

developmental capacities for shared attention, engagement, reciprocal communication

and problem solving Joey went on to develop some verbal

language and motor planning to now express his ideas through symbolic

play. His love of airplane rides readily expanded to symbolizing many other

aspects of his real life experience as he pretended to be ‘Pilot Joe’ or ‘Chef

Joey’ serving various foods (some of which he did not eat in real life!) at

picnics and dinners. He was also a good daddy, giving his babies baths and

putting them to bed with his personal rituals. He was the doctor, the teacher

and the traffic controller, eager to ‘play’ at any time with his parents, sister,

therapists and playdates. His language propelled forward in his eagerness

to express his ideas with words, built on the strong gestural communication

and comprehension aided by the use of toys, another language he could

‘see’ as he listened and talked. He practiced the words, embedded with rich

meanings and affect cues, provided during the interactive play. His excitement

and impulsiveness was co-regulated through affect cues signaling

caution, moderation or action. The elaboration of play and ideas with toys

relies on expanding interaction and communication, as well as motor

planning abilities which allow the child to plan and execute his ideas. He

was encouraged to develop ideas or stories with a beginning, a middle and

an end which had a point or mission.

Soon Joey entered the world of symbolic solutions and magical thinking

as his emotional range expanded and he moved from safe dependency

themes, feeding, fixing and ‘in control’ of the world through symbolic role

play and use of figures and toys related to reality, to the new emotional

themes lurking in the shadows as he encountered meat eating dinosaurs

ready to pounce on the plant eaters, jealous queens with spells and potions,

mean stepmothers or sea witches impeding romance, brother lions fighting

for a kingdom, hungry alligators ticking as they waited for mean pirates,

and noble kings ready for the rescue. Now baskets became cages and jails,

rubber bands bound the enemies, and Nerf swords were ready for battle so

romantic weddings could go on. When all else failed or fears were too high,

a magic wand could come to the rescue. To be sure, the ‘good guys’ almost

always won. Time and space had no bounds!

During this stage Joey became very anxious as he struggled to understand

what was real and what was fantasy, as well as to grasp his emerging

range of new complex emotions related to competition, jealousy, power,

loss, aggression, death, justice and morality which he would encounter in

the next few years. Again it was lots and lots of symbolic play and reflective

conversations which would give him the opportunity to safely explore

these emotions, their meanings, and the alternative solutions they posed.


Joey’s floor time partners all followed the same principles: let Joey

initiate the idea, follow his lead, be a ‘player’ (not interviewer), do not

change topics, help him elaborate by challenging him to solve the problems

at hand (of which some occurred incidentally and others were opportunities

created by you), provide new language to encourage conversation,

not ask questions he already knew the answers to but get him to think, get

him to predict what you will do through signals and cues, keep the back

and forth pace rapid, and use affect cuing to provide challenges and continuous

flow as long as possible. It was also at this time the stage was set

up for the development of abstract thinking through reflective conversations

where Joey was encouraged to give his opinions, figure out what he

and others were feeling, empathize, and determine what was right and

wrong, safe and dangerous.

Three years later

As he turned 6, Joey was contemplating motives as he discussed different

strategies to capture the ‘dark side’! He no longer automatically arrived in

space ready to win. He even negotiated with Dad who would be on which

side as he now planned his play and debated what was possible. Their conversations

were now rich with why questions and discussions of feelings

and motives as Joey embarked on his journey into abstract thinking and

increased empathy. Dad asked questions that required Joey to anticipate how

he would feel in certain situations as well as how someone else would feel.

He asked Joey his opinions about choices and to compare and contrast

experiences. Dad also realized Joey had missed a lot of incidental learning

during the years that auditory and language processing difficulties impeded

picking up information about the world around him. The combination of

these efforts through daily conversations and floor time play started to move

Joey towards more abstract thinking. The world was becoming less black

and white.

He applied these emerging capacities to his interactions with peers as

he realized some days his friends would be nice to him and other days not.

Running with the crowd was now easy as he had learned to join social

games on his numerous playdates, enjoying chase, ‘capture the flag’, and

even soccer. On the floor, he and his friends engaged in superhero battles

and tigers were no longer kitty cats. He joined the ‘Justice League’ as he

borrowed the power of different superhero roles to compensate for his

growing realization he was only a little kid after all in a world full of rules

and many bosses loomed above him. He discovered the other ‘darker’ side

of emotions as he encountered characters consumed with jealousy, competition,

and lust for power.With his parents, he turned to his fears, sorrow,

loss and disappointment, and need for compassion and support as he

expanded his emotional range. After a tough day he brought his daily

struggles to floor time, reenacting his conflicts and confusion. After a victorious

day he brought his success to floor time to analyze what was fair

and loyal, as well as to empathize with others. As he experienced defeat or

disappointment, it was only in play he could experiment with negative

emotions and aggression without getting in trouble.Without play symbols

he was at risk for acting out his newer emotions and conflicts. During floor

time he prepared for the next day’s encounters.

Symbolic play and conversations were now the opportunity to work out

real life dilemmas whereas before he used it to imagine, fulfill wishes,

practice roles, and enjoy the magic he conjured. Now, entering school

years, ‘saying so no longer made it so’, as he grasped reality and reflected

on the experience of others. He was now prepared to go onto the next

stages of emotional development.


Not every child progresses at the same rate as Joey during 4 years of intensive

intervention, central to which were the daily floor time interactions.

But every child with developmental challenges must have the affective

interactions necessary to develop each functional milestone. More than 6

months were necessary just to build the foundations for higher level

problem solving and symbolic process. Whether playful rough housing or

tickle games, or gleeful chase and hide and seek, the foundation was established

for pleasurable relating and communicating through interaction.

Joey’s progress represents the stages of symbolic play and thinking essential

for later life, stages traversed through affect based interactions as each

stage emerged. This is evident when toys become symbolic ideas and words

convey emotions, empathy and logical and abstract thinking.

Joey progressed continuously during the course of a comprehensive

intervention program addressing his specific processing difficulties, and

rooted in building interactive relationships, enabling him to climb the

symbolic ladder. We believe that floor time was central to his progress

in that it helped him build the structure necessary for each successive

achievement. A single child’s progress cannot, of course, prove the efficacy

of an intervention. Neverthess, our observations suggest that play provided

the lifeline for Joey’s development. It set the foundation for abstract

thinking needed for comprehension of literature and history, as well as

logical thinking related to time, space and numbers. When symbols can

stand in for reality, there is the opportunity to experiment, practice, comprehend,

communicate, empathize, develop theory of mind, and become

logical and abstract through the interactions inherent in relationships, the

essence of life.

Follow-up studies indicate many children initially diagnosed on the

autism spectrum can achieve the developmental capacities necessary for

relating and learning as Joey did following appropriate interventions

(Greenspan and Wieder, 1997b; ICDL, 2002).


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