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.
Introduction
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
thinking.
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
provides.
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
relating.
The DIR model examines the functional developmental capacities of
children in the context of their unique biologically based processing profile
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