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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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