Child Health & DevelopmentChildren with Disabilities

The DIR Floor-Time Approach Meets Children At Their Own Developmental Level


The DIR Floor-Time Approach Meets Children At Their Own Developmental Level

In today’s world there are so many methods offered by both professionals and parents to help their children deal with developmental delay. Most methods focus on academic skills or redefining behaviors. Maybe it is time for us to understand the child’s needs before imposing our ideology on them.

DIR floor-time approach allows adults to help children expand their circles of communication by meeting them at their developmental level and building on their strengths. This approach has existed for more than 35 years with many scientific researches proving its ability to help children develop socially and cognitively.

DIR floor-time is divided into two main parts:

Firstly, DIR, which focuses on the child’s development. Secondly, floor-time, whereby it is a form of free play in which we follow the child’s lead and then we challenge him/her to extend their play to achieve higher stages of development.

Wondering what DIR stands for?

“D” stands for the child’s development. In DIR floor-time there are 6 main stages of development. These are basically the foundation of every child’s development. This model is considered to be a collective or global developmental model that does not separate between speech, cognitive and motor skills.

What are the 6 main stages of development?

  1. Regulation: This stage allows the baby to take in all the exciting things going on in their environment through various senses, organize them internally and focus on a specific stimulus while ignoring other factors happening in the environment. The aforementioned stage could happen with the help of the baby’s caregiver.
  2. Engagement; whereby the baby mainly falls in love with his/her mother, showing different kinds of emotions and more sustained attention.
  3. The Purposeful Two Way Communication; the preverbal stage where the child smiles to mummy and she smiles back.
  4. The Complex Communication and Shared Problem Solving; by which the child understands gestures and can communicate using them. During that stage, he/she can try to solve his/her own problems and build on mummy’s play.
  5. Using symbols and Creating Ideas; as the child will begin to develop ideas and experience different emotions that he/she will later use in play.
  6. Logical Thinking and Bridging Between Ideas, whereby the child can link between his/her ideas in play. By now their pretend drama has more logic with appropriate use of language.

Moving on to the “I”, individual differences. Regardless to their diagnosis, each child will remain unique with specific biological needs. Here we try to understand how each child process sensations coming in, and how he/she grasps what they hear, smell, taste, see and touch.

Finally the “R”, relationship based model. The relationship between the child and his/her parents, therapist etc. Accordingly parent training sessions in DIR are mandatory. Because understanding a child’s individual differences and his/her unique sensory system allows us to tailor our interactions to meet the child at his/her developmental level.

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Nagwa Khedr

Nagwa Khedr graduated with an art major and psychology minor in 2009 from the American University in Cairo. She found her passion for working with kids while on a community service trip to work with underprivileged children in Ethiopia. Then in 2010 she joined the Learning Resource Center as an early intervention specialist, working mainly with children aged 1 to 8 years old. For the past 3 years, Nagwa has been using the DIR Floor-time approach to work with children with ASD and any developmental problems. In 2017, Nagwa finished her Expert Training Leader certification from the Interdisciplinary Council on Development and Learning and became the first DIR Floor-time provider in Egypt. In addition she is an ICDL faculty and a certified parent coach.


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