Customer Reviews

Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate, and Think (A Merloyd Lawrence Book)

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This is a detailed look at a difficult subject but for the parent of a child with autism it is one of those stones that should not go unturned. Dr. Greenspan makes the extraordinary claim that he has treated thousands of children and adults with ASD and has never seen one that could not be moved forward on the spectrum, not even one. In many cases they have been be able to join their peers in full healthy emotional and intellectual lives.

Dr. Greenspan is no quack. He is Clinical Professor of Psychiatry and Pediatrics at George Washington University Medical School. He and Dr. Serena Wieder have spent the last twenty five years developing the approach they call Floortime. Their thesis is that all learning begins with emotion. The tiniest infant typically bonds and begins to communicate with its mother because it finds that communication pleasurable and desirable. Each little step in the process represents a foundational building block required for the next step. Children with autism have missed some of those building blocks. The idea behind Floortime is to meet the child wherever she is emotionally. Find what the child likes to do. Join her in the activity. Follow her lead and establish an emotional bond that can be used to communicate in a way the child finds pleasurable. That in turn can allow her to put some of the missing foundation in place. Over time the child moves up on the spectrum.

I find Dr. Greenspan's success stories inspirational. My four year old grandson has made remarkable progress in the two years since he was diagnosed with autism. He plays with his peers, makes strong eye contact, and laughs with his dad. But for the past six months or so he seems to be stuck on a language plateau. He hasn't regressed, but beyond asking for what he wants he is distressingly quiet, rarely engaging in conversation though he loves to sing. And his stimming has gotten worse. Don't bother to look it up. You won't find it in Webster's, not even in the unabridged edition. It's what Greenspan calls self-stimulation and Weston's mother calls sensory overload. Weston dances on his toes in what Mom and Dad call his happy dance. He also paces incessantly back and forth in a little trot. He is excessively excited and that appears to be interfering with his therapy. If I understand Greenspan, he would see it as an opportunity. Weston does that because it makes him feel good. So dance with him, sing with him and if he wants to trot, trot. Let him share his pleasure with you. Turn it into a game. It could be a non-verbal game that would help him develop an appreciation for non-verbal cues such as tone of voice, body language, even flirting. It just might add a foundation building block. That would be a wonderful thing.

My daughter is 8. We did the early intervention from age 2,Kind. and 1st grade. School goals were to make her autism not so obvious by teaching her to be quiet in class and follow a schedule. I found a mom who did her own consulting. Her daughter started non verbal at age 2 like mine. However, she used Greenspan and her daughter is amazing and in a reg. Kindergarten with no shadows. Very articulate, executive functioning (planning etc) is excellent. When asked how she did this she replied I worked my "blank" off! You would be amazed at what floor time accomplishes. We got pretty normal eye contact in a month. When you imitate them they look at you. She has learned nouns, not nouns, verbs, pronouns... When I read Greenspan I found a wealth of ideas for all kind of situations and I needed stories to see how to do it. She doesn't need much chair time except some of homeschooling. I want a kid who argues with her brother, can whine like any kid. I want her to play and make friends. Remember, be a kid yourself,laugh,have fun during therapy. Your presence has to be the reason playing is more fun. Read Greenspan. I did like the second book better. My husband and I have seen such huge positive changes. You begin to take for granted what didn't exist before. Isn't that nice? Greenspan keeps it functional, real life teaching in the moment! P.S. The disciplinarian teaches nothing. Knock off the military mindset.

Engaging Autism provides clear, practical information on how parents, therapists, and other caregivers can use the DIR/Floortime Approach to help children with autism spectrum disorders. As a pediatric OT and author of a book on sensory integration issues, I really appreciate Dr. Greenspan's explanations of sensory modulation difficulties and sensory and emotional overload and how these problems interfere with development. He examines a few of the many challenges posed by sensory issues, such as potty training and mealtime, and offers some good strategies, including working with a knowledgeable occupational therapist. This excellent resource helps parents start asking the right questions about what approach to use to help the child with ASD, provides useful advice on handling everyday problems, and offers current brain research and efficacy studies about the DIR/Floortime approach.
--Lindsey Biel www.sensorysmarts.com

I am "seasoned" in DIR/FT, having read numerous books by Dr. Greenspan and Dr. Wieder and attended ICDL and Floortime Foundation conferences. This book thoroughly explains the core deficits of autism spectrum disorder and the DIR/FT approach. If your child was recently diagnosed with ASD or if you have an older child/adolescent with difficulty with social interactions (pragmatic language) or sensory needs, this is an excellent book to read. There are also examples with respect to integrating FT into the school curriculum. It complements Dr. Greenspan's "The Child with Special Needs".

I am a psychologist (PHD) and also mother to a child with Autism. I own several of Greenspan's other books and have been doing floortime with my son for 3 years. This book is an excellent resource for parents of autistic spectrum kids or professionals who work with these children. I had read Greenspan and Wieder's earlier book on floortime, but this 2nd book expands on the method considerably, laying it out in an even better format. It is also interesting to read Greenspan's examples of cases that he has worked with. Since children on the spectrum are so diverse, these examples are varied and represent ways that floortime can be used with children who have many different issues. I highly recommend this book. It is designed for parents to read, so anyone considering buying it should not feel that they have to be a professional to understand it.

This review of Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate, and Think) is written for any person interested in autism. Its main intent, however, is to speak directly to a parent or caregiver who may be dealing with a child with the disorder. In this review, I refer to a child with the disability as "her" and "daughter," even though there is a predominance of boys with this disability. Early in the book's chapters, authors Greenspan and Wieder warn that the presence of one symptom should never lead to a diagnosis of autism. Engaging Autism lists these three problem areas as indicative of the disorder.

1. The first problem you may notice is your child's inability to establish closeness and affection when relating to you and others. You may notice she does not turn meaningfully to greet you. Her general body motions appear uncoordinated and random for her age - purposeless. You get the unmistakable gut feeling that she shows little or no affection in spite of your best attempts to show her intimacy and warmth.

2. The second problem you might notice is her failure to communicate with gestures and expressions of emotion. Engaging Autism believes your child may feel pleasure and sense affection; still she is unable to express this feeling. To add to her problem, you may be more hesitant to respond to her, thus reducing the chain of social and emotional exchanges necessary for her to develop a sense of self.

3. A third area where your child may languish would be expressive language. You may find that although she has begun to use basic words, she may use them without showing longing or emotion. When she does vocalize, it may be the same words repeated over and over as if memorized with little or no feeling involved.

In Engaging Autism, floor-time refers to three actions you, and everyone who deals with your daughter, must be encouraged to take, in order to help her develop to her full potential. The actions must be taken as often as possible and should include other family members, neighborhood children, relatives, teachers etc.

1. Floor-time means you begin a sequence of two-way communication with your daughter at her own developmental level. It may not involve talking.
2. Floor-time means you start a communication sequence by following your daughter's lead regardless of what she is doing.
3. Floor-time means challenging your daughter to respond verbally or with some other kind of cue: a grin, a smile, an emotional change on her face - any noticeable reaction.

It can be extremely frustrating for you trying to engage your daughter if she is staring off into space or is engaged in obsessive stimming behavior. But before any real communication can begin, you must first engage her.

Floor-time could involve getting down on the floor with her many times a day. It could be a sequence of communication at any time, hopefully many more times than not: while you and she are showering and/or bathing; while going shopping together; while playing inside and outside the home with peers; while you attend some classes at school with her, until both teacher and aide (if available) can use the same sequencing system you use.

The key to begin communicative behavior is to place your body physically where your daughter is focused (called floor-time regardless of place), you follow her lead, and challenge her to respond. The following few paragraphs contain an example of floor-time as I, the reviewer of Engaging Autism, understand it:

If your daughter is staring off to one side of the room or out a window or at a wall, it is necessary for you to go to that spot and be seen by her. It is important that you don't stand in front of her and demand her attention nor would you turn her head to force her to look directly at you. No, you must start where she is focused.

If you now jiggle her favorite doll (any toy), you might challenge her, "How can we play with this doll now?" If she responds, "Play," or "Me Play" (just an example), then a communication circle -- you-daughter-you -- has happened.

Suppose you challenge again, "What can we play?" she might just answer, "Play here," or "Play now!" Holding the doll, you would then approach your daughter in her line of vision and attempt to keep communication going by repeatedly challenging her with simple questions, hopefully to add more layers to your circle of communication. As you develop this engaging, you'll want to try to ask questions which require more than a "Yes" or "No" response.

Another example of floor-time by this reviewer: Suppose you want to take your daughter outside to play. She is sitting at a table rubbing the same spot over and over. There is no possibility of eye contact because she stares downward, vacantly. You place your hand beside hers so that her hand now slides alongside yours. If she utters anything and you answer, a communication circle has started.

If she doesn't respond, you push your hand slightly against hers to move it a tiny bit. This is a challenge. Back off if you suspect a meltdown is coming.
She may respond; she may not. If you keep challenging by moving against her hand, she may eventually look up and make eye contact, or even smile - another response. Now you might challenge her again with words, "Let's put our fingers on a toy we can take outside?" or you might just begin to play some kind of finger game. The book describes several.

Engaging Autism would readily agree that it is not always easy to start a communication circle, but RESPONSIVE communication is your main objective. The longer - the better; the more circles of communication you can build - the more helpful your floor-time will be in helping your daughter learn to relate, communicate, and think.

This is not to say there will never be lapses, or tantrums, or days of complete frustration on your part. After taking a break -- a few minutes, an hour, the rest of the day -- the most critical thing to remember is: keep trying! Don't give up.

What I have described here are only two imaginary examples of floor-time approaches to engage your daughter in communication circles with you at a relatively low level. But Engaging Autism describes a multitude of ways to engage her at every level of development from infancy through her schooling years.

It suggests ways you can work with your daughter's teachers so that at school and at home, the same floor-time approach provides her with a wrap-around interactive environment. It even discusses successful ways to toilet train. Finally, the book explains how you can help playmates interact and accept her, by literally joining in their play and showing them how to interrelate.

After some 30 years working with exceptional children in the Pittsburgh Public School System, this reviewer feels that floor-time as described in Engaging Autism is a genuinely unique way of helping a child with autism to communicate and relate to others in a meaningful and satisfying way. There are many approaches out there, but I think a lot will be ventured and a lot gained using floor-time.

Engaging Autism is a must read for parents, caregivers, teachers, physicians, psychologists and psychiatrists who have been frustrated in their attempts to help young and older children with autism. Its methods will give all of them more than just a ray of hope.

Other interesting reads:
Strange Son
He's Not Autistic But...: How We Pulled Our Son From the Mouth of the Abyss
1001 Great Ideas for Teaching and Raising Children with Autism Spectrum Disorders

I purchased this book as a parent with a recently diagnosed adolescent with autism spectrum disorder, but the book is a better source for parents/educators/professionals with very young children.

I have 2 boys with Autism. With both I used the Floortime method. They are now 5 and 3 and are doing so well! The oldest was dxgd @ 18 months and was at 2month levels. He is now 5 and communicates at a 5 year old level! It takes hard work and dedication but Floortime is worth it!

Engaging Autism has been one of my mainstays for working with families with children in the autism spectrum. I have been able to teach them simple strategies from the Floortime method that allows them to quickly see glimmers of engagement with their children. Dr. Greenspan's explanations of why these children have problems and how to help them find us worth joining is very thoughtful.

Parents that I have recommended this book to have come back with a better appreciation of the struggles and strengths of their children. They are more ready to get down to their child's developmental social-emotional level to allow them to grow, thus enabling them to be available to the other therapies that are needed.

Not everyone has a Floortime/DIR trained therapist available to work with them, but with this book they at least have some strategies to include as they play with, work with, and learn to enjoy the child they have.

The book gives you insight not only about autism but as well how our feelings and social skills develop in general.
An autistic person meets with respect for her unique personality, the aim is to support personal growth not to manipulate behavior. It has humanistic approach to see a man as an integrated whole personality not just as a number of separate functions.