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Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate, and Think (A Merloyd Lawrence Book) Paperback – February 10, 2009
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From Publishers Weekly
Greenspan and Wieder (The Child with Special Needs) start out by redefining autism in realistic yet positive terms which open the door for successful intervention: instead of focusing solely on the autistic spectrum, a more flexible axis measuring progress, on which placement is not fixed, can give parents and children a "a healthy developmental trajectory," taking into account such goals as "showing intimacy and warmth ... communicating with gestures ... and talking meaningfully." The authors give readers a pragmatic approach to thinking about people on the autistic spectrum, including specific ideas for enhancing connectivity and communication in people of any age, most of whom "rarely advance intellectually above the ten-to-twelve-year-old level ... when they could progress far beyond the level of concrete thinking," if only there were a curriculum that would "challenge them to do so." Most of the text is used to help develop an engaging program for someone with autism, including resources and examples, in order to address "relationships, specific behaviors, the creative use of ideas, and the various processing areas." This is essential reading for caregivers, parents and friends of people on the spectrum, as well as compelling reading for anyone who wants to learn more about autism.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.
“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.”
Mid-Ohio Valley Parent, June/July 2009
“For parents looking for new ways to work with their autistic children, this book would be extremely helpful.”
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Top Customer Reviews
So our son was given the ASD diagnosis in 2014 when he was 2.5 years old. DIR is not our only therapeutic approach with him, because in our state, ABA is the only one of the therapies that is covered that addresses the symptoms of Autism, and ASD is not his only diagnosis. For our son, I think both approaches have their value and their uses. So, my first piece of advice is about something you may have already encountered: many times parents of children on the spectrum will tell you what worked for their child and say this is for sure going to work for your kiddo. You know, I'm not trying to do that. I think DIR is a good approach, and it may certainly help your child, but I think therapeutic approaches are best tailored to each individual child because the circumstances can vary so much, and this is an area where knowing your child is important in directing your approach if possible. But you may need to experiment with some things to figure out how each approach affects them. And sometimes, knowing your own personality and how you feel comfortable interacting can also be a necessary component in deciding approaches as well.
DIR is different from many forms of ABA in that you follow the child's interests and use those to “enter into their world.” Once they are interacting with you doing whatever it is they are doing, even if it's a behavior you ultimately want them to not be doing, like turning the light switch on and off repetitively, you can start building engagement, joint attention, and communication skills and work towards modifying what they are doing into something more functional. One of the reasons I like DIR so much is that I feel like it does a great job of recognizing an important rule of social reciprocity. Greenspan himself points out in this book that when you go to a party and meet new people, you often try to engage them in conversation about their interests, et cetera first and I agree with him. I feel like sometimes ABA is a bit more authoritarian in that it is very focused on teaching the child the current model for socially accepted responses without helping them to first feel the joy of socially connecting with others. And with some things, for my son, unless he feels that joy, it doesn't matter what kind of reward, reinforcer, or treat you offer him. He's not going to cooperate with you. Period.
Unlike some of the other therapeutic approaches, DIR allows for the use of other methods concurrently without insisting on exclusive devotion to this. DIR can be very time consuming, and it can require a great deal of creativity and trouble shooting. But if you have a child on the spectrum, especially if they have significant challenges, anything effective is going to require extensive time supports. I think this book does do a great job of explaining things, but I also like the book “Floortime Strategies” by Davis/Isaacson/Harwell because it's a bit more concise and can serve as a great reminder/refresher. Also, even though Dr. Greenspan himself is deceased, there still is a website in his name being maintained that has teaching resources for the Floortime approach.
The one thing I would mention about this is that the authors state that challenging behaviors will lesson over time as they become drawn into the shared world. I would say that if a child's behaviors are sensory based, that may not be the case. For our son, one of the reasons he bangs his heads onto things is that he has sensory imbalances involving his vestibular senses. And, because his deep pressure nerves are less responsive, he doesn't feel the damage he does when he bangs his head hard, so it's not self limiting that way, and it can be scary when he tries to do it with a lot of force. He had a dental procedure a few months ago that threw some of his sensory stuff out of whack, and the head banging which we had pretty much fully extinguished came roaring back with a vengeance. Like, 2-5 hours a day for the first few weeks post procedure kind of vengeance. Because the problem started sensory, being in a shared and engaged place isn't going to completely get us back to where we were, so we've been using an approach that uses some DIR, some sensory integration, and some ABA and we're down to 5-15 minutes most days, but we're still not back off that hill yet. And this is one where I'm going to agree with some other authors who are behavioral specialists that you may need to hold your child in a basket hold for a time to keep them safe before you can get them to calm down enough to engage in other forms of communication or behavioral substitution with this. Otherwise, I do agree with the strategies given for challenging behaviors in this book, just be prepared it could be a marathon and not a sprint depending on what is going on with your child.
My son recently turned 5, and sometimes people look at him and his list of diagnoses (they total 5 currently and include other developmental disorders) and that is how they choose to define him. They see that his overall level of functioning is much lower then that of a typical child his age, especially since he's non-verbal. But you know what? He uses the potty. He self dresses. And he communicates with us for a number of things on his speech device, and those are big accomplishments to have. If there is one gift I could give people, it would be to see what things were like 4 years ago, because comparatively speaking, I think he's doing very well. And there's never been any doubt that he loves me and feels that bond, because I've taken time to be in his world with him and I know what love looks like to him. And, regardless of how low functioning people tell you your child is, pay attention to everything they do. Two years ago, when my kiddo still couldn't imitate most anything, my friend L came over for lunch. He wanted her phone, but she wouldn't give it to him. So, he grabbed her by the hand, led her over to his toy bus. At this point, I've seen a few of his schemes, so I'm watching suspiciously because I know. My son does not like to roll a bus back and forth, but he's already experienced her trying to get him to do that, so he knows that's what she wants to do. So she sits down and once she's got her hands on the bus and in a difficult position for chasing him down, he gets up and runs quick as he can towards her phone. Which I beat him to, because at this point, I'd already been caught off guard by some of his schemes and I had come to be on the look out for them.
I would say, if you see those types of moments, while believe me this type of ability to plan can be really scary in a child without risk assessment abilities, this is still what hope can look like. Every time my son problem solves to get out of something (like trying to throw away his crayons so I won't continue practicing scribbling with him as part of an ABA target) or to try and get something he wants, I rejoice. Because if he can problem solve that way, I feel like that list may not define him long term to the degree some people might expect it to. And other then saying I have experienced how effective DIR can be in engaging my son, that is the one thing I would really want to encourage. We needed to know his diagnoses to know the best way to take care of him and to get him the services he needs, just as you needed to know that for your child, but they are not ultimately who he is. And that is something I love about DIR. It can help your child feel comfortable enough to reveal to you who they really are underneath the behaviors that come with the labels.