Friday, September 10, 2010

Integrating Art Therapy and the DIR/Floortime Model

In recent years, there has been a great effort to meet a rising need and demand for innovative and therapeutic services that can give children on the Autism Spectrum the best chance to develop intellectually and socially; to discover their talents and to cope with their challenges. There are more creative art therapists offering services for this population, but are seeking effective and imaginative ways to work without compromising the goals of the field.

Art Therapy can help the child with Autism in many ways. Some main areas that art therapists focus on include: increasing communication and social skills, developing a sense of individuality, building of relationships, and facilitating sensory integration (Betts, 2005). Children on the Autism Spectrum struggle with all these challenges in varying degrees however communication is an area that will affect them the greatest. We need to define what communication is for the child with Autism. It is not just language as a form of communication, but rather the totality of the communicative framework that appears from infancy onward which experts such as Daniel Stern and Donald Winnicott theorize. (Evans and Dubowski, 2007). We need to understand these basic areas and become aware of the level which the child with Autism is functioning developmentally in order to provide appropriate therapeutic interventions.

The DIR®/Floortime™ Model( Developmental, Individual Difference, Relationship-based) is a systematic way of working with the child that enables him to climb the developmental ladder and takes him back to the milestones that may have been missed earlier on (Greenspan and Weider, 1998). The six milestones within the model include: 1) Self regulation and interest in the world, 2) Intimacy, 3) Two-way communication, 4) Complex communication, 5) Emotional ideas, and 6) Emotional thinking. This model is a framework that helps clinicians, parents and educators perform a comprehensive assessment and develop an intervention program tailored to the unique challenges and strengths of children with Autism Spectrum Disorders and other developmental challenges. Greenspan explains that the five activities to engage children in Floortime are to observe, approach, follow the child's lead, extend and expand play, and let the child close the circle of communication.

The Creative Arts Therapies combined with the DIR®/Floortime™ Model creates a unique and comprehensive approach that accomplishes these tasks. The blend of a child-centered focus along with creative and expressive modalities brings together a dynamic and integrative model that children thrive on. Art Therapy can help children with sensory issues or deficits “play” with materials in their own way and at their own pace; then develop a system of regulation to participate in artistic expression. Dance and Movement Therapy has been incorporated successfully as well; using the kinesthetic qualities to help children move purposefully and engage socially in sensorial activities. Dr. John Carpente, a music therapist has incorporated the DIR®/Floortime™ Model into his work as well. He states that the therapist’s task is to improvise music built around the child’s responses, reactions, responses, and/or movements to engage him or her in a musical experience that will facilitate (musical) relatedness, communication, socialization, and awareness (Carpente, 2009).

Art Therapy has unique qualities that help the child with Autism. Many children with Autism tend to be visual learners and traditional methods of instruction can often be quite challenging. Therefore, visual art directives and projects are a great way to help children with Autism learn and communicate, as well as interact and function in the world.


Betts, D. J. (2005). The art of art therapy: Drawing individuals out in creative ways. Advocate: Magazine of the Autism Society of America, 26-27.

Carpente, J (2009). The Effectiveness of Nordoff-Robbins Music Therapy within a Developmental, Individual-Differences, Relationship-based (DIR®)/Floortime™ Framework to the Treatment of Children with Autism. Dissertation, Temple University.

Evans, K., & Dubowski, J. (2001). Art Therapy with children on the Autistic Spectrum: Beyond Words. London, UK: Jessica Kingley.

Greenspan, S. and Wieder, S. (1998). The child with special needs. USA: Da Capo Press.

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