Floortime Play Therapy for Autism Kids

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Kids with Autism exhibit different types of difficulties with social language (e.g, eye contact, turn-taking) and communication skills. They present with very limited interests or heightened focus on specific items or topics.

Floor time play (FTP) is a type of intervention that is being utilized for children who are on the spectrum by addressing specific areas of weakness. However, there are very few studies that look at it’s effectiveness for these children. 

Why Was it Created?

Autism is becoming an ever increasing diagnosis for children ages three and older. According to the National Institute of Mental Health (2008), 3.4 per 1,000 children aged 3–10 years are affected by this disorder.

Due to the nature of the disorder, intervention with these children should include:

A therapeutic approach based on the child’s uniqueness rather than follow a standard program designed for all children with the same diagnosis.

Greenspan & Wieder, 1998, p. 2

Although researchers  have all determined that early intervention of these kids is beneficial, there hasn’t been one research study as to the effectiveness of one approach over another.

The goal of behavioural-based approaches is to encourage appropriate behaviours through their reinforcement and ignore behaviours that can limit the functional independence of the child.

Applied behavioural analysis (ABA) is one such approach in which basic and complex skills are taught using discrete trial teaching. Skills are broken down into small steps and each step is taught, using prompting and positive reinforcement, until it is mastered before going on to the next step of the skill (Harris & Delmolino, 2002).

Although ABA is a very popular means to perform therapy on children who are on the spectrum, it has been met with some criticism.

Critics claim that within behavioural approaches, communication and interaction occur in a structured artificial environment; instead, the child should be interacting and communicating in a logical, intentional, and creative manner in a more natural environment (Greenspan et al., 2001; Greenspan & Wieder, 1998).

This is why floortime play therapy (FTP) has been introduced. 

Six Key Milestones to Floortime Play Therapy

The goal of floortime play therapy is for adults to help children expand their “circles of communication.” They meet the child at their developmental level and build on their strengths.

The FTP approach is of particular interest to occupational therapists as it takes place in the participant’s environment, centering on the child’s occupations, such as play or activities of daily living, such as brushing their teeth, getting dressed or using the bathroom

Floortime aims to help the child reach six key milestones that contribute to emotional and intellectual growth:

  • Self-regulation and interest in the world
  • Intimacy, or engagement in relationships
  • Two-way communication
  • Complex communication
  • Emotional ideas
  • Emotional thinking

Floortime does not work on speech, motor or cognitive skills in isolation. It addresses these areas through its focus on emotional development.

Overall, this method encourages children with autism to push themselves to their full potential. It develops “who they are,” rather than “what their diagnosis says” (Autism Speaks). 

How Does Floortime Therapy Work?

Floortime takes place in a calm environment. This can be at home or in a professional setting. Therapy sessions range from two to five hours a day, which can be alot and overwhelming for your child, at first. They include training for parents and caregivers, as well as interaction with the child.

During a session, the parent or provider joins in the child’s activities and follows the child’s lead. The parent or provider then engages the child in increasingly complex interactions.

Floortime encourages inclusion with typically developing peers when used in a preschool setting. Typically, the therapist will perform services in school so that your child learns to carry over activities into all settings.

Sessions emphasize back-and-forth play. This builds the foundation for shared attention, engagement and problem solving. Parents and therapists help the child maintain focus to sharpen interactions and abstract, logical thinking.

How to Get Started with Floortime Play?

  1. Videotape your first session.
  2. Set a timer for 20 minutes.
  3. Find a place where you and your child are comfortable.
  4. Observe what your child is doing and then join in.
  5. Be patient.

Who Provides Floor Time Services?

There are several different types of professionals who will work on FTP. These people may include:

  1. Occupational Therapist
  2. Speech Therapist
  3. Child Psychologist
  4. Special Education teachers

Is Floortime Covered by Insurance? 

Sometimes. Many types of private health insurance are required to cover services for autism. This depends on what kind of insurance you have and what state you live in.

All Medicaid plans must cover treatments that are medically necessary for children under the age of 21. If a doctor recommends Floortime and says it is medically necessary for your child, Medicaid must cover the cost. Also, if your child has a diagnosis of Autism (in the state of NJ), most insurance companies will cover treatment no matter what that treatment may entail (Autism Speaks).

Some young children receive Floortime through their Early Intervention program. Early intervention is offered in each state to children under age 3 who are not growing and developing at the same rate as others. These services are free or low-cost based on your family income. I’d recommend checking out your state/health insurance for specific information. 

If this is a type of therapy that you are interested in for your child, I would get some referrals from your pediatrician and start making some phone calls. Shop around, visit the location and meet the therapist to see if it’s a good fit for you and your child. 

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