Autism Lifeline

Therapies

Floortime and the DIR Model

DIR/Floortime is a developmental, relationship-based therapy that meets children where they are through play. What it is, evidence, and how to try it at home.

Expert guidance·4 min read·Last reviewed 07/02/2026·Guide to Autism Editorial

Action panel

What can I do today?

Small, doable steps for right now, this week, and when to bring in a professional. Educational only — not individualized medical or behavioral advice.

Step 1

In the next 10 minutes

Pause and take three slow breaths together — regulate yourself first.
Reduce sensory load: lower lights, turn off background noise, offer quiet space.
Drop non-essential demands for the next few minutes. Safety and connection first.
Offer a preferred item or activity, or a familiar comfort routine.
Use fewer words. Try a visual, gesture, or written cue instead of talking through it.

Step 2

This week

Track what happens before, during, and after for 3–5 days (ABC notes).
Look for patterns in sleep, hunger, sensory input, and transitions.
Test one small environmental change (lighting, timing, warning before switches).
Introduce or review a visual schedule for the parts of day that are hardest.
Plan a 15-minute connection time daily, without demands, to fill the tank.

Step 3

Questions to ask a professional

Pediatrician or physician

Could a medical issue (pain, reflux, constipation, sleep apnea, allergies) be contributing?
Are there any recent changes in health, medication, or growth we should investigate?
What screenings or referrals would you recommend at this stage?

BCBA or behavior specialist

What might this behavior be communicating, and what function does the data suggest?
What antecedent changes and replacement skills would you prioritize first?
How will we measure progress, and how often will we review the plan together?

Occupational therapist

What sensory patterns are you seeing, and what supports do you recommend?
Which activities of daily living should we target first, and how?
Are there environmental adjustments we can try at home or school?

Step 4

Helpful printables

DIR/Floortime (Developmental, Individual-differences, Relationship-based) was developed by Dr. Stanley Greenspan. It treats play and emotional connection as the engine of development, not just its reward.

Core idea

Meet the child at their developmental level and follow their lead. If they line up cars, you join the line and gently expand: "Uh oh, my car needs gas!" The goal is to open and close "circles of communication" — back-and-forth exchanges that build shared attention, engagement, and thinking.

Evidence

Smaller than ABA''s evidence base. Several controlled studies (Solomon 2014; Pajareya 2011) show gains in social-emotional functioning and parent-child interaction. Fewer large RCTs.

Doing it at home

Get on the floor, at the child''s eye level
Follow their interest, even if it seems repetitive
Add one small "obstacle" or twist to invite interaction
Aim for many short back-and-forth exchanges rather than teaching a skill

Finding a provider

Look for ICDL-certified Floortime therapists. Many OTs and SLPs incorporate DIR principles even without formal certification.

Sources & further reading

ICDL — DIR/Floortime overview
Solomon R et al. (2014) — PLAY Project Home Consultation randomized trial
Pajareya K, Nopmaneejumruslers K (2011) — DIR/Floortime pilot RCT

Educational content only. For individualized assessment or treatment, please consult a qualified professional.