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Pediatric Occupational, Physical, ABA/Behavioral, Feeding, Speech and Language Therapies 1445 East 10th Street Cookeville, TN 38501 Phone: (931) 372-2567 Please call today to get started! Fax: (931) 372-2572 Email: [email protected] Most insurances accepted!     |
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Floor Time Model |
The "Greenspan" Floor Time Model 1. Goals of Floor Time Intervention 2. Glossary of Floor Time Terms Closing the Circle: Allowing the child to close the circle when child brings your extensions and expansions to a close. Emotional Thinking: The child leans to elaborate fantasies and to make connections between different ideas. (3 to 5 years) Engagement: Babies coo, smile, gesture and exchange motor movements with their partners. (0 to 8 months) Extending and Expanding the Drama: Tuning in to the child's imagination and ideas and taking them one step further through gestures and words. Floor Time: A warm and intimate way of relating to a child. A floor time philosophy means engaging, respecting and getting in tune with the child in order to help the child elaborate through gestures, words, and pretend play what is on the child's mind. As a technique, floor time is a five step process that is used to support the emotional and social development of the child. Following the Child's Lead: Seeing the child as the director and yourself as the assistant director of the activity. Observing: Noticing how the child is special and unique in style, rhythm and mood. Opening the Circle of Communication: Turning in and following a child's special interest. Shared Meanings: The child begins to communicate ideas with words or pretend play. Emotional themes enter the child's play. The child uses themes not only to express wants and needs but also to expand fantasies and creativity. (18 month to 36 months) Stages of Relating: Stages in emotional and social development of children. Two-Way Communication: The child is able to have an emotional dialogue. Opening and closing circles can take place. You need to take an interest in and respond to the child, and the child responds with gestural and verbal reactions. (6 to 18 months) 3. Greenspan's Model of Stages of Relating and Communicating Stage 1: ENGAGEMENT (Birth to 8 months) Stage 2: TWO-WAY COMMUNICATION (6 to 18 months) Stage 3: SHARED MEANINGS (18 to 36 months) Stage 4: EMOTIONAL THINKING (3 to 5 years) Does the child help to structure and organize play themes? 4. Specific Goal Behaviors and Strategies to Attain Them Goal Behavior for child to become more: Floor Time Activities: alert & aware notice something is different discriminating visual, auditory and other sensory information recognizing that they are facing an obstacle identifying the problem, etc. initiative taking encourage to be less passive in environment do not allow process to proceed in more or less automatic way assist child to become more critical and ready to take action to help self it is critical to "wait" to give child chance to recognize problem and realize they must be ones to start doing something about it flexible create small changes and problems to help child notice, initiate and tolerate changes help child to learn to cope with by solving problems and taking in more information able to sequence longer and more complex actions and communications Have experiences which require taking as many steps as possible to solve the problem at hand and to communicate: who wants the problem solved what they want solved when they want it solved where they want it solved why they want it solved how it can be solved through actions, gestures and words able to mediate more ways to solve problems guide child through the process of solving problems do not tell or show how to do a skill (e.g., Where should we look?, Did you check all the sides? Is there a tab? Let's try pulling. Does it work? Is it stuck? Do you need a tool? 5. Five Steps in Floor Time Step One: OBSERVATION Both listening to and watching a child are essential for effective observation. Facial expressions, tone of voice, gestures, body posture, and word (or lack of words) are all important clues that help you determine how to approach the child, e.g.: Step Two: APPROACH - OPEN CIRCLES OF COMMUNICATION Once a child's mood and style have been assessed, you can approach the child with the appropriate words and gestures. You can open the circle of communication with a child by acknowledging the child's emotional tone, then elaborating and building on whatever interests the child at the moment. Step Three: FOLLOW THE CHILD'S LEAD After your initial approach, following a child's lead simply means being a supportive play partner who is an "assistant" to the child and allows the child to set the tone, direct the action, and create personal dramas. This enhances the child's self-esteem and ability to be assertive, and gives child a feeling that "I can have an impact on the world." As you support the child's play, the child benefits from experiencing a sense of warmth, connectedness and being understood. Step Four: EXTEND AND EXPAND PLAY As you follow the child's lead, extending and expanding a child's play themes involves making supportive comments about the child's play without being intrusive. This helps the child express own ideas and defines the direction of the drama. Next, asking questions to stimulate creative thinking can keep the drama going, while helping the child clarify the emotional themes involved, e.g.: suppose a child is crashing a car: Rather than ask critically, Why are those cars crashing? You may respond empathetically, Those cars have so much energy and are moving fast. Are they trying to get somewhere? Step Five: CHILD CLOSES THE CIRCLE OF COMMUNICATION As you open the circle of communication when you approach the child, the child closes the circle when the child builds on your comments and gestures with comments and gestures of own. One circle flows into another, and many circles may be opened and closed in quick succession as you interact with the child. By building on each other's ideas and gestures, the child begins to appreciate and understand the value of two way communication. 6. Strategies for Floor Time Intervention 7. Questions to Ask Yourself if You Are a Good Floor Timer 
1. Goals of Floor Time Intervention 2. Glossary of Floor Time Terms 3. Greenspan's Model of Stages of Relating and Communicating 4. Specific Goal Behaviors and Strategies to Attain Them 6. Strategies for Floor Time Intervention 7. Questions to Ask Yourself if You Are a Good Floor Timer 8. Props Needed for Floor Time 11. Creating and Expanding Ideas 12. CONSTRUCTIVE OBSTRUCTION to Extend Problem Solving 13. Opportunities for Doing Floor Time with Child 14. Home Based Opportunities for Floor Time 15. Turning Every Day Activity into Problem Solving for Child 16. Strategies for Engagement and Two-way Communication 17. Strategies for Helping Child Build Symbolic World 18. Strategies to Develop Abstract Thinking 19. Strategies to Develop Motor Planning Abilities 20. Strategies to Address Processing Difficulties 21. Developmental Stages of Greenspan's Functional Emotional Assessment Scale (FEAS) 22. Structural and Thematic Characteristics of Greenspan's FEAS Developmental Stages 23. Greenspan's FEAS Levels of Functioning and Corresponding Floor Time Strategy 24. READING LIST and ONLINE RESOURCES on Floor Time
To help the child: become more alert take more initiative become more flexible tolerate frustration sequence longer actions - plan and execute them mediate process of finding solutions communicate gesturally and verbally take pleasure in learning Does the baby smile joyfully in response to vocalization and facial expression? What are the kinds of gestures the baby uses to elicit responses? How does the baby use senses such as hearing, sight, and touch to form attachments? Is child beginning to exchange motor movements? How would you describe baby's temperament (stable, intense, irritable, unresponsive, assertive)? What evidence is there that the child is reciprocating and copying your behaviors and emotions? Does the child begin to instigate activities based on own needs and wants, rather than by imitation alone? How? Provide examples of how the child combines gestures and words to communicate. What evidence is there that the child is beginning to understand basic emotional themes, such as whether child is being approved of, is safe and secure, or is being admired? Provide examples of how the child is beginning to communicate ideas through words. How does the child use pretend play to communicate emotional themes such as curiosity, independence and rejection? Describe ways in which child makes wants, desires, and emotions know through pretend play. Describe how pretend play becomes more complex. How are feelings expressed? What evidence do you have the child realizes the relationship between feeling, behaviors, and consequences? How would you describe the child's relationship with adults? How does the child control impulses and stabilize moods? How does the child interact with peers in pretend play?
is a child's behavior relaxed or outgoing? withdrawn or uncommunicative? bubbling with excitement? is child a real go-getter. follow child's lead and join them - it does not matter what they do as long as they initiate the move persist in your pursuit treat what child does as intentional and purposeful - give new meanings help child do what they want to do position self in front of the child invest in whatever child initiates or imitates join perseverative play do not treat avoidance or "no"as rejection expand, expand, expand - keep going, play dumb, do wrong moves, do as told, interfere etc. do not interrupt or change the subject as long as it is interactive insist on a response do not turn the session into a learning or teaching experience
Do I use a calm voice?
Do I give gentle looks?
Is my body posture supportive?
Arm my actions non-intrusive?
Do I use encouraging gestures?
Do I demonstrate calm and supportive listening?
Am I aware of the child's rhythms and gestures?
Am I able to help the child identify play themes?
Do I expand and extend the child's drama by staying involved with the play theme and help to elaborate the details?
Am I able to help the child extend the drama by summarizing main ideas of play themes?
Do I observe the behavior, language, and gestures of the child?
Do I observe the child's style of relating?
Do I approach the child slowly, with respect and thoughtfulness?
How often do I allow the child to take the lead? Do I follow that lead?
Do I let the child know through gesture, facial expressions, emotional tone, and supportive body posture that I am there for the child?
Do I know when to be verbally responsive, and when it is better to quietly share a child's emotion?
Do I work to understand the emotional needs of the child?
8. Props Needed for Floor Time
Food:
plastic vegetables and fruits etc.
plastic foods: chicken, hot dogs, eggs, bacon, french fries etc.
plastic dishes, cups, forks, knives and spoons
plastic or paper soup cans and boxes of foods
plastic cooking utensils, pots, mixer, toaster etc.
play kitchen with table and chairs
Transportation:
minimum of 12 match box size cars, trucks etc
tool kit to fix cars, e.g.: screwdriver, wrench, pliers, etc.
garage
road signs, play road
road construction equipment
other forms of public transportation: airplane, boat, bus, train
Empathy and Nurturing of others:
minimum of two dolls, one boy and one girl
minimum of two bottles
plastic figures of a family whose sex and number of members matches the child=s family
plastic figures of helpers in the community: doctor, nurse, fireman, construction person, police
doctors kit to help dolls
tool kit to fix objects owned by dolls
doll house for plastic family
blankets and clothes for dolls
play bath equipment for dolls
play crib or bed for dolls
Fantasy Play:
plastic animals from the jungle, zoo, water and farm
plastic dinosaurs
Fisher Price or
Communications:
set of two telephones
chalk or white board on easel
books on a variety of topics which are age appropriate
word signs around the room
display of letters of alphabet and numbers 1 to 10 in room
school desk for dolls or child to go to school
Aggression Fantasy:
toy soldier set with military transportation (e.g.: tanks, helicopter, boat, and armored trucks) guns, tents, etc.
cowboy and Indian set with horses, tents, wagons, guns, bows and arrows etc
Construction Play:
wooden block set
plastic block set
tool kit for construction e.g.: saw, hammer, screwdriver etc.
construction equipment: truck, earth mover, etc.
Art Play:
crayons and paper
watercolor tempera paints, brush and paper
finger paints and finger paint paper
clay or Play Dough for sculpting
Outdoor Play:
sand box, pails, shovels and other sand containers
water play table
gym set with slide, swings and ladder
rubber football and/or baseballs to throw and catch
rubber soccer ball and/or basketball to kick
Constructive Obstruction Props:
soap bubbles to be blown on child while playing with other props to create need to be flexible and attend to distraction in a coping way
balloon or light ball to bounce on the drama which is occurring to create crisis
blanket to hide the desired objects under
rubber bands, to fix or bind things together
tape, to fix or bind things together
bunch of nerf balls to throw to create obstacle which needs to be attended to
Prop Storage: keep theme related props in "shoe box" size transparent plastic containers with covers so child can see inside and select theme to play with. This will make it easier to keep play room orderly and neat when floor time is ended. Enlist child to assist you in putting props in their respective containers.
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9. Opening the Symbolic Door
10. Follow the Child's Lead
11. Creating and Expanding Ideas
12. CONSTRUCTIVE OBSTRUCTION to Extend Problem Solving
Remember: goal is not to frustrate child but to mobilize child's thinking and acting in face of something which matters personally to the child. 13. Opportunities for Doing Floor Time with Child To assist child to solve problems and handle changes identify opportunities in the child's daily life which present a "stage" for problem solving and change accepting "dramas" Brainstorm how you could utilize the following opportunities:
14. Home Based Opportunities for Floor Time
15. Turning Every Day Activity into Problem Solving for Child
16. Strategies for Engagement and Two-way Communication
17. Strategies for Helping Child Build Symbolic World
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Encourage role playing with dress-up props, use puppets - child may prefer to be the actor before using symbolic figures
Use specific set of figures/dolls to represent family members and identify other figures with familiar names
Give symbolic meaning to objects as you play:
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When child climbs to top of the sofa, pretend child is climbing a tall mountain
When child slides down the slide at the playground, pretend the child is sliding into the ocean and watch out for the fish
Substitute one object for another when props are needed. Pretend that the ball is a cake or the spoon is a birthday candle.
Resume use of gestures for props along with toy objects and substitutes
As you play, help child elaborate on personal intentions.
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Ask who is driving the car,
where the car is going,
whether child has enough money,
did child remember the keys to the car,
why is child going there,
why not somewhere else, etc.
Expand as long as you can. (Use all of the Who, What, Where, Why, When questions, and keep them open ended)
Make use of breakdowns.
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When a problem crops up during play, create symbolic solutions.
Get the doctor kit when the doll falls so child can help the hurt doll, tool kit for broken car etc.
Acknowledge child's disappointment and encourage empathy.
Get involved in the drama.
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Be a player and take on a role with your figure.
Talk directly to the dolls rather than questioning child about what is happening or narrating
Both help the child and be your own player.
Talk as an ally (perhaps whispering), but also have your figure oppose or challenge child's ideas.
Insert obstacles into the play. (e.g.: make your bus block the road. Then speaking as a character, challenge child to respond. If necessary, get increasingly urgent (whispering to child to encourage to deal with the problem, offer help if needed by becoming an ally).
Use symbolic figures child knows and loves, such as Barney, Disney or
Use play to help child understand and master ideas/themes which may have been frightening. Work on fantasy and reality.
Let child be the director. Child's play need not be realistic (child may still be a magical thinker) but encourage logical thinking.
Focus on process as you play; which character to be, what props are needed when ideas have changed, what the problem is, when to end the idea, etc. Identify the beginning, middle and end.
As you play, match your tone of voice to the situation. Pretend to cry when character is hurt, cheer loudly when your character is happy, speak in rough or spooky tones when you are playing the bad guy. Remember, drama, drama, drama to give child affect cues.
Reflect on the ideas and feelings in the story both while playing and later on as you would with other real life experiences
Discuss child's abstract themes such as good guy/bad guy, separation/loss, and various emotions such as closeness, fear, jealousy, anger, bossy, competition, etc.
Remember symbolic play and conversation is the safe way to practice, reenact, understand and master the full range of emotional ideas and experiences.
18. Strategies to Develop Abstract Thinking
Follow child's lead, build on child's ideas
Challenge child to create new ideas in pretend play
Heighten affect and engagement
Practice and expand rapid back and forth interactions and conversations (gesturally and verbally)
Carry on logical conversations all the time (e.g.: while driving, at meals, during baths etc.) Content does not have to be realistic
Encourage understanding of fantasy-reality:
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child will use toys as real objects for self as if real (e.g.: puts feet in play pool, tries to go down toy slide, tries on doll clothes, etc.)
child may prefer to start with role play and puppets
child will use toys in pretend fashion
child will use symbolic solutions for problems and fears
child will find safety to experiment with themes of aggression and power
Recognize fears and avoidance of certain feelings, themes and characters.
During play and conversations get beginning, middle and end of story or idea - identify problem to be solved, motives and feelings - accept all feelings and encourage empathy
Select books to read that have themes, motives and problems to solve - discuss alternative outcomes, feelings
Encourage abstract thinking:
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ask why questions
ask for opinions
compare and contrast different points of view
reflect on feelings - come back to experiences again later
don't ask questions you know the answer to
don't tell child which dimensions to use
Use visualization - picture yourself
avoid rote, fragmented, academic questions
Be creative
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if child puts foot in pretend pool, ask if it's cold.
if child is thirsty, offer an empty cup or invite child to a tea party
if child is hungry, open toy refrigerator and offer some food, pretend to cook, or ask if child will go to pretend market with you to get things to eat.
if child want to leave, give pretend keys or a toy car
if child lies down on the floor or couch, get a blanket or pillow, turn off the lights, and sing a lullaby.
Encourage role playing with dress-up props, use puppets - child may prefer to be the actor before the child uses symbolic figures.
Use a specific set of figures/dolls to represent family members and identify other figures with familiar names.
Get involved in the drama. Be a player and take on a role with your own figure. Talk directly to the dolls rather than questioning child about what is happening or narrating.
19. Strategies to Develop Motor Planning Abilities
Encourage "undoing"
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move object in line
cover desired object
put puzzle piece in wrong place
bury desired object(s) under other toys and very different objects
hide desired object from the place where child last put it etc.
Provide destinations for actions - treat as intentional and symbolic
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child throws - catch it in basket
child holds figure (little person, animal) -bring over toy slide, school bus, food (if child does not use spontaneously, ask if the figure would like to... give choices if needed...ask figure directly...try not to direct)
child taps - bring over drums (can be plate, plastic toy, sticks etc)
child rolls car - bring over garage, crash into it, block with figure
child reaches for hand - play give me five, variations, dance
Create problems to solve - require multiple steps
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put desired objects in boxes to open, untie, remove tape or rubber band
pretend object needs to be fixed using tools, tape, rubber bands, Band-Aids (symbolic)
create obstacles to child getting around or mor or restore to correct position
hold book to read upside down and/or backwards
offer pens/markers which do not work
sit in child's special place
get to where the child is running first
hide object child desires in one hand or the other so that the child can choose
when child seeks your hand instead of using own hand, put your hands on your head or in your pocket
put socks on child's hands instead of feet
give child your shoes to put on
make desired toy/object a moving target (move from place to place)
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move expected objects (change drawer content, change content in baskets)
rearrange furniture and create problems (child find chair upside down, or is told to sit down when chair is across the room)
hang up pictures from magazines at eye level and change frequently
Encourage child to initiate/continue action
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Ready, set, Go!
put toy which child was using back in child's hand. (Oh, you dropped, forgot)
provide cues - uh oh, knock, knock, help
use indirect prompts (call the figures to come, where are you?)
bring over next step (puppet to eat pretend food, mirror to see the hat etc.)
trade objects, positions etc.
Deal with consequences of actions symbolically
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baby doll fall (is dropped) - Uh oh! He's crying. Are you hurt? Get a bandage. Go to the doctor. Call an ambulance...
car crashes - Oh no, it's broken! Can you fix it mechanic?
Basket is dropped - What a mess! What do we do now?
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Plan your idea - discuss what child will need for their idea
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get toys/props child will need
identify setting and destinations
while playing identify problems and sequence of solutions
identify beginning, middle and end
challenge, reason, negotiate
Play interactive song-hand games
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Itsy bitsy spider
one potato two potato
slap my hand
sailor went to sea, sea, sea etc.
Play Treasure Hunt and use maps (use visual and verbal cues)
Play games
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social playground/party games
board games (cognitively challenging)
cooking
drama
arts and craft activities
Encourage athletic activities
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individual sports e.g. tennis, roller skating, shooting baskets, ice skating etc
group sports e.g. soccer, baseball, basketball etc
gymnastics
Tae Kwon Do
20. Strategies to Address Processing Difficulties
| Child's Actions | Adult's Solutions |
| Avoids, moves away | Persist in your pursuit Treat as intentional Provide visual cues Playfully obstruct Attract with "magic" Insist on a response |
| Stays stuck, does not know what to do next | Provide destination Return object of interest Use object in some way Expand, expand Give new meanings Use ritualized cues to start ("ready, set, go") |
| Uses scripts | Join in Offer alternative scripts Change direction of script |
| Perseverates | Ask for turn, join, imitate, help Make interactive Ask "how many" more times Set up "special" time |
| Protests | Act sorry, play dumb, restore, blame figure |
| Rejects, refuses | Provide more things to say "no" to Expand, give other choices or time |
| Says something unrelated | Insist on a response Notice change or bring closure |
| Becomes anxious or fearful | Reassure Problem solve Use symbolic solutions |
| Acts out, pushes, hits | Provide affective cue ("Uh, uh, uh"; "No, no, no") to encourage self-regulation Set limits. Reward for absence of negative behaviors |
21. Developmental Stages of Greenspan's Functional Emotional Assessment Scale (FEAS)
Regulation and Interest in the World (by 3 months)
Forming Relationships and Attachments (by 5 months)
Intentional Two-Way Communication (by 9 months)
Complex sense of Self I: Behavioral Organization (by 13 months)
Complex sense of Self II: Behavioral Elaboration (by 18 months)
Emotional Ideas I: Representational Capacity (by 24 months)
Emotional Ideas II: Representational Elaboration (by 30 months)
Emotional Thinking I: (by 36 months)
Emotional Thinking II: (by 42-48 months)
22. Structural and Thematic Characteristics of Greenspan's FEAS Developmental Stages
| Stages of Development | Organizing Fantasies and Themes |
| Regulation and Interest in the World | Omnipotent control; being overwhelmed; falling apart |
| Engagement and Relating | Isolation; emptiness; inanimate objects; unconditional love |
| Intentional Communication | Part object pleasures or fears; chaotic, fragmented interactions |
| Complex sense of self | Narcissistic self-absorption; grandiosity; suspiciousness; somatization; global self deprecation |
| Emotional Ideas | Neediness, being taken care of and/or fear of separation and/or danger |
| Emotional Thinking | Power; being admired; respected; shame; humiliation; loss of love; injury or harm to self or others |
23. Greenspan's FEAS Levels of Functioning and Corresponding Floor Time Strategy
| Developmental Level | Child's Skills Needed | Floor Time Strategy |
| Regulation and Interest in the World (by 3 months) | Sense of protection, care and encouraged engagement in world | Provide one on one ping ponging and cuddling to set a pattern that is predictable and comforting |
| Forming Relationships and attachment (by 5 months) | Rich investment in human world; woos and is wooed | Provide secure relationship which evolves into an attachment that survives negative feelings |
| Intentional Two-Way Communication (by 9 months) | Reads and responds contingently to range of affective and behavioral cues | Provide experiences which help develop capacity to facilitate empathic reading of the "other" |
| Complex Sense of Self: Behavioral Organization & Behavioral Elaboration (9-18 months) | Secure availability to others while admiring and supporting greater behavioral organization, initiative and originality | Provide experiences which encourage self-observing capacity and permits integration of affective opposites around dependency, aggression, passivity and assertiveness. |
| Emotional Ideas: Representational capacity and elaboration (18-30 months) | Using evolving, representational (symbolic) capacities across a wide thematic and affective range | Provide experiences which work at the use and elaboration of fantasy and pretend play |
| Emotional Thinking: Representation, Differentiation and Consolidation (24-48 months) | Using of representational capacity and reality orientation | Provide experiences to shift between fantasy and reality and integrate wide range of affective and thematic issues |
24. READING LIST and ONLINE RESOURCES on Floor Time
ONLINE RESOURCES:
For more information about Floor Time and other Greenspan Early Intervention concepts contact:
Stanley Greenspan's Homepage: http://www.stanleygreenspan.com/
The Interdisciplinary Council on Developmental and Learning Disorders at http://www.icdl.com or contact them at: The Interdisciplinary Council on Developmental & Learning Disorders,
Greenspan's Floor Time Related Books:
THE CHILD WITH SPECIAL NEEDS: ENCOURAGING INTELLECTUAL AND EMOTIONAL GROWTH.
INFANCY AND EARLY CHILDHOOD - THE PRACTICE OF CLINICAL ASSESSMENT AND INTERVENTION WITH EMOTIONAL AND DEVELOPMENTAL CHALLENGES, Stanley I. Greenspan, M.D., International Universities Press, Inc.(1997, 3rd Printing Madison, WI). The comprehensive coverage of the whole range of Behavioral, Sensory Spectrum Disorders which is addressed to clinicians. The FEAS scales used in this program were developed from material contained in this book.
Other books by
THE CHALLENGING CHILD - UNDERSTANDING, RAISING, AND ENJOYING THE FIVE "DIFFICULT" TYPES OF CHILDREN. Addison Wesley (1995,
THE CLINICAL INTERVIEW OF THE CHILD. Co-authored with: Nancy Thorndike Greenspan, American Psychiatric Press, Inc. (1991,
DEVELOPMENTALLY BASED PSYCHOTHERAPY. International Universities Press, Inc. (1997,
FIRST FEELINGS - MILESTONES IN THE EMOTIONAL DEVELOPMENT OF YOUR BABY AND CHILD. Co-authored with Nancy Thorndike Greenspan, Penguin Books, (1985, NY).
THE GROWTH OF THE MIND - AND THE ENDANGERED ORIGINS Of INTELLIGENCE. Addison Wesley (1997,
Floor time film with Greenspan:
FLOOR TIME - TUNING IN TO EACH CHILD. Scholastic Inc, NY, 1990. Contact at Toll Free Number: 1.800.325.6149
If you want to get copies of the above material please contact Dr. Stanley Greenspan through www.stanleygreenspan.com only, please do not contact this site.
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