©David Sponder, Licensed Educational Psychologist
Board Certified Behavior Analyst (BCBA)
DIR/Floortime Intermediate

Observing

Experience will soon tell you that it is wise to go slowly at first and take some time to observe what is going on at the moment with the child.

Take some time to see how alert and aroused he is. We all have moments where we are not very alert or “under-aroused,” and we’re kind of aimless, unmotivated or even spacy. This is in contrast to being excited and alert, and far from being over-excited, anxious and rigid, or wild and disorganized.

“Highly interested” is the ideal state for learning. This is a big reason why we want to work with the child’s affect or lead. “Interest,” “Intention” and “Lead” are fairly synonymous in this way. At best, the child has a strong interest and a well-motivated intention to provide you with a strong, clear lead to join.

Pretend play can be pretty easy to join as it has some sort of a theme that it represents or is associated with. So can play with push-button or simple “cause-effect” toys promote pretty reliable intentions in children. Sensory play can be more difficult to join, especially with a child whose been stuck in that type of play for a long time. Since the point of a lot of sensory play is to produce private feelings of sensation from things like the feel of water or sand, or lining up trains to form a visual tableau for instance, the private nature of sensory play can make it difficult to share. (The same can be true of cause-effect toys since they produce a limited range of very predictable responses and leave little room for creative, novel actions with them. As a matter of fact, a person with autism can turn even stories into sensory objects – repeated with sameness and predictability, and many times just as difficult to join or share or vary).

Pay Attention to Affect [1], Arousal, [2] and Processing First

Optimal states of arousal for Floortime are marked by high interest, fluid and flexible attention, and coordinated motor responses. Floortime techniques exist to bring underaroused children “up” to this state, and to bring over-aroused children “down” to this state. Many of the techniques used come from the field of Occupational Therapy/Sensory Integration.

  • Underaroused children space out and have trouble focusing on any single thing. They tend to appear apathetic, and Therapists often feel that they have to work really hard to get a response. Wanderers tend to be underaroused.
  • Hyperaroused children can be highly impulsive, compulsive, or distracted, and can have trouble controlling shifts in their attention. They can be anxious much of the time. They can be either at the mercy of every passing stimulus – darting between activities and abandoning them quickly, or, they can be riveted to a single stimulus (like a computer game) and have trouble shifting away from it. These children can sometimes be aggressive, and need to slow down.

The goal is to get the child into a state of affect regulation that is optimal for the situation at hand. Generally, the right level is marked by high interest, the ability to engage in long chain, reciprocal communication exchanges with fluid and flexible attention.

Arousal is usually the end result of the mind/body’s response to “input.” Input can be in the form of environment/sensory stimuli, or internal stimuli such as ideas and thoughts. Personal interest and meaning have a lot to do with arousal, and “optimal levels” of arousal have a lot to do with learning and retention.

  • Sensory Input comes from sensory stimuli through the five senses and proprioception. The neurological mechanisms that regulate [3] sensory input can be      biologically immature or poorly coordinated in children with regulatory and developmental disorders such as PDD and ASD.
  • Symbolic Input has to do with thoughts and ideas (mental representations of reality or imagination), and mental associations. Symbolic input can affect changes in arousal and affect states as much as sensory input. Symbolic input can come from internal or external sources.
The Static, Rigid Child

The child that engages in rigid, static play, such as lining up objects or performing the same actions repeatedly can present a challenge to joining and sharing, but they do show clear patterns. This is where spending some time observing can do some real good.

The Floortimer watched as the child took out her cardboard box of railroad tracks and trains. By now, she’d developed an elaborate ritual where she set up the trains in a very particular way. Over time, she began to bring other objects into this routine, setting up dolls and other ornaments around the tracks, again – in a very particular way. She would become very upset if anyone tried to touch or daresay – move any of the objects. For this child, this was more art than play. She was creating a visual tableau that she happened to like very much. She behaved in every way like an artist – trying to achieve that vision she had. Each day was just practice. The point was to get it just right.

She saw any efforts to join this play as a violation of her art. She viewed other people’s efforts to contribute as a nuisance and definitely impolite. This was her masterpiece, and the idea of someone else messing with it was like someone painting a mustache on the Mona Lisa.

One low-risk strategy was to observe and then learn her very clear pattern. She had a pretty well worked-out way in which she took the objects out of the box and set them up. So the Therapist sat between the box and the artist. He knew what she was going to do next, so he made sure to get the next item out of the box and hand it to her as she built her tableau. She looked at him as if someone had finally understood.

Action Melodies
Deciphering Intentions and Anticipating Actions, “I can name that tune in …notes.”

Try to think of actions as melodies. Some melodies have only a few notes that get repeated a lot in the same way. They are easy to learn. Others are complex – like symphonies. They have many interweaving themes and variations. But whether they are simple or complex, behaviors are like melodies in that you can get a good sense of where “they want to go;” their directionality and trends. From observing how events “unfold,” in a narrative way, we get a sense of people’s intentions.

By listening and observing, you can see these directions and get ahead of the action a bit – meeting the child when he gets to the next step. This can create a feeling of familiarity and another type of connectedness between you. You respect it. You don’t march in and take over as if what is important to him isn’t valid. Sometimes, that’s the most you can accomplish at once – but it is a lot. The feelings [maybe for once in the world!] that “You get it!” “You’re not taking over…” “You’re not telling me to stop and do something else…” “I feel OK around you…” can mean that, “You can stay.”

The child probably won’t be able to tell you how much or whether he appreciates your efforts to watch carefully and to try to become attuned to what he’s doing (figure out and acknowledge his intentions). He may not be able to share with you clearly that he appreciates your not intruding or taking over or telling him to stop and do something else. But if he begins to spend more of his energy in the pursuit of his interests – and less mental energy trying to figure out how to defend himself from intruders – YOU and ME, we know that we’re building that foundation of trust that will lead to deeper and more reciprocal engagement soon enough.

Waiting

It takes some confidence in the process to restrain yourself from jumping in there. You can certainly do that with any child that welcomes your engagement. But what we want is to trust; to drop their defenses (because they don’t need them) and become as willing to share his experience as possible.

A common mistake is to come in too fast and too much. You might want to wait until you see a pattern of actions that can help you understand what he likes or he is trying to do or what is going on with him at the moment. You might not want to enter the child’s space until you have something figured out. Logically, the less time you spend appraising the situation before doing anything, the more prone to error your attempts to join will be.

Barring any dangerous possibilities, wait before you join a hyperaroused or disorganized child. See what the hyper-arousal is about. Think about what you want to do next. You want to join the child and show him that you share his feelings of excitement, but to truly support him you don’t allow him to careen into disaster. You might add an element that helps the child regulate – such as playing or singing a song, or asking him to help you move some furniture (sensory input to assist regulation) or putting some object out there that tends to promote focus (avoid TVs, computers, handhelds or other “screens” if you can because these items “pull” for isolation). Sometimes a change of scenery helps. But if you rush in too soon and you either join the excitement too quickly without understanding it – you can push the child over the edge into over-stimulation. If you come in to the situation having not taken time to appraise the situation, your own demeanor can be too subdued to really engage the child. There’s too much of a mismatch, and the child spirals away from you.

It is easy to wait with a hypo- or under-aroused child. Some wander around with almost complete aimlessness, reaching and grabbing for objects that they soon drop and moving in and out of possibly dangerous areas such as hot stoves. This is an extreme, but not that unusual scenario (see Difficult Situations/Wanderers). These children need help finding a coherent pathway through space and an idea that occupies them for more than a few seconds. In this scenario, a challenge for the Floortimer is to find a lead, since the child seems to have difficulty forming intentions (affects). There are techniques useful in a situation like that, such as “Playful Obstruction,” but these are tricky and can backfire by encouraging the child to avoid you further. It is best to wait then to figure out what strategy you’ll use.

 

[1]   An “affect” describes a particular emotional response or “emotional set.” Affects are readily discernible through nonverbal signals such as facial or body expressions and activity levels in most people, including most children with PDDs.

[2] “Arousal” has mainly to do with physiological states ranging from excitement to sleep. Arousal has to do with the autonomic nervous system, which controls heart rate, blood pressure, temperature, breathing, and motor output, etc. These physiological parameters are signs of arousal.

[3] In this sense, “regulate” or “regulation” is interchangeable with “modulation” or “processing.” It has to do with the performance of “gatekeeper” functions such as allowing stimuli in, filtering it or blocking it, integrating or associating it with other input for meaning and memory, and controlling motor responses to it (behavior).