It is great to see new toys or ways of encouraging my son to develop new skills.
March 28, 2013
Bill Bogaard, the mayor of Pasadena, made an appearance at PCDA's Open House to learn about our programs and services for children with special needs and their families. The mayor (far right) is joined by board member Normand Leduc, Creative Arts Head Melissa St. John, Development Associate Julia Scheibmeir, and Executive Director Dr. Diane Cullinane.
Description of DIR/Floortime and the services offered at Pasadena Child Development Associates.
Watch the video and read the preliminary study report co-authored by Devin Casenhiser, PhD, the keynote speaker from our 2012 DIR®/Floortime Conference: A View From the Floor.
The study evaluates a social-communication-based approach to autism intervention aimed at improving the social interaction skills of children with autism spectrum disorder. We report preliminary results from an ongoing randomized controlled trial of 51 children aged 2 years 0 months to 4 years 11 months. Participants were assigned to either a target treatment or community treatment group. Families in the target treatment group were given 2 hours of therapy and coaching each week in an intervention emphasizing social-interaction and the parent-child relationship. Children in the community treatment group received a variety of services averaging 3.9 hours per week. After 12 months, outcomes were measured to determine changes in the groups in social interaction and communication. In addition, a regression analysis was conducted to determine whether changes in social interaction skills were associated with language development. Results suggest that children in the treatment group made significantly greater gains in social interaction skills in comparison to the community treatment group, but no between-group differences were found for standard language assessments. Initiation of joint attention, involvement, and severity of language delay were found to be significantly associated with improvement of language skills in children with autism. Finally caregiver skills targeted by the intervention were found to be significantly associated with changes in children's interaction skills.
Click here for the complete article in the Sept 26, 2011 issue of Autism. (Adobe Acrobat PDF)
... MAJOR ACCOMPLISHMENTS IN 2011: PCDA worked with over 1,000 children and their families, an increase of 24% from 2010. At the forefront of developing innovative models of care for children with developmental disabilities, PCDA develops evidence based programs for these children and their families. Exemplary programs include: the interdisciplinary feeding program, Augmentative and Alternative Communication Center, Teen Club for teens with high functioning autism and related disabilities that focuses on social skills and pre-vocational skills, Social Skills groups that are play based using DIR/Floortime, sibling support program and a creative arts program that provides adaptive music, art lessons and music therapy.
Additionally, PCDA staff shares their best practices at workshops and conferences for parents and professionals across the country and, this year, in China. PCDA provides professional training opportunities in the following fields: Speech and Language, Occupational Therapy, Music Therapy, Nutrition and Psychology and Counseling.
PCDA also is active in contributing to the child development field through advocacy and policy development at local, state and national levels....
Hello. My name is Daniel Roman and I am nine and a half years old. I live in Glendora, California with my mom and dad. I also have two older sisters who are in college. I am in the fourth grade at Sellers Elementary School. My teacher's name is Mrs. Fallon.
To me diversity means that it's okay to be different. I think I knew what diversity meant long before I ever heard the word. You see I have autism. Having autism has always made me different from other children. I get bothered by loud noises or tags in my clothes that make me itch. It is very hard for me to look at people in the eye, and I don't like it when anything at school or home does not follow the usual routine. I go to a lot of programs to help me learn how to do things that other kids just know how to do automatically like telling jokes.
It was when I was in the second grade that I first noticed I was different from other kids. This is when I started to learn about diversity. At that time I didn't like being different. I thought that no one would ever think I was cool. I just didn't know how to talk to other kids about anything other than American history or Star Wars. I also got teased sometimes because I was different...
Click here for the complete article: Daniel_Reflections_Final_Essay.pdf (Adobe Acrobat PDF)
Autism spectrum disorders are characterised by severe deficits in socialisation, communication, and repetitive or unusual behaviours. Increases over time in the frequency of these disorders (to present rates of about 60 cases per 10,000 children) might be attributable to factors such as new administrative classifications, policy and practice changes, and increased awareness. Surveillance and screening strategies for early identification could enable early treatment and improved outcomes. Autism spectrum disorders are highly genetic and multifactorial, with many risk factors acting together. Genes that affect synaptic maturation are implicated, resulting in neurobiological theories focusing on connectivity and neural effects of gene expression. Several treatments might address core and comorbid symptoms. However, not all treatments have been adequately studied. Improved strategies for early identification with phenotypic characteristics and biological markers (eg, electrophysiological changes) might hopefully improve effectiveness of treatment. Further knowledge about early identification, neurobiology of autism, effective treatments, and the effect of this disorder on families is needed.
Click here for the complete article: Levy-Autism.pdf (Adobe Acrobat PDF)
The Developmental, Individual Difference, Relationship-based (DIR®/FloortimeTM) Model is a framework that helps clinicians, parents and educators conduct a comprehensive assessment and develop an intervention program tailored to the unique challenges and strengths of children with Autism Spectrum Disorders (ASD) and other developmental challenges. The objectives of the DIR®/FloortimeTM Model are to build healthy foundations for social, emotional, and intellectual capacities.
One of the most difficult challenges for parents and therapists is to help children become more flexible eaters. This happens particularly when the children are rigid, stubborn, and narrow in their choices. It is often due to sensory processing differences, where particular tastes and smells may be aversive and lots of controlling behavior has developed to minimize surprises.
The strategy, which is based on the DIR® model, involves harnessing the child's initiative and problem-solving and, if possible, verbal or symbolic mastery. This is done in the context of pleasurable, regulating experiences and the gradual modulation of sensory overreactivity in areas of taste and smell. The strategy involves first establishing shared attention and engagement with the child through Floortime play and then in eating contexts. A critical step is to reduce any anxiety from a history of power struggles around eating and replace it with calm, regulating experiences. Again, this begins simply with regular Floortime sessions where a child is tuned into at his functional level in terms of his sensory profile, with nurturing and follow the child's interest-type interactions. As one takes this now soothing, regulating, pleasurable relationship to the eating situation, one is likely to see increased anxieties and negative behaviors. It's therefore important, once having established pleasurable, soothing interactions in play, to establish this around eating as well. Therefore, begin with foods the child enjoys and tolerates well and don't try to introduce new foods or stretch the child's capacities at the outset.
Click here for the complete article: Greenspan-Eating.pdf (Adobe Acrobat PDF)
The development of social skills, specifically skills in relating to peers, is an important capacity that provides the foundations for life long success. Challenges in the development of social skills impact individual happiness and family function for many children with developmental disabilities, especially those with autism. Indeed, deficits in social behaviors are a major component of the diagnostic criteria for autism. In a survey done at Tri-counties Regional center, parents of children with autism reported that social skills were their number one concern. A study of children with ASD in elementary school showed that children with autism were less accepted and had fewer reciprocal friendships than matched peers at each grade level, and that the deficits increased with advancing age. A detailed review of the theoretical understanding and approaches to social skills intervention is available in the report of The Committee on Educational Interventions for Children with Autism by the National Research Council (NRC). They note: "Interaction with peers is another dimension of children's social development that becomes increasingly important for children..."
Due to the recent budget cuts in California, the 'evidence' to justify public funding for DIR®/FT programs is currently under scrutiny by regional centers in California. This article attempts to summarize the most current research evidence pertaining to the DIR®/FT approach, which will not only provide sufficient basis for a determination that DIR®/FT is evidence-based but will also present an historical view that shows that the field of intervention for children with PDD is shifting from more behavioral approaches towards more developmental models overall.
From Trailer bill: "Evidence-based practice" means a decision making process which integrates the best available scientifically rigorous research, clinical expertise, and individual's characteristics. Evidence-based practice is an approach to treatment rather than a specific treatment. Evidence-based practice promotes the collection, interpretation, integration, and continuous evaluation of valid, important, and applicable individual- or family-reported, clinically-observed, and research-supported evidence. The best available evidence, matched to infant or toddler circumstances and preferences, is applied to ensure the quality of clinical judgments and facilitates the most cost-effective care.
"Evidence-based" has become the gold standard for determining funding. The terms evidence based medicine, treatment, guidelines, practice, models, etc are often used interchangeably. The distinctions are particularly important for the care of children with disabilities and complex medical conditions. Evidence based treatments refer to specific treatments which have been studied on specific and limited populations. These types of treatments are more amenable to study and validation because they limit variables, such as a single diagnosis, and use more easily measured outcomes. Affect, initiative, creativity, warmth, and reciprocity in complex dynamic systems are less often measured. For children with complex conditions, EBTs must be integrated into EB practice. Sackett1 defined evidence based medicine as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients."Click here for the complete article:
The Developmental, Individual Difference, Relationship based approach to helping children with special needs, known as DIR®, was described by Dr. Stanley Greenspan and Serena Wieder beginning in the 1980s. This approach is the culmination of years of observation and study of infants and children, done by many outstanding researchers since the 1950s. Dr. Greenspan and Serena Wieder brought together the knowledge from developmental studies, and mental health research, and recognized the critical importance of relationships and affect to learning. DIR®/Floortime is a framework for understanding child development, a philosophy that emphasizes the critical importance of relationships and affect, and a set of treatment strategies built upon those principles. DIR® is a broad and comprehensive approach which encompasses all disciplines that work with children.
... The objectives of the DIR/Floortime Model are to build the healthy foundations necessary for a child to develop social, emotional, and intellectual capacities. As stressed in the general literature that promotes healthy emotional and social development, two of the key elements to building these foundations are: spontaneous communication between children and their caregivers and nurturing relationships, that promote joyful and pleasant engagement. These two elements are basic components of the DIR/Floortime Model. Importantly, the National Research Council of the National Academy of Sciences, in their 2001 landmark report, Educating Children with Autism, called for tailoring the treatment approach to unique features of the individual child and recommended to give priority to interventions that promote functional, spontaneous communication...
Centers for Disease Control and Prevention (CDC) and the Interdisciplinary Council on Developmental and Learning Disorders (ICDL) Collaboration Report on a Framework for Early Identification and Preventive Intervention of Emotional and Developmental Challenges
Click for an Adobe Acrobat PDF version of the complete article: CDC-ICDLCollaborationReport.pdf
Dr. Barry Prizant is the Director of Childhood Communication Services and an adjunct professor in the Center for the Study of Human Development, Brown University. Barry has more than 35 years of experience as a researcher and international consultant to children and adults with ASD. He has published more than 90 articles and chapters on childhood communication disorders and has given more than 500 seminars and workshops at national and international conferences. He also serves on the Editorial Boards of six scholarly journals. Barry is a co-author of the SCERTS Model (Prizant, Wetherby, Rubin, Laurent & Rydell, 2006 - www.SCERTS.com). In 2005, Barry received the Princeton University-Eden Foundation Career Award "for improving the quality of life for individuals with autism".