The developmental, individual-difference, relationship-based model (DIR), a theoretical and applied framework for comprehensive intervention, examines the functional developmental capacities of children in the context of their unique biologically based processing profile and their family relationships and interactive patterns. As a functional approach, it uses the complex interactions between biology and experience to understand behavior and articulates the developmental capacities that provide the foundation for higher order symbolic thinking and relating. During spontaneous 'floor time' play sessions, adults follow the child's lead utilizing affectively toned interactions through gestures and words to move the child up the symbolic ladder by first establishing a foundation of shared attention, engagement, simple and complex gestures, and problem solving to usher the child into the world of ideas and abstract thinking. This process is illustrated by a case example of a young boy on the autism spectrum interacting with his father during 'floor time' over a 3 year period.
Historically, severe developmental disabilities, including autism, have been approached from the point of view of presenting symptoms as well as the overall syndrome. Although individual practitioners, such as speech pathologists, occupational and physical therapists, and educators have worked with the child's individual capacities, a developmentally based functional approach has not been sufficiently articulated and systematized to guide assessment, intervention, and research efforts. In this article, we describe a dynamic, developmental model that conceptualizes the child's functional emotional developmental capacities, individual differences in sensory processing and modulation, motor planning and sequencing, as well as child/caregiver and family interaction patterns. Because each child with developmental challenges is unique, the functional developmental approach will capture the child's special strengths and challenges, as well as provide a more comprehensive and individualized framework for clinical work with a child and his or her family.
This research is based on a 4‐year longitudinal study of 51 normal, low SES infants and their mothers. It was conducted at the Clinical Infant Development Program sponsored by the Clinical Infant‐Child Development Research Center (NIMH‐HRSA). Infants' free‐play sessions with their mothers were analyzed at 4, 8, 12, 24, and 36 months of age by use of an observation method based on Feuerstein's theory of Mediated Learning Experience (MLE). The participating children were tested with the Bayley Scales (to age 2 years) and the McCarthy Scales (at 36 and 48 months). Ten‐minute observations of motherchild interactions, which used molar criteria of observation based on MLE theory, predicted cognitive performance at 2, 3, and 4 years of age. The observation made at 12 months was most predictive of long‐term cognitive performance. Mother‐infant interaction patterns were less predictive of cognitive performance in infancy than they were of performance at 2, 3, and 4 years of age. Each of the observed MLE criteria increased with age, although the frequency of some of the criteria remained low throughout the study. Stability of all MLE criteria was significant across most comparisons over time.
Symbolic play is a powerful vehicle for supporting emotional development and communication. It embraces all developmental capacities. This article describes how symbols are formed and how emotional themes are symbolized whereby children reveal their understanding of the world, their feelings and relationships, and how they see themselves in the symbols they choose in play. The DIR (Developmental, Individual Difference, Relationship) model provides the framework and context for understanding the unique profiles of all children, including those with autism, and the importance of elevating feelings and impulses to the level of symbolic ideas that support emotional and behavioral regulation. Children need play where interactive relationships with parents and caregivers help them climb the symbolic–emotional ladder, even when development is uneven, as in autism spectrum disorders. Examples illustrate children solving emotional challenges, exploring the range of emotions, developing reality testing, and reaching abstract levels of thought and empathy through symbolic play and conversations unifying emotions and intellect in early childhood development.
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