DIRFloortime Glossary of Terms

Adaptive Response: An appropriate action in which the individual responds successfully to some environmental demand. Adaptive responses require good sensory integration, and further the sensory integrative process.

Affect: Emotion, intent, or desire. “Raise the level of affect” refers to bringing the individual into greater enjoyment or heightened pleasure. The brain imprints things more efficiently when those things occur at “high affect.”

Affect also refers to emotional messaging. The use of facial expressions, gestures, body language and tone of voice to express ideas and emotions. In this instance, it is important that the ‘affect’ is sincere expression of emotional experience rather than ‘acting’ or ‘clowning’.

Agency: A sense of agency refers to the individual’s awareness of his/her own potential to initiate and create change in his/her own world and in the world of others.

Attachment: The way an individual habitually relates with other people, based on the deeply embedded patterns of connection experienced with primary caregivers in infancy and early childhood and the way these patterns were, or were not, ‘made sense of’. Ideally all individuals experience safe, attuned and nurturing relationships and attachment is secure.

Attunement: Being able to ‘tune into’ and understand an individual’s own experience of the world and hold it as separate to one’s own experience. The ability to identify and respond to the sensory and emotional experience of another person.

Auditory Processing: The capacities involved in processing and interpreting auditory information, or what the brain does with what we hear. These capacities can include the ability to pay attention to the spoken word (e.g., to pick out a person’s voice from background noise), the ability to hear differences in sounds (e.g., “pat” vs. “pack”), the ability to remember what is heard, and the ability to comprehend what is heard (e.g., understand grammar).

Auditory: This sensory system provides information about sounds in the environment as well as our own voices (via bone conduction) and some interoceptive sounds (see ‘interoception’ below).

Body image: A person’s perception of his/her own body. It consists of sensory images or “maps” of the body stored, and constantly updated, in the brain. May also be called ‘body scheme’ or ‘body percept’.

Circle of Communication: A completed cycle of response between two people, where the learner opens or initiates the communication, receives a response, and closes the communication contingently (see below). Circles of communication require and promote awareness of the learner’s own actions (cause and effect), and therefore facilitate development of intent.
The caregiver’s role is to be aware of the learner’s sense of self and interests by following their lead, and then expanding, through use of gestures, visual contact, and/or verbalizations (i.e., child reaches, parent looks back at the child, child smiles or vocalizes, and a circle is completed).
Sustaining multiple circles leads to a foundation for other learning and development.

Communicative Intent: Any signal (message) that is expressed by the learner to indicate a need, want or desire. This can be with or without eye contact, proximity/distance, gestures, words or other vocalizations, facial expressions, sign language, or AAC.
At the early stages of a DIR program, a caregiver often ‘ascribes intent’ through attuning to microexpressions and indications of interest or disinterest. By ascribing communicative intent to these gestures, movements or expressions and acting on them, a learner can develop understanding of social ‘cause and effect’ and begin to open circles of communication.

Contingency: A contingent response is when the quality, intensity, and timing of the other’s signals clearly reflects the signals that we have sent.

Coping Strategies: A person’s ability to stay regulated while adapting to changing or new situations, environments, etc., or his/her ability to use coping strategies during challenging situations (e.g., does he fall apart under stress or do adapt and cope?).

Developmental Capacity: The functional ability of an individual to achieve developmental milestones can be measured throughout domains – for example, sensory motor, expressive language, visual perceptual, etc. DIRFloortime particularly focuses on those capacities related to a person’s ability to stay engaged, express mutual pleasure and attention, and to engage in complex problem solving and symbolic play. These are referred to as Functional Emotional Developmental Capacities. The concept of ‘developmental capacity’ in the DIRFloortime model is somewhat more fluid and non-linear concept than ‘traditional skill attainment’ is in other models.

DIR: The Developmental, Individual differences, Relationship-based model of human development developed by Stanley Greenspan, M.D. and Serena Wieder, PhD. It is often described as a paradigm or lens through which one sees and interprets the world, relationships and development. See www.icdl.com for more information.

Special Note on Pronunciation: "DIR" is an initialism form of an acronym meaning that each letter is stated rather than pronouncing it as a word.  So, "DIR" is pronounced "D" "I" "R".  Likewise, DIRFloortime is pronounced “D.I.R. Floortime.”

DIRFloortime: A warm and intimate way of relating to a person. A Floortime approach involves engaging, respecting, and attuning to the person while encouraging the person to elaborate his/her ideas through gestures, words, and pretend play. For a definition of formal ‘Floortime’ see below.  

Dyspraxia: Difficulty in planning, sequencing, and carrying out unfamiliar actions in a skillful manner.

Dysregulation: The state of being unavailable for engagement and interaction, either by  being over- or under-aroused, physically and emotionally.

Echolalia: Echolalia is the use of remembered whole phrases or sentences for communication. Previously believed to be a parroting or repetition of words or phrases. Echolalia is now considered a natural part of language development progression. It is a functional way of expressing communicative intent for the gestalt language processor prior to the development of self-generated language.

Engagement: Infants and toddlers coo, smile, gesture and exchange motor movements with their partners. Building intimacy, joy, and a rhythm of interactions is the foundation for more purposeful interactions and learning. An older child should be able to sustain engagement while sharing ideas, experiencing a range of emotions, etc.

Expressive language: Capacities and abilities involved in both verbally and nonverbally communicating one’s thoughts, feelings, desires, and needs to others.

Extending and Expanding the Drama: Tuning in to the individual’s imagination and ideas, and taking him/her one step further through gestures and words.

Fine-Motor: The control and movement of shoulders, elbows, forearms, hands, fingers and thumbs to manipulate small items (e.g., pinching, grasping pencil and scissors, handwriting).

Floortime: Formal Floortime sessions are usually 20 minutes in length and, in accordance with the model, would take place 6-8 times per day. These sessions honor DIRFloortime principles (see above) and are process-based (i.e., follow the persons lead and challenge the person at the same time), while considering individual differences of the learner and caregiver(s) playing.

Following the Child’s Lead: The use of naturally motivating interactions to target development. Following the child’s lead involves attuning to the child’s experience, motivation and intent in the world, and joining the child in his/her preferred activity. We enter the world of the learner, create a shared world, and from there, supportively and respectfully expand his/her world.

Functional Emotional Developmental Capacities (FEDCs) or Milestones: Refers to the emotional development of the person. The six foundation capacities in the DIR model are:

I.                    Self-Regulation and Interest in the World: Capacity for regulation and shared attention. To be calm, alert, and available.

II.                  Engaging and Relating: Capacity to form relationships, attachment, and engagement. Forming loving connections with caregivers.

III.                Purposeful Two-Way Communication: Capacity to conduct two-way, purposeful communication.

IV.                Complex Communication and Shared Problem Solving: Capacity to engage in shared social problem solving, use gestures in continuous patterns, and support a complex sense of self.

V.                  Using Symbols and Creating Emotional Ideas: Capacity to use ideas representationally and functionally.

VI.                Logical Thinking and Building Bridges Between Ideas: Capacity to build logical bridges between ideas and emotional thinking.

Three higher levels represent the more advanced reflective and abstract thinking that we expect our children on a typical developmental trajectory to develop in Grade School. In order, they are:

VII.              Multiple Perspectives: Capacity to engage in multi-cause, comparative, and triangular thinking (e.g. “I feel left out when Susie likes Janet better than me.”)

VIII.            Gray Area Thinking: Capacity to differentiate emotional grey-area thinking (e.g. ability to describe feelings about anger, love, excitement, and disappointment, as in, “I feel a little annoyed.”)

IX.                Reflective Thinking and an Internal Standard of Self: Capacity to support intermittent reflective thinking, a stable sense of self, and an internal standard (e.g. “It’s not like me to feel so angry.” Or “I shouldn’t feel this jealous.”)

Gleam: The ‘there you are’ moment of DIRFloortime when an individual’s face lights up and you see him/her as fully present and integrated in the moment.

Gross-Motor Abilities: The ability to use the whole body to execute large muscle movements (e.g., running, jumping, skipping, climbing).

Gustatory: The taste sensory system.

Hypersensitivity/ Sensory Reactivity: When a person is over-responsive to sensory information. A generalization could be that Hypersensitivity results in tendency to be fearful, anxious and cautious, or negative and defiant.

Hyposensitivity/ Sensory Under-Responsive: When a person is under-responsive to sensory information. A generalization could be that Hyposensitivity results in tendency to crave intense sensations or to withdraw and be difficult to engage.

Individualized Education Program (IEP): A document describing the agreed-upon services a school will provide to a student with a disability (ages 3-21).

Integration: The act of being able to combine or bring together sensorimotor, emotional, language, and cognitive functions in a useful, functional level of performance. This term can be about one developmental domain (e.g., sensory integration, emotional integration) or can reference the integration of the whole person.

Interoception: The experience of internal bodily sensation (e.g., hunger, bowel movements, ‘butterflies’ in the stomach, blood rushing to your head, your heartbeat pounding).

Joint Attention: At least two individuals (e.g., baby and mother) are sustaining attention on a third "object" (e.g., person or an inanimate object). For example, when a mother holds a red ball and the child looks at the ball, they both are attending to the same object at the same time (jointly). 
(Note: At the first FEDC, attending to the same object is not the same as a social interaction).

Kinesthesia: The perception of the movement of individual body parts; dependent on proprioception.

Low tone: The lack of supportive muscle tone, often with increased mobility at the joints; the person with low tone has limbs that are floppy, poor core recruitment, and inefficient/compensatory movement patterns. This lack of muscle tone results in poor ability to act in a sustained state of alert performance.

Neurodiversity: The concept that there is no ‘normal’ and there is immense value to variation in the expression of humanity. This concept embraces the autism spectrum experience as divergent rather than disordered. Within this belief is the view that individuals on the autism spectrum follow an alternative developmental trajectory rather than a ‘delayed’ typical trajectory. Implicit to this concept is that those on the autistic spectrum often experience disability and exceptionality.
The Autism Self Advocacy Network (ASAN, USA) prefers and promote the use of this term.

Normalization: To achieve social conformity; an antiquated goal of autism therapies.

Observation: How every DIRFloortime evaluation begins, and crucial before and during every Floortime session. Observation asks questions about the individual’s individual differences, developmental capacities, temperament, attachment style, rhythm and mood.

Occupational Therapist (OT): A licensed therapist who helps people develop the “skills for the job of living” necessary for independent and satisfying lives. Many OTs are trained in Sensory Integration therapy.

Olfactory: The sensory system involved with experience of smell.  

Perception: The meaning the brain gives to sensory input. Sensations are objective; perception is subjective.

Perseverate: To repeat or prolong an action redundantly.

Playful Obstruction: Always kind and respectful. Playful obstruction is the art of adding obstacles to play interactions without compromising the reciprocity/rhythm or loosing ‘gleam’. Playful obstruction may entice the player towards initiation, or repair, of an interaction; or may playfully ‘misunderstand’ a previously mastered gestural communication until it is expanded upon with a sequence of gestures or vocalizations.

Praxis: The ability to interact successfully with the physical environment; to plan, organize, and carry out a sequence of unfamiliar actions, and to do what one intends, wants, and needs to do in an efficient, satisfying manner. It is a broad term which includes all of the following:

Ideation: Conceptualizing an idea of what to do in response to environmental, social or educational task demands. The thinking or developing of an idea in the mind.

Motor Planning: The ability to organize the body and environment for the idea, generating a movement scheme. Motor planning involves making appropriate adjustments according to task and environment changes. Adjustments can be based on feedback from experiences or can be anticipatory based on visual/auditory data for instance.

Execution: Purposefully acting on a plan or executing the action. Requires response inhibition to stay on task and motor control and finesse for successful completion of a task.

Presume Competence: The belief that all individuals have the desire and ability to connect with others, engage, and learn regardless of neurobiological challenges.

Proprioceptive: The unconscious awareness of sensations coming from one’s joints, muscles, tendons, and ligaments; the “position sense”. Receptor sites are in the joints and the muscles. This sense underlies one’s ability to place body parts in a position in space and to grade movements (i.e., the ability to judge direction of force and pressure).

Receptive Language: Capacities involved in understanding the thoughts, feelings, desires, and needs of others. This includes the ability to interpret both verbal and nonverbal information from others.

Reciprocal Interaction: A back-and-forth exchange between individuals. A common goal of DIRFloortime is for an individual to enjoy long chains of contingent reciprocal interactions.

Registration: The ability for the body to register that sensation has occurred.

Regulation: The ability to stay in the ‘just right’ state rather than being over- or under- aroused. When well-regulated, you are calm, alert and available. Your regulatory state for taking a written examination is different from when you are participating in a soccer match.
Regulation is best when the following areas come together: sensory integration, cognitive understanding, problem solving, adaptive and coping abilities, and the ability to sustain interactions.

Rhythm and Timing (also see Shared Timing): This refers to the individual’s ability to sustain rhythm and timing during interactions. A person must be well regulated to sustain rhythm and timing. This ability is a core foundation to successful back and forth interactions with others.

Scripting: Often used to refer to communication that uses substantial quotes from songs, books or television/movies. Such a string of quotes may be used while re-enacting a story, or to communicate a gestalt language chunk. Other times, a quote may just pop out at unexpected times, and can often be used to self-regulate. It is useful to look for the meaning behind scripts.

SEIT: Special Education Itinerate Teacher. Usually, a one-on-one teacher assigned to a student to help manage the difficulties of a less-restrictive academic environment.

Sense of Self: The ability and degree to which an individual can be comfortable with his/her own views, likes and dislikes, temperament and beliefs in the context of family, community and wider world.

Sensory Defensiveness: The inability of the nervous system to accurately discriminate danger from the environment; produced by an oversensitivity to sensory stimuli. There is a constant state of “fight or flight” (sometimes ‘freeze’) in response to input to one or multiple sensory systems.

Sensory Integration Therapy: A neurological approach to enhancing occupational performance through supporting an organized, adaptive and functional response to sensory input.

Sensory Integration/Processing Disorder: “[A] condition that exists when sensory signals do not get organized into appropriate responses.” (Source: http://www.spdfoundation.net)

Sensory Modulation: The brain’s regulation of sensory information. Modulation involves facilitating some neural messages to maximize a response, and inhibiting other messages to reduce irrelevant activity.

Sensory Processing Profile: An individual’s unique neurological make-up including processing abilities related to auditory, visual, proprioceptive, vestibular, and tactile systems.

Shared Attention: Attention to an object or third person is interpersonal and social, glancing back and forth occurs, and there is a shared affect / a felt mutual connection. When two people attend to the same object and know they are doing it, this is a socio-emotional experience, not only a cognitive or perceptual experience. Robustly demonstrated when a child exclaims “Mom, look at the helicopter!”.

Shared Timing: The ability to sustain a back and forth interaction in a rhythmic way. For example, two people take turns hitting a drum while maintaining a rhythm. It is important during shared timing to attend to the other person, know when to act and when to hold back. This activity encourages regulation and sustained interaction. It is used to build the foundations of sustaining back and forth interactions. A hierarchy of activities is used to build from simple back and forth turn taking to more complex back and forth interactions that require thinking and language.

Somatosensory: Refers to “sensations arising from the body” and includes tactile (touch) and proprioceptive input.

Stimming: Not preferred terminology within the DIR model. People use the word ‘stimming’ to refer to repetitive or stereotyped behaviors, especially in individuals on the autism spectrum. Within the DIRFloortime model we would always seek the purpose of a behavior and often join a person ‘in’ a behavior rather than extinguish, correct or redirect.

Strengths Based: A view of the individual that seeks to optimize self-determination and strengths, maximize joyful experiences and celebrate successes.

Tactile Defensiveness: A sensory integrative dysfunction in which tactile sensations produce negative emotional reactions (see sensory defensiveness). It is often associated with distractibility, restlessness, and behavior problems.

Tactile System: Information taken into the body through the sense of touch (skin) via the deep pressure receptors (which activates discriminative system) or light pressure receptors (which activates the protective system).

Theory of Mind: The ability to understand that other people experience the world differently than you do – that they have different thoughts, beliefs and desires, know things you do not know and vice versa, and that people can be deceived.

Threshold for affect: The extent and type of affect an individual can process effectively. Due to individual differences, people can tolerate different types and levels of affect while remaining organized and regulated. This may further vary at different times and in different places.
It is crucial to gauge a person’s threshold for affect at all times and respond accordingly to sustain regulation and engagement. Individuals with sensory processing difficulties often need heightened affect or soft affect in order to respond. The goal is to help the individual eventually process a range of affect while staying regulated, engaged and purposeful.

Two-Way Communication: The ability to have an emotional (often gestural) dialogue. An individual would be able to register and receive the communicative overtones of another and respond gesturally or verbally. Opening and closing of circles can take place.

Vestibular: The sensory system that responds to changes in head and body movement through space, and that coordinates movements of the eyes, head, and body. The receptor site is in the inner ear. Intimately connected to receptors of auditory (hearing) and visual senses.

Visual Processing: Taking accurately interpreting, and using the visual information from the environment. Includes depth perception, directionality, form constancy, position in space, spatial awareness (distance between you and objects), visual discrimination, visual figure-ground (identifying a specific item from a busy field/background).

Visual: The visual system which is not just measured by accuracy of sight but also involves the use of both eyes together and ‘ocular motor’ control (i.e., the hardware), as well as perception and processing (see visual processing).

Acronyms:

ABA                 Applied Behavior Analysis

ADHD              Attention Deficit Hyperactivity Disorder

ASD                  Autism Spectrum Disorder

CT                    Computed Tomography Scan

DIR                  Developmental, Individual-difference, Relationship-based Model

EEG                  Electroencephalogram

FMRI                Functional Magnetic Resonance Imaging

GI                     Gastrointestinal

IBI                    Intense Behavioral Intervention

ICDL                 Interdisciplinary Council on Development and Learning

IEP                   Individual Education Plan

MRI                 Magnetic Resonance Imaging

NBDI                Naturalistic Developmental Behavioral Interventions

NICU                Neonatal Intensive Care Unit

OCD                 Obsessive-Compulsive Disorder

OT                   Occupational Therapy

PECS                Picture Exchange Communication System

PT                    Physiotherapy or Physical Therapy

SEN                  Special Education Needs

SEIT                 Special Education Itinerate Teacher

SI                     Sensory Integration (Also referred to as Ayres Sensory Integration)

SLP / SLT          Speech and Language Pathologist / Therapist

SPD                  Sensory Processing Disorder


Acknowledgements:

Greenspan, S. I., & Tippy, G. (2011). Respecting autism: the Rebecca School/DIR casebook for parents and professionals. New York: Vantage Press.

Some of the items in the glossary were adapted from the following website: Coping.org Tools for Coping with Life’s Stressors/Tools for Early Identification and Intervention-0-5 years/ The “Greenspan” Floor Time Model http://www.coping.org/earlyin/floortm.htm#Abstract

Contributors: Daria Brown, MA, Gerard Costa, PhD; Jackie Bartell, MEd; Joshua Feder, MD, Amanda Binns, MA SLP-CCC, Charlene Slezak, PsyD, Keith Landherr, MA OT, Cecilia Breinbauer, MD MPH, and Jeffrey Guenzel, MA LPC

Compiled by Virginia Spielmann, MS OT