DIR 440: Preparing the body for symbolic play


Course Description

The sensorimotor system informs us about the flow of affect. Affect and action are integral components to consider when thinking about symbolic play. We as therapists understand the underpinnings of affect and action. This masterclass is to guide us in becoming more specific when considering all that action entails. We look to our knowledge of motor science to assist us in becoming better informed about how we can use the signals that the dynamic postural system gives us to continuously inform us about how affect is flowing. Our increased awareness will lend itself to increased opportunities for symbolic play. 

When there is “stuckness” we will see it in affect and action simultaneously. Motor endurance versus affective resilience will be discussed.


Peruse DIR-FloorTime® organization and its website to familiarize yourself with the model: www.ICDL.com.

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320716/ or  10.1146/annurev-psych-010418-102836 to familiarize yourself with Motor Development by Karen Adolph

Learning Objectives

The participants will:

1. Explain what’s needed by analyzing the FEDCs to support symbolic play.

2. Describe the role of affect regulation, relationship, motor control, and its influence on motor planning.

3. Explain the concepts of force control, power, endurance, eccentric control, and graded movement.

4. Describe the concept of degrees of freedom and affect regulation.

5. List how to use affect and action to support symbolic play. 


Madonna Nash, OTR/L, C/NDT, received her degree in Occupational Therapy from the University of Illinois in 1978. She has been an NDT/OT Instructor since 1982 and is a member of NDTA and AOTA. Her many years of work experience included a large Rehab Medicine Department at Michael Reese Hospital, Dupage-Easter Seal Center and for 24 years, she co-owned City Kids, Inc., a private practice in Chicago. Madonna is known throughout the world and has taught several Pediatric NDTA Certificate and Baby Courses, Advanced Upper Extremity, Blending NDT and SI courses. She published an article in the NDTA Network on the Hidden Dangers of Baby Seats and Hands-Free Parenting. Madonna recently accepted a position at Timber-Ridge Pediatric Therapy in Skokie, Illinois. She is currently moderating Instagram Live Discussions, consulting, and teaching throughout the world.

Lois Gold, OTD, OTR/L, has 40+ years of experience as an occupational therapist and recently received her Occupational Therapy doctorate degree. Her capstone was on including the concept of affect into Occupational Therapy literature. Since 1987 she has owned and directed the Center for Pediatric Therapy, Inc in Florida. She holds certifications in NDT, infant treatment, sensory integration, DIR-Floortime® Model and is a faculty member of ICDL.com and Profectum.org. She is an adjunct member of Florida Psychoanalytic Society of Miami. Lois has extensive experience in providing lectures on the importance of relationship and the emotional components of behavior and development.

Professional Continuing Education

All participants can request a Certificate of Attendance documenting hours of participation and available professional continuing education credits at the time of registration. Please note that continuing education credit is only provided for direct seat time. Course preparation including readings, lectures, and mentoring is not included in the CE hour or credit total. This course is a live online course and participants must log in individually to the online classroom, following the instructions provided by ICDL and with their camera on, so there is a record of each participant's attendance individually. If participants join in a room with a group, each participant must still log in on their own device so ICDL can see each participant and verify each individual's login and log out of the online classroom. Participants must attend the entire course to get CE credit. Partial credit is not an option.  

Please CLICK HERE for Instructor Disclosures 

The course content is focused on specific products or services (DIRFloortime® and NDTTM) and there will be no mention of other products or services. ICDL does not receive any commercial support for this course.

Continuing Education Questions?  E-mail ceu@icdl.com

Speech and Language Pathologists

This course is offered for 0.3 ASHA CEUs (Various levels, Professional area).

Participants must attend the full session to receive credits. No partial credit will be available. 

Non-Credit Onsite Events: Continuing education credit is not offered for breakfast, luncheon, and dinner functions nor breaks, board and committee meetings, and networking events.

Skills Level: This Training is appropriate for occupational therapists, speech and language pathologists, educators, and mental health treating professionals of all skill levels.

Important Information for Speech and Language Pathologists:

As part of your registration, you were asked to share your ASHA account number. This is required for ICDL to process your ASHA continuing education credits. Our Continuing Education Department will complete and submit an ASHA participant form on your behalf at the conclusion of your course.

We also request that all participants complete a course evaluation form that will be received via email. This course evaluation is for ICDL and is used to help improve all aspects of our training program. Your feedback is valuable and we thank you for your time!

If you have any questions about this process please email us at ceu@icdl.com.

Occupational Therapists

DIR 440: Preparing the body for Symbolic Play

ICDL is an AOTA Approved Provider of professional development. Provider approval ID # 6778. This live online course is offered at 0.3 CEUs, introductory level, professional area. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.

(Introductory level, Professional area)

Participants must attend the full session to successfully complete the course.

Non-Credit Onsite Events: Continuing education credit is not offered for breakfast, luncheon, dinner functions or breaks; board and committee meetings, networking events.

Skills Level: This Training is appropriate for occupational therapists, speech and language pathologists, educators and mental health treating professionals of all skill levels.

Please complete the course evaluation form that has been e-mailed to you from ICDL. This course evaluation is for ICDL and is used to help us improve our course offerings. We thank you for your time.


ICDL has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6733. Programs that do not qualify for NBCC credit are clearly identified. ICDL is solely responsible for all aspects of the programs.  This course is available for NBCC continuing education credits.  The number of CEUs for NBCC is based on the number of "seat" hours for the course.  This course has three (3) seat hours of instruction.

Social Workers


International Council on Development and Learning, Inc., SW CPE is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #0371.  This course is offered for 3 contact hours of credit.  


3:00 – 4:00 PM Review FEDCs and its relationship to symbolic play

4:00 – 5:00 PM Review processes within motor control including alignment, base of support, anticipatory postural control and elements of gross motor performance

5:00 – 6:00 PM Integrate didactic information with video case studies