At first glance, Floortime (DIR) and Applied Behavior Analysis (ABA) may seem very similar. Although there is an overlap in some parts of treatment, they better serve as a complement to one another. Floortime focuses on relational, social, emotional, and cognitive development through play, while ABA emphasizes behaviors through the use of rewards.
What is Floortime?
Stanley Greenspan and Serena Wieder created Floortime therapy from the Developmental Individual-difference Relationship-based model (DIR). This framework uses adults to assist a child’s communication skills by meeting the child at his/her developmental level. Parents are encouraged to play on the floor with their child, engage in activities that the child enjoys, and uses social interactions to bring our their child’s curiosity and creativity.
As described in Greenspan and Wieder’s book The Child with Special Needs, the primary purpose of Floortime is for parents to “open and close circles of communication” in order to help their child reach six emotional and intellectual milestones:
- emotional ideas
- emotional thinking
- two-way communication
- complex communication
- self regulation/interest in the world
- intimacy or engaging in relationships.
Therapists train the parent how to engage in back-and-forth play through shared attention, problem solving, abstract thinking, focused concentration, and logical thinking. Although floortime does not specifically address speech, cognitive or motor skills, it places the emphasis on emotional and intellectual development.
Multiple research studies (by Greenspan and Weider, in Thailand, and in Canada) have shown improvement in children with autism who engage in floortime. You can find a parent workshop or browse the Greenspan website area for parents. Many occupational therapists, speech therapists, special ed teachers, and child psychologists are trained in floortime and can assist your child, even in combination with other types of therapies.
What is ABA?
Applied Behavior Analysis (ABA) is an approach that observes how one’s behaviors and actions are influenced by changes in the environment. For example, if a reward is provided after a certain behavior is performed, then that behavior is likely to be repeated again if continually reinforced. For example, you ask a dog to sit and reward him with a treat when he sits. Then he will continue to sit when you ask, in hopes of receiving a treat again. Parents, teachers, and therapists can provide this structured interaction one-on-one, small groups, or in large groups (such as classrooms).
Typically, ABA is customized by a trained therapist to provide the best treatment for the child, family, and situation. It will include:
- personalized planning
- continual assessments of goals
- treatment targets communication, self-care, play, motor skills, and academic development; independence
- teaches skills beginning with the simplest step and gradually progresses in difficulty
- uses positive reinforcement and interactions to make play and learning enjoyable
- no interaction or reinforcement is provided for unwanted behaviors
- the therapist regularly meets with the parents to ensure that goals are being met and treatment is effective.
The U.S. Surgeon General recommends ABA as an effective treatment for autism, even adults who have autism, due to years of studies and the efficacy of research. It has been known to enhance skills such as reading, verbal communication, listening, self-care, and understanding the perspectives of others. Some studies have shown that there is greater improvement across all skill sets when intensive ABA is performed compared to other interventions.
Both Floortime and ABA are utilized frequently, often at in complement to one another. There are three main similarities: the involvement of parents, progressive steps toward a goal, and intensive planning.
- Parental Involvement. Parents are a large part of therapy in Floortime. They engage their child in both therapy sessions and in everyday environments, and work with the therapist to create goals. With ABA, Parents are involved in the setting of goals and planning programs, as well as regular meetings to reassess their child’s progress.
- Progressive steps toward a goal. Both Floortime and ABA require a progression of levels in order to reach a goal. Floortime begins by gathering the child’s attention and focus so that he/she can be ready to learn, while ABA teaches “how to learn” behaviors.
- Intensive planning. Lastly, both programs require intense amounts of time. Floortime includes sessions with a therapist plus intentional time with the parent throughout the day, adding up to be over 25 hours per week. ABA often has more than 25 hours per week of therapy with the therapist directly. The American Academy of Pediatrics recommends a minimum of 25 hours of intervention per week, so both modalities fulfill that requirement.
Although we reviewed a few similarities, there are multiple differences between the two types of treatments, such as: how the child processes and learns, how the child’s mood affects his/her level of attention, the role of relationships in therapy, how well emotion is regulated throughout the programming, and how the child views the world and shares his/her ideas.
- How the child processes and learns. Floortime focuses on how each child has a unique “sensory motor profile”, which explains the child’s behaviors and directs future treatments. ABA considers these individual differences and behaviors to be either an antecedent or consequence of other behaviors.
- How the child’s mood affects his/her level of attention and the role of relationships in therapy. As previously mentioned, parents play a central role in Floortime. Relationship with the parent is supportive and loving, which brings emotions to the front of Floortime therapy, furthering attention, engagement, and communication. Every behavior is considered important and is analyzed to understand what the child is trying to communicate. Although the parent’s are involved in ABA, they do not necessarily play a role in implementing therapy, but rather reinforce the techniques across settings.
- How emotion is regulated. As previously mentioned, parents provide and demonstrate emotions to their child in floortime, including love and support. When the child reacts with any kind of emotion (joy, fear, anger, etc.), parents and therapists attempt to find what caused that reaction. But with ABA, emotions and moods are typically considered behaviors that can be measured and changed through reinforcements. The root of behaviors is not considered, but desired behaviors are rewarded with a positive reinforcement.
- How the child views the world and shares his/her ideas. The child uses self-directed play to represent his/her internal representations of the world and his/her ideas in Floortime. In opposition, ABA teaches the child how to play, which is believed to allow future growth and development in their expressions of internal ideas and processes.
Although different, both Floortime and ABA are valuable interventions and each bring unique characteristics to treatment. Let’s recognize the differences between the two, but also respect each; where one lacks, the other provides. And in many cases, utilizing both together offers a greater benefit to the child.