What is Greenspan Floortime?

What is Greenspan Floortime? Greenspan Floortime is the center of a comprehensive program that benefits children at risk for developmental disorders that include autism spectrum disorders.

Overview of Greenspan Floortime

The first of these two dimensions comprising Greenspan Floortime is a specific technique in which you get down on the floor with the young child for twenty or minutes a few times each day. The second of these two Greenspan Floortime dimensions is a general philosophy. This general philosophy informs all interactions with that child, incorporating both the overall features of Greenspan Floortime and the particular goals of that specific interaction, whether occupational therapy, speech therapy, or a set of educational goals.

Floortime seeks to join a child in their world and gradually interest them in joining ours.

Ultimately, Floortime seeks to join a child in their world and gradually interest them in joining ours. By engaging a child in the Greenspan Floortime process, that child can learn how to

• Focus and attend
• Relate with real warmth
• Be purposeful and take initiative
• Engage in back-and-forth communication with others
  • Initially through gestures
  • Eventually through words

Then we can help a child learn how to

• Problem solve and sequence actions so that the child is in a continuous interaction with their environment, including the people within it
• Create ideas and use them logically, leading to higher levels of
  • reflective thinking
  • empathy
  • understanding of their world

One day that child with a developmental challenge, if they can evaluate their own feelings, might say “Hmm, I’m angrier than I should be today.”

While not every child is capable of achieving the highest level of reflective thinking, most children are capable of moving up the developmental ladder. Regardless of developmental diagnosis, we have found that there is in fact a sizable subgroup who can reach the highest levels of reflective thinking.

To help you go further and learn how to apply Greenspan Floortime, we have created online training in Greenspan Floortime for parents and professionals that includes video-based courses and a Greenspan Floortime manual.

3 Steps of Greenspan Floortime

To achieve these goals of helping a child climb their developmental ladder towards the highest levels of reflective thinking, Greenspan Floortime uses three steps. These three steps must work together to be successful. The three steps are

1. Following the child’s lead and joining the child’s world
2. Pulling the child into a shared world, often by challenging the child
3. Helping the child master the Developmental Stages by expanding on their own interest

Step 1: Following the Child’s Lead

Following a child’s lead is the most well-known step of Greenspan Floortime. Following the child’s lead implies that we are harnessing the child’s own natural interests.

Why would we want to follow the child’s lead? After all, in our own development and education, we had to learn and do things that we didn’t want to. We were never permitted to study or behave however we wanted to. Why then would Dr. Greenspan advise us to take our cue from the child? Is this overly indulgent? We follow a child’s interests because they are the window into a child’s emotional life. Through these interests we see the picture of what is enjoyable and pleasurable for that child.

We follow the child’s lead because the child’s interests are the window into that child’s emotional life.

It is too easy to use a child’s diagnosis as a way of explaining that child. Why does a child stare off at a fan? Another child, why does he rub a spot on the floor over and over again? Why does this other child repetitively open and close a door? Because they have a particular disorder. If we become trapped in explaining a child solely through the lens of their diagnosis, we run the risk of losing the child as a person in that process.

If instead we begin with the essential question–“Why is this specific child doing this specific thing?,” we acknowledge that this child is a human being. Sure they may have a disorder or a set of problems, but that child is not the disorder or that set of problems. That child is a real human being with real feelings, real desires and real wishes.

Sometimes a child can’t tell us what their feelings, wishes and interests are, so we have to figure out what they are. We need to read their behavior to learn what gives them pleasure. We start by following their lead and using their own interests to engage them.

With this first step, we join the child in their world. We demonstrate that we respect and care about what they are interested in. This is so important because our ultimate aim is to form a close relationship. Everything begins with the relationship between the caregiver and the child.

The child is not the disorder. That child is a real human being with real feelings, real desires and real wishes.

So if a child aimlessly wanders around the room, we wander with that child. In so doing, the child experiences a partnership in aimless wandering. Similarly, when we rub a spot on the floor with them, we are entering their world.

This first step is just the beginning, and it is often very short-lived. Our intention is to have the child share their world with us, letting us in, and not merely tolerating our presence.

Two outcomes can occur at this point. Sometimes, the child responds to our participation. They look at us or gesture to us, or engage us in whatever is going on in their world. Once the child lets us into their world, we move on to the second step of Floortime. Following the lead may only last for a few seconds or a few minutes. We do not simply stay in their world following their actions. If, however, the child still does not respond to our participation, then we have a few tips. In either case, we need to move to the second step.

Step Two: Challenge

In step two of Greenspan Floortime, we are challenging the child to connect to a shared world so they can master each of their developmental stages. This second step of challenge can be used in two distinct ways. One is to use it to start the initial interaction with a child who continues to ignore you. In this case, its use is to solve the avoidance problem. The other way is to use it to expand the initial interaction once the child begins responding to you.

Solve the Avoidance Problem

In the first case, a child is wandering around the room paying us no attention regardless of what we do. So how do we get their attention?

We introduce a challenge, using their movement to create a simple game. That is, we get in front of the child so that the child has to go around us to continue to avoid us. He looks at us to check out how to get past and we look back. It’s a cat-and-mouse game and the first little moment of interaction. Even if fleeting, he has let us in. A big grin and positive emotion from us—and importantly letting him get past us—lets him discover the fun in interacting. Soon he may even smile back as we keep up the game and he bests us by getting around us.

Our ultimate goal for entering their shared world is to bring them into ours and to support them in becoming empathetic, creative, logical, reflective individuals. We don’t want to pull them in screaming and yelling. Instead, we want to pull them in with warmth and pleasure. We want the child to want to be in a shared world. ‘Wanting’ is the key. When following the lead, we need to be sensitive to the child. With a fun challenge we will see that, instead of looking annoyed or running away, the child starts giving us friendly glances, warm smiles and letting us in.

Our ultimate goal for entering their shared world is to bring them into ours and to support them in becoming empathetic, creative, logical, reflective individuals.

What will motivate a child to be a part of a shared world? Is it as simple as running around and jumping with the child or playing on the floor with building blocks? Or is it as simple as being silly and making funny noises with them or playing copy-cat games with them? In other words, how does “following their lead” actually mobilize a child to master the critical developmental milestones, the fundamentals of relating, communicating, and thinking?

The Dialectic

The goal is to follow the child’s lead on the one hand but then create opportunities and challenges that bring them into a shared world where they can master the developmental stages. That is the “dialectic,” the two opposite polarities of Floortime: joining the child in his rhythms, joining the child in his pleasure, but harnessing them to bring the child into a shared world, and a shared world where they then master each of their functional emotional milestones. That means creating systematic challenges to expand their abilities and master each level of development. It is in these systematic challenges that many of the specific techniques and strategies of Floortime come in. Now we are talking about the real skill in doing Floortime, its real infrastructure.

Let’s say a child has a favorite car that he loves to bang on the floor. We bang our car next to him. He looks at us and giggles but no more. Playfully we reach for it a couple of times and retreat as he protects his car. Next we can grasp it, making sure he is holding it, so we have a tug-of-war game that he wins. After much playful back-and-forth, we take his car and ‘hide’ it outside the door, showing him where and closing the door. Now he bangs on the door, and we say, “Can we help you? Can we help you?” Being really motivated to get that car, he takes our hand and puts it on the doorknob to open the door.

Over a few weeks, we expand the interaction, and he begins to say “Op, op, op” and eventually “Open” so he can get that toy. Through following the child’s interest and then challenging, we have mobilized not only attention, engagement, and purposeful action, but also problem solving and even the beginning use of words. This type of challenge strategy “playful obstruction.” We don’t want to do to the child. We want the child doing to us. Challenge the child to do something to us rather than us do to the child.

The goal is to follow the child’s lead on the one hand but then create opportunities and challenges that bring them into a shared world where they can master the developmental stages.

Sometimes we can start the interaction by doing something to the child that we know they enjoy, especially physical activity such as a little tickle game or a horsey ride. Children love to get on daddy’s shoulders and move a lot. But then how do we get the child to do to us? As soon as he is up on our shoulders, he has to gesture or make a sound to show us that he wants the horse to move more or he wants the airplane to go again.

We challenge the child to take initiative. If we give the child a backrub, he can show us where he likes to have his back rubbed or whether he wants his tummy or arms rubbed. If we are playing a finger game or toe game – which foot he wants rubbed or which toes on which foot – he can show us by wiggling or moving that foot a little bit. So we are always challenging the child to take the initiative to do to us rather than us do to him. The key is to harness the child’s initiative.

Step 3: Expanding the Interaction

Let’s say the child is now in our world and wants to engage with us. He moves a truck back-and-forth, and we open our hands to make a tunnel. He looks at that, gives us a big smile, and moves the car into our tunnel. Now we have shared attention, engagement, purposeful action, and some problem solving: real thinking. Words, “truck, truck, move,” often follow soon. But there’s more to be done. We begin to give his choices, expanding the play: “Do you want to move it into the tunnel or the house?” He goes, “Ha, ho” indicating “house” and points. We ‘play dumb’—another type of challenge—and ask if he wants the truck in the house or on our head. He laughs and points to the house again.

Once we get the interaction cooking, a back-and-forth where we get attention, engagement, and purposeful communication, then the whole question is, and this is the biggest missing piece that I see and the hardest part for both professional colleagues and parents, other caregivers, and educators, is how to get a continuous flow of communication. In other words, children usually communicate once they can be purposeful with gestures – a smile, a nod, arm gestures, body posture – as well as, hopefully and eventually, use words. But the hardest thing for children, particularly children with developmental challenges including autism, is how to make that a continuous flow: going from a few interactions where they use a single word or gesture to 50 or 100 back-and-forth interactions in a row so you two are having a real conversation.

Continuous Flow

Dr. Greenspan’s advice is very, very simple: Make it a major objective. Don’t skip it. With the child who wants to go out the door, we make it into a 10-step interaction rather than one. “Well, mommy can’t open the door. Get daddy.” The child pulls on daddy, and daddy has a hard time too. “Can you show me? Do I turn or pull the knob?” and the child shows you. The child can make a sound to make the door open and so forth, until you get 10 circles of communication rather than one of simply opening the door.

We need to expand circles of communication—often by playing dumb—to get a continuous flow where the child takes the initiative, where it isn’t just us doing to or for them. And continuous flow is not just repeating the same action over and over. We always need to vary what we do. That challenges the child to expand his ideas and come up with new solutions, often within the same basic scenario or game.

Once the child has words, it’s the same thing: can we get a lot of back-and-forth use of words? Once a child is logical, can we get many logical circles of communication? I see many, many children who read and do math. They can use whole, long sentences but can’t have a long back-and-forth conversation. That becomes the hard part. That is often the missing piece in many children’s development: getting the continuous flow going.

We are always trying to broaden the child’s capacities in terms of their current milestones — strengthening and broadening those and introducing the next one.

So when doing Floortime, I’m asking you to always think about its two poles – following the child’s lead and challenging them to master new milestones. We are always trying to broaden the child’s capacities in terms of their current milestones — strengthening and broadening those and introducing the next one. If they are a little purposeful, we want them to be very purposeful. Once the child can open and close three or four circles of communication (back-and-forths with gestures or words) we want to get it to seven and eight and then to ten and twenty until we get 50 or more. If a child has a few words, we want to extend back-and-forth conversations to get a continuous flow.

Greenspan Floortime is for all the time

In summary, Floortime involves a polarity or dialectic between following the child’s lead, entering his world and pulling him into our world, and challenging him to master each of the developmental stages. It means paying attention to the child’s individual differences in terms of processing sounds, sights, and movements and modulating sensations as well as paying attention to the family patterns and to our own personalities. It means getting into a continuous flow.

That is the heart of Floortime. And that is why Floortime is not just a technique where several times a day we spend 20 minutes or more with a child at home. It is also a philosophy for school interactions and for interactions in the store or car.

Greenspan Floortime is for all the time.