Dr. Stanley Greenspan defined Floortime as an intervention that focused on strengthening a  child’s ability to relate, communicate, and think. He developed the milestones in his Greenspan/DIR Model and his milestone as a guide to understand a child’s social-emotional abilities and challenges, and to help parents and professionals encourage development within these 3 areas.  While many professionals doing “floortime” only work on 1 or 2 of these elements, it is always best to fully integrate them.  After all, when are children not supposed to use all 3 of these capacities together?  Can we effectively communicate without thinking or relating?  Can we truly relate with someone without communicating and interacting with them? If we develop skills in isolation then we tend to use them in isolation, and as a result working on skills in this way can lead to fragmented development. When working on this bigger picture holistic growth, we must understand how Dr. Greenspan described his bigger picture goals; Relate, Communicate, and Think?

The ability to relate is our ability to connect with those around us, not with objects or activities, but with people and their interests, feelings, opinions, and ideas. In order to successfully relate, we have to develop things like shared attention, engagement, and the ability to interact.  By attending to someone and sharing your attention within an activity, you are now participating in something together. This shared attention, showing an interest in someone else and what they are doing, is a key first step in building a relationship.  If we think about our own lives, when someone else shows an interest in what we’re doing, we feel more connected with them. It is this emotional connection with another person that leads to greater and greater engagement with that person, and builds a foundation of trust allowing us to form relationships with others.

As this development progresses and we become more interested in people, versus objects or activities, then we see an expansion of engagement including an understanding of more emotions and different perspectives.  We learn to do this around a broad range of emotional experiences, while building and deepening these relationships.  A large body of research shows that this begins with caregivers. As children build and deepen relationships with caregivers and other meaningful adults in their lives who are adaptable to them, then they have the foundation allowing them to apply these skills with peers.

Another important aspect of Floortime is that it focuses on and stimulates communication. Communication is both a non-verbal and a verbal capacity that we all have to master in order to effectively navigate the world around us.  Communication begins as a pre-verbal skill with simple looks, smiles, frowns, and simple sounds. All are forms of communication that begin to establish reciprocity, back and forth exchanges/interactions. These early exchanges are types of communication, and they are a necessary prerequisite skill that leads to higher levels of communication, including language.

These interactive patterns, or social patterns, are the foundation for other pattern recognition later in life. Understanding social-emotional patterns in the world around us helps us become adaptable, flexible, and creative, and understand other people’s opinions, ideas, and perspectives.  For example, the first time a child sees a frowning face on their caregiver is the first time they begin to understand a limit or a boundary.  They see that not everything they do is safe or good. These boundaries help them understand where danger is, what’s appropriate and inappropriate, and it helps them organize their exploration at early ages. Without these interactive communication patterns many children end up not understanding boundaries and are more likely to develop behavior problems and can struggle developing higher level emotional communication skills.

This reciprocity within caregiver interactions is also the foundation for successful social interactions with peers. We learn to participate, take turns, and share, not because we’re taught to do so in a rigid and instructional manner, but instead because we have fun playing peek-a-boo, hide and seek, or exchanging objects with our caregivers.  As we start to understand and accept that sometimes waiting or slowing down is necessary to play these games and have fun, as well as taking turns and sharing things, then we learn to apply these with peers. These early playful interactions lead to more adaptability and flexibility, especially within our social environment.  Communication begins as a non-verbal or pre-verbal skill developed with caregivers, and it turns into a verbal skill that’s used with caregivers and other meaningful adults in our lives.  Eventually, communication becomes a tool we also use with peers. 

The third foci  of Floortime is thinking. This is the most frequently overlooked and misunderstood component.   Dr. Greenspan described thinking as the process by which an individual generates their own solutions, ideas, and plans in order to accomplish a specific goal or express themselves. Unfortunately, most interventions and education programs are based on adult led education, meaning the adult shares the specific expectation/outcome, effectively telling or showing the child what to do.  The child then performs the action.  The adult is effectively giving the child the answer, and telling them to replicate it. That does get certain specific results, however, the results are very limited and often only used rigid ways and in the specific location they were learned. This type of learning has been shown to lead to children becoming rigid and/or passive participants.

Teaching elements of health and safety will require more adult directives, instructions, and explanations. However, the initial social-emotional capacities that children need to master early in life are things they need to learn through experience with our involvement and support. Unfortunately, if we interrupt the natural learning process, learning through experience and exploration, then we are inhibiting the development of their creativity, problem-solving, and thinking skills.  They’re no longer developing ideation, executive functioning, critical thinking, and analytical skills.  Instead, they are simply following instructions. While following instructions is a goal that can be addressed eventually, it’s a secondary goal.  First, we need to be able to generate our own sets of instructions before following someone else’s.  

Creativity and ideation are important capacities that are negatively impacted when an adult teaches a child what to do, how to play, answers to problems, et cetera. While many children still develop bits and pieces of these skills, they develop them in isolation and have poor generalization.  If you ever heard Dr. Greenspan review videos of people trying to do Floortime, you would know that he frequently asked, “who’s doing the thinking here?”. He was referring to instances where adults began to lead and direct the child. Giving prompts, suggestions, and directions are all examples of the adult doing the thinking.  

The alternative to directing a child or giving them the solution is encouraging them to come up with their own idea.  This may require modifying the challenges to be more suitable for their individual development and abilities.  The adult should also be encouraging them to figure out their way of doing it. This requires caregivers to be emotionally and physically supportive and involved without taking control and giving them the answer or solving the problem for them.
The goals of Floortime are broad and inclusive and can be integrated into a number of different environments and curriculums.  Each therapist should find the ways that work best for them to address these goals while also addressing the specific goals within their curriculum.  The Greenspan Floortime Approach® techniques we teach are meant to be used as an optional guide to address these bigger picture goals.  They are by no means the only techniques that can be used to address a child’s ability to relate, communicate, and think during your sessions.