Maximo Carson

DIR/Floortime (also known as floortime or DIRFloortime®) is a play and relationship-building therapy for autistic and neurodivergent children. Floortime is also helpful for people with a traumatic background. As the name suggests, the parent or therapist plays with the child on the floor.

DIR/Floortime therapy is designed to help parents build stronger relationships with their child in a playful and engaging environment. DIR/Floortime is based on the idea that a child’s development is affected by their environment, relationships, and interactions. This therapy is used to help children develop their social, emotional, cognitive, and communicative skills.

One unique aspect of DIR/Floortime is that anyone can get certified and trained. Parents and caregivers play an important role in DIR/Floortime because they are responsible for providing a supportive and encouraging environment for their child to explore.

Many parents work with developmental health professionals like occupational therapists, speech therapists, and psychologists who have the DIR/Floortime certification. Therapists and teachers who are certified in DIR/Floortime can help create activities and provide guidance on how to best support your child’s development.

It has become more common! While some families try DIR/Floortime on its own, it can be done in combination with other therapies, such as occupational therapy, speech therapy, and applied behavior analysis (ABA) therapy. Many families enjoy incorporating exercises from DIR/Floortime with other therapies. Many therapists and providers like to include DIR/Floortime’s play and child-led approach into their practices.

DIR/Floortime is exclusively child-led. ABA is usually therapist-led. They are both usually in a play-based format, but ABA may also be in a more formal setting, such as sitting at a desk. DIR/Floortime focuses on building relationships. ABA focuses on changing behavior.

Insurance usually covers ABA more than DIR/Floortime. The nature of ABA is to collect data which then allows them to prove to insurance its effectiveness. DIR/Floortime research has been ongoing for 32 years. Since floortime is a developmental therapy, there is less data collection and more qualitative information. With the lack of data collection insurance needs, it’s harder to “prove” it’s effective like ABA. Because insurance is less likely to cover DIR/Floortime, ABA therapy tends to be more commonly used.

Some research supports DIR/Floortime as a practical approach for improving the unique, individualized challenges autistic children experience. One 2013 study found improvements in turn-taking, communication, and cause-and-effect understanding.5 More research is needed to solidify DIR/Floortime as an evidence-based practice. However, many families report a positive experience.

Your home or a playground are popular options for DIR/Floortime. Here are a few options for you to consider:

One DIR/Floortime session usually lasts 20 minutes at a time. Many families do multiple 20-minute sessions each day doing DIR/Floortime activities. The intention is for learning (and play) to become embedded into a family’s daily routines and activities. In DIR/Floortime, everything becomes a learning opportunity by finding the balance between following a child’s lead and challenging them to acquire new skills.

Families can spend a few months to several years working with a trained DIR/Floortime professional. Parents are encouraged to continue DIR/Floortime exercises after therapy has ended until children are young adults. DIR/Floortime can continue into adulthood, though it often looks different than it does with young children.

Unlike many other types of care for children diagnosed with autism, DIR/Floortime is typically not covered by insurance or Medicaid. This is primarily due to insurance considering DIR/Floortime an experimental treatment. There are exceptions: states like New Jersey and Minnesota have started covering services. Check with your insurance and ask if DIR/Floortime is covered under your plan.

While you are likely to pay out of pocket, many families consider DIR/Floortime an affordable option for therapy. Instead of a medical practitioner providing direct care, parents and caregivers receive coaching and learn how to care for their children. Parents attend training sessions and use techniques with their child in their home, making it more cost-effective. A DIR/Floortime 16-week training program can start around $900.

If you’re considering DIR/Floortime therapy for your child, check with your insurance provider to identify whether it is a covered service. Beaming Health is also building a directory of DIR/Floortime providers and other top-rated local autism experts covered by your insurance.

Once you find a therapist or certified professional you want to work with, here are a few things you need to know:

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