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Episode 7: Joining In: The Key Differences Between Behavioral and Developmental Approaches—and Why Connection Always Wins
42 Plays17 days ago
In this enlightening episode of DIVERG., we sit down with Dr. Jeffrey Guenzel, CEO of the International Council on Development and Learning, to explore the fundamental differences between behavioral and developmental approaches in supporting autistic individuals. Dr. Guenzel breaks down how these models shape the way we engage with neurodivergent children and why prioritizing connection over compliance leads to meaningful progress.
ICLD Website
DIR/Floortime® Training Courses
Dr. Jeffery Guenzel
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Transcript
Introduction to Diverge Podcast
00:00:00
Speaker
you're joining with what's already there. You're not trying to recreate and your child gets the sense of somebody else understands me.
00:00:11
Speaker
And there's nothing better in the world than having someone else understand you, especially when you're in a place in the world where it feels like nobody understands you. Welcome to the diverge podcast, inclusive of autistic and other neurodivergent voices.
00:00:26
Speaker
We exist to bridge the gap between specialized knowledge and everyday parenting. We are on a mission to bring together the most forward thinking experts who are deep in the trenches, championing neuro affirming and developmentally based approaches to therapy, to education and life designed for parents, educators, friends, and allies conversation by conversation, insight by insight.
00:00:49
Speaker
We are building community and making space for all kinds of minds.
Guest Introduction: Dr. Jeffrey Gunzel and DIR Floortime
00:00:55
Speaker
Hi, everyone. Thanks for joining the podcast today. We are so excited to chat with Dr. Jeffrey Gunzel. He is the CEO of the ICDL, which is the home of Dr. Stanley Greenspan's work and also DIR Floortime.
00:01:09
Speaker
For those of you who are unfamiliar, di r is a developmental model that focuses on what sets children up for cognitive learning. And floor time is the therapy or application of that model generally used to support either autistic kids or kids with developmental delays.
00:01:28
Speaker
Dr. Gunzel has graciously agreed not just to talk about DIR floor time and give us a little bit more insight into what it is and what it isn't and some of the feedback he's received over the years, but also to really break down the difference between developmentally based and behavioral based philosophies, which is an excellent tool when you really understand it for...
Developmental vs. Behavioral Approaches
00:01:50
Speaker
knowing what sort of approaches are going to be a little bit more naturalistic and give your kid a chance at developing what is already there ah versus interrupting, which is something we talk about a lot on the podcast.
00:02:03
Speaker
So really excited to get into this. As always, i will link information in the show notes. You are welcome to check out ICDL. I actually highly encourage parents who are interested to take the 101 course and It's a lot of clinical information about how to do DIR, which is helpful, but even more so some of those 360 philosophies have found when implemented in my house just opened up a whole new world.
00:02:28
Speaker
ah So definitely check those out. I'm really excited to get into this. So let's do it.
00:02:36
Speaker
Thanks for joining the podcast today. We have Dr. Jeffrey Gunzel of the ICDL, which is the home of DIR floor times. We are big fans at my house and it has been huge in helping us move the needle with my son.
00:02:51
Speaker
So really excited to chat with him today. So dr Gunsel, do you want to introduce your yourself? Thank you so much for having me. I'm i'm thrilled to be here. um So let's jump in. One of the things we kind of wanted to chat about today was ah this idea of developmental versus um behavioral approaches.
00:03:14
Speaker
ah when working with kids on the spectrum or kids who have developmental needs in general. um So would love your sort of take on that um and how you guys approach it.
00:03:28
Speaker
So I, I think there's lots of things to think about from a comparing or considering developmental versus behavioral approaches. And for parents, there's ah real practical aspect of what am I doing today and how am i supporting my child today?
00:03:46
Speaker
And then there's probably a more academic, like what is the theoretical underpinnings of each and and how does it work? um I'll start a little bit and I'll try not to get um too academic about it, but I'll start at the higher paradigm level because I think it's worth thinking about because it then impacts why we make the decision on the service we we choose, which so many times a service we choose gets decided by what insurance coverage what is is works in the schedule. and And it's hard to think about the bigger ah picture. but
00:04:23
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um I'll step into the bigger picture for a moment. So at a very high level, behaviorists and developmentalists see human development vastly differently.
00:04:37
Speaker
um A behaviorist sees the primary way that a human grows and develops and learns is through behavioral interactions with the world. That we experience things that give us feedback and that feedback can work towards reinforcing that behavior or extinguishing that behavior. And there's technical terms they'll use for describing how that happens, but that's essentially the process of We experience things behaviorally.
00:05:07
Speaker
We get feedback back. And it tells us that this is something that um we want to do again or something we want to avoid. So a child touches a hot stove and they get what would be called punishment, although it's not like a parent issuing punishment is the more technical term from a behavioral standpoint.
00:05:26
Speaker
But they experience something that would most likely extinguish that behavior from happening again. um And usually the the bigger that punishment is, the less likely we'll do it another time. And sometimes we do things a few times before we get get the understanding that it's not something we want to go back to. And same with things that are more reinforcing.
00:05:50
Speaker
um And you can have both positive and negative reinforcers. There's different ways of ah thinking about it. um But it's the whole idea is that it reinforces that behavior. And that is the primary way of behaviorists. And I think this is a fair objective. It's not just my opinion, because opinion wise, I absolutely from my clinical experience and having done a fair amount of behavioral oriented work,
00:06:16
Speaker
I think there's incredible limitations to it, and and I don't think it captures um human development well. But I think that ah assessment of mine or my description is a fair one. I don't think it's a biased um presentation of it. That's basically the idea from a behavioral ah standpoint.
00:06:36
Speaker
And from a developmental standpoint, I don't think anyone that works from a more developmental perspective like myself discounts that there's realities of behavioral reinforcers and punishment and things that that happen in that regard.
00:06:51
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But that we see this developmental process of human beings being much more complex, that there's more things going on that interact with that developmental process than just the behavioral interactions with the world.
00:07:06
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So we have internal processes that are happening that are a part of that developmental process relationships with other humans.
The Role of Relationships in Development
00:07:16
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There's, you know, when when mommy when baby is is baby is first born and mommy is holding her baby and and soothing her baby.
00:07:25
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she's not really correcting the behavior of crying um she's connecting at a very what i would call a human level and she's helping that her child develop the capacity to feel okay in the world and it oftentimes the developmental parts or the developmental process can feel a little more abstract or a little harder to identify. So what is happening when mommy is holding her baby?
00:07:54
Speaker
We know a lot of the science. We know a lot of what's going on in the brain, but there is also a process that that is just... the relationship like humans are developed in the context of relationships with other humans a a baby um when a baby's born that the only way they survive is if they have a relationship with another human that's a requirement of humanity is is relationships with other humans um and there's absolutely some abstractness to it even though when you really dig back and look at the science, it's not necessarily as abstract as it as it may seem on the surface, because we know um that and that little baby, that their
00:08:37
Speaker
um Neuro pathways in their brain are developing at a very high rate and that interaction is connecting that affective emotional connection is connecting in with their brain and helping their brain be more regulated and calm like we know a lot of the science behind that but for the average person it's harder to see it's hard to identify what it is it's easier to see behaviorally i give a cookie and someone in the child's happy and i can see the immediate cause and effect on the developmental side it's harder to see sometimes that always that immediate cause and effect but that's the idea is that developmentally
00:09:19
Speaker
It's all the things like building a house. You start with the foundation, and you building build up from there. The developmental perspective is is all about that, is how we develop that human, you know, for example, in a very practical way, you'll see developmentalists focus a lot more on intrinsic motivation. Why do we do the things we do?
00:09:40
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from a more intrinsically motivated reason, versus extrinsically because of that feedback that we get, those reinforcers or things that will extinguish that the behavior. And how does that intrinsic motivation get developed?
00:09:56
Speaker
So it's it's two very different ways of thinking about human development. And then the approaches, the therapeutic approaches that come out of that um there's lots of different behavioral approaches lots of different developmental approaches i think in the world of autism clearly the leading uh behavioral approaches i mean ah yeah behavioral approaches aba and really in many ways the leading developmental approaches is dir floor time um but they're not the only things by any means um and there's lots of i think sometimes uh parents think that
00:10:35
Speaker
All of behaviorism is ABA and that's just absolutely not not the case. It's a very specific, very specific, systematic way to apply behavioral ah theory into practice.
00:10:47
Speaker
Interesting. And I think it's really, you know, one of the conversations I have a lot that's harder for people to understand when it comes to developmental therapy, specifically for autistic kids or kids who are experiencing delays.
00:11:02
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is a lot of the narrative is that these kids aren't motivated by relationship or what a typical kid would be motivated by. So they need something different.
00:11:17
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And i think, you know, one of the things that we found with DIR, I'll let you speak to this, was one that's not really entirely true. and two it comes down to,
00:11:31
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timeline to an extent. It might take longer, but nurturing those same things ultimately produces the skills that you're looking for. so I would actually start with your the word you used of motivated.
00:11:46
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the motivation um a lot of what people think about ends up almost being a more behavioral um why you're doing something and what you're going to get back for like schools and more extrinsic motivators and um i and so want to bring it to the more internal motivation the the desire and i think the humans across the board, while there can be lots of variation in how it plays out, we want to be connected to other humans.
00:12:20
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It is part of, again, the way we're wired from birth. We're we're wired for relationships. again, with respecting that, that can be very different for different people.
00:12:31
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Some people may not want, like can make choices about what those relationships look like. And um so I don't want to um say that we're forcing relationship upon people in the context of the way that we define it.
00:12:45
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we want to We want to help create that relationship. while respecting the perspective of the person we're engaging with. So while that we're engaging with how they want to be in relationship with others, this gets to also the double empathy theory about how um ah think individuals really can communicate and connect much more than neurotypical people often think.
00:13:07
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It's just that we have to figure out what that looks like and and how it happens and set aside some of our neurotypical expectations and really engage with the person more.
Personal Insights: Dr. Gunzel's Story
00:13:19
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the The other thing that I'll say, and this is maybe, um ah folks, it's just an example that i use with parents sometimes about getting in a relationship and what it what it looks like.
00:13:32
Speaker
When I was 14 years old, um I fairly quickly over a couple month period, I had a medical condition. I became legally blind. And I was down to what the doctors would do was finger counting about six inches from my face.
00:13:48
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And that's how they measure my visual acuity. So I could see some, um but i I couldn't see much. And for about 10 years of my life, i I had I was legally blind. And and over over a 10 year period, um I saw a lot of recovery, not complete recovery, but a lot of recovery. I remain i remain visually impaired today.
00:14:10
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but um But the one of the things that I share with parents sometimes as I'm talking about that is when I was a hat was legally blind, I wanted to experience the world.
00:14:26
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But if something was too far away or too small, it's almost like it didn't exist to me. I didn't know that it was there. And for me to experience things, it had to be bigger and closer.
00:14:41
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And so for my brain to process it, it had to be different than the vast majority of the other people in the world.
Communication with Autistic Children
00:14:49
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And while that affective and human experience, it may not just be that it needs to be bigger and and closer, even though I think oftentimes that works really well for autistic people, um kids, is to make it a little more intentionally, like your expression, your joy of the interaction, to make it more intentional and expressive.
00:15:12
Speaker
There's lots of nuances to how to do that. And I don't want to leave this podcast with people going in and acting like clowns with their kids and thinking that's that. But but there's a lot to be said for how we we interact and very intentionally make our affective nonverbal communication really clear because we know that processing.
00:15:33
Speaker
those facial expressions and that nonverbal communication is processed differently for many people on the audience spectrum for many autistic kids. um And while the, my, my analogy may not be exactly the so exact match to the science of always bigger and and closer.
00:15:52
Speaker
There's, I think a lot to think about. And that is that we just have to, Think about it differently and approach it from a more neurodiverse perspective of what do they need to connect?
00:16:03
Speaker
Not how do I get them to connect the way I need to connect? Right. Well, and I think couple good practical examples is when we first started doing DIR, when we pulled my son out of school.
00:16:18
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we had our supervisor who, you know, come over and kind of train us. And one of the things that I had never heard before was, okay, if he is, you know, running around making noises or you guys are playing, mimic that.
00:16:30
Speaker
Like if, if he's making a sound like mimic it which was a really simple thing, but it ended up making a huge shift. And that probably for the first time,
00:16:41
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he was like, oh, my communication is valid. And almost immediately, tons more attempts at language. He was more comfortable saying things wrong that he couldn't get out right.
00:16:55
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um And a lot more eye contact. And what's interesting is I've seen that translate across multiple kids. ah We had a kid at Diverge who was like buried in the dirt one day, like just in it.
00:17:08
Speaker
And was paying attention to it realized, it was like, oh, you are 100% pretending to be an excavator right now. I can't remember what he said, but something clicked.
00:17:19
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And I started talking to him about excavators, probably started singing to him because there's a lot of lippy and meat going on in my house these days. And all of a sudden, this kid who hadn't made attention to anyone all day long grabs my hand, looks me dead in the eye, and we like walked back to...
00:17:33
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um the classroom where I was trying to get him to go. And it's just so interesting. Like the second you kind of get into their world, they come back into yours for not forever, but like they're just, it's a comfort level.
00:17:48
Speaker
And, and that gets to one of the things about developmental approaches, generally speaking versus behavioral approaches, generally speaking is that developmental approaches are typically much more strength-based so you're starting with what is already there developmentally and joining in it we may not always like understand it and especially as parents and trying to figure all this out for the first time oftentimes we oftentimes don't understand it but it's it's joining in that because when you joined in the mimicking
00:18:22
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you were joining in what your child was doing and had the capacity to do.
Strength-Based vs. Deficit-Based Approaches
00:18:29
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It may not have made sense to you, but there was strength in that. And you joined in that and then build up from there.
00:18:36
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and and And the goal then is to, how do we make it a little more elaborate? How do we make it expanded a little bit where Most behavioral, and again, I'm making too general because you could approach developmental in a more deficit-based way, and you could approach behavioral in a more strength-based way.
00:18:55
Speaker
um But I think most behavioral... is more deficit-based defining what's not there um and trying to fix those things and determining what behaviors are appropriate what papers are inappropriate and working to shape those in more of a deficit-based lens going towards this is abnormal and we want to go towards normal um and fundamentally i think that's another big difference um between most developmental and most behavioral.
00:19:27
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It's not an absolute line. I don't want to get it. Yeah, I that's what saying. behavioral person listening may say, but this is, and there's definitely buts. People can approach it differently.
00:19:39
Speaker
more more strength-based potentially from a behavioral standpoint and potentially do developmental work a little more deficit-based. But on a whole, what you just described is totally a strength-based approach.
00:19:54
Speaker
and And I think sometimes parents think of strength-based when they hear it, as just being nicer or kinder or more gentle. And it's actually, it is all those things, but in many ways, it's much more effective because you're joining with what's already there.
00:20:12
Speaker
You're not trying to recreate and your child gets the sense of somebody else understands me. And there's nothing better in the world than having someone else understand you, especially when you're in a place in the world where it feels like nobody understands you.
00:20:30
Speaker
Right. No, totally agree. And that was a big conversation on another interview where it's just like, You get to a point where this is important conversation, whether your kid is gifted or not, there's likely a whole lot more going on inside than they can express outside, especially when they're on the spectrum.
00:20:48
Speaker
And it creates an identity crisis to an extent when you get in certain situations. situation so that makes that makes total sense um and i think from a you know one of the things we kind of wanted to chat on was like just parental fears i know one of the things that comes up a lot is but they can't do that forever so so for example you know um i find this a lot in the in the autism space specifically but um
00:21:18
Speaker
you know, anything from walking away from circle time to darting across the road is always called like elopement, and no matter the age or stage. And, you know, people get nervous. They're like, well, they can't do that forever. That's unsafe. And it's like, yeah, certain things are unsafe, but like there's no guarantee that your four-year-old kid who gets up and walks away from circle time is still going to be doing that at 18.
00:21:41
Speaker
um So would love to kind of just dive into the, some of the fears around these more strength-based approaches where we approach things in a bit of a gentle, more gentle capacity and build over time.
00:21:56
Speaker
I think there's lots of layers to this. I'll start with um how we are most of the time with our our kids. So if, because nothing has to be, or nothing with parenting or therapy is absolutely black and white.
00:22:12
Speaker
So as a a parent, while a parent may use more of a developmental perspective, there's absolutely times where you're going to do things that are more behavioral that need to be managed. And there's nothing wrong with that. I think of developmental approaches ah much more about developing the human and behavioral approaches much more about managing the human. and And we all need to be managed sometimes. And there's nothing...
00:22:41
Speaker
wrong with that like even i was talking before even as adults we do things to manage our lives and we set boundaries for ourselves and we say we're not going to do this or we're going to do this. And we might even give ourselves a reward if we do something that has been hard for us to do, um even as adults. And so with kids, there's nothing wrong with that in that we need at times to manage um behaviors and manage our our kids.
00:23:13
Speaker
However, the managing the child does not do as well to help them develop their internal capacity to manage themselves and that's where developmentally um our goal is really develop their core capacities that they can be the poets of their own inner selves as dr greenspan but at one point oh that's beautiful what is it and and really be able to manage their own selves to have their own sense of agency and manage their own behaviors
00:23:49
Speaker
And in order to do that, we actually have to give them space to do that. If we over manage them, if we overly manage their behaviors, we actually don't give them space to develop their own capacity to develop their own ability to engage with the world because we're essentially kind of getting in the way of that process because we're so anxious about their behaviors don't look right and their behaviors are necessary and their behaviors are and so it's harder to to give the space for that but we debt we desperately need to for
00:24:23
Speaker
our kids, um because that's what's going to develop them much more as a a human um to be able to successfully engage with the world and not just kind of look like they're human
Understanding Child Behaviors
00:24:37
Speaker
in a way. Like, I don't know that's ah a bad way of saying it. And autistic self-advocates would probably throw things at me for saying that way.
00:24:44
Speaker
But I think a lot of times the behavioral therapy is about trying to shape. This is what we've decided humans are supposed to look like. And we're going to shape your behavior until you get near this mold.
00:24:55
Speaker
and and And that's the the goal of it. And that's what I mean by looking. ah go but And a lot of the conversations I've had, I think certain things come back to this like tips and tricks philosophy, right? Where like you see something that maybe you don't like or doesn't make sense. And here's the tip.
00:25:13
Speaker
tip or trick that you use to sort of correct it. And that's all well and good. But there's also always a layer underneath it of, okay, what's actually going on? Like, is, am I looking, is what I'm asking for right now developmentally appropriate is, am I interpreting this behavior in the right way? So like a really great example was actually really recently a friend of mine who has a son who's about the same age as mine was laughing because her son was like running back and forth.
00:25:48
Speaker
And she goes, when he spins his arm, he thinks it makes him go faster for all intents and purposes. It's a typical kid. He's around six or seven years old. My son does that all the time. write it off as like stimming.
00:26:01
Speaker
and then I, she said that and I sat back and I'm like, yep, he's racing his car. He starts spinning his arm. He thinks it makes him go faster. and so there's, there's just this lens that sort of gets put over things where sometimes you just sort of forget, i hate to say it, but like, these are kids and it's a very six, seven year old behavior to race your car back and forth all day long if you feel so inclined.
00:26:26
Speaker
ah So that's one of the things I think I struggle with is like taking a deep breath and backing up and saying, okay, what's developmentally appropriate right now? And then sort of chipping away at things before we go to, okay, just don't do that anymore, please.
00:26:42
Speaker
For lack of a better sort of framework. Oh, that is, um if any anyone's ever been in a course I teach, I often talk about, from an autism standpoint, the parts of the diagnosis that are more what people think of more stereotypical autism with the repetitive behaviors and the lining up the cars. Yeah.
00:27:03
Speaker
the sameness things, to really be careful about pathologizing those behaviors, because we spend way too much time turning those into pathological things that we need to control.
00:27:17
Speaker
And i say we in the broad sense of a lot of therapies. And And in many ways, they are just typical human behaviors. They're maybe exhibited in certain patterns that seem different or odd to ah neurotypical person, but they're very typical behaviors. example i always use, and I don't know who the person was that that talked about this, but it was a woman on the autism spectrum who was presenting, and she said something, and i'll I'm paraphrasing this part, you know, um we're going to go to to lunch and
00:27:53
Speaker
If we go to lunch and my absolute favorite meal is there at lunch, you might see me jumping up down and flapping my my hands because my body responds to that in a whole body kind of way. You poor neurotypical people need to win a car and price is right to know what that feels like.
00:28:13
Speaker
and And I think it's a ah good kind of reference point of that know like that is a human behavior. and And yes, maybe we don't want all humans jumping up and down and flapping their hands with every little thing that's happening because it can be more disruptive to the world.
00:28:29
Speaker
but But we also need to be really careful how much we turn that into a pathology because if...
Encouraging Natural Development
00:28:37
Speaker
Um, like I always think about it. My goal is that to help each person, whether it's a person on the spectrum or not a person, a neurotypical child, um, to be as engaged with the world as they possibly can be, to be fully wanting to be a part of what's happening in a way that's meaningful to them.
00:28:59
Speaker
because then managing behaviors just becomes so much easier. You don't generally have to manage behaviors as much. And the individual will make choices for themselves of, I want to choose to control this behavior in this situation, um or I'm okay not, rather than being a victim of kind of the masking issue of, I have to try to pretend to be something I'm not in a way that's not in the in in control like i think we all do a form of and i'm getting in a different direction a form of of masking where we present ourselves in certain ways in certain situations and right but we're making a choice and it can be a very healthy thing where masking can be really dangerous and detrimental is when we're not really making a choice when it's
00:29:46
Speaker
um we don't feel like we have any choice and we have to try to fit in in a way that it really undermines our sense of who we are and our identity and and that's a whole nother tangent we could do a whole whole yeah podcast there's a between i never between masking or changing your behavior being strategy versus being survival i think exactly yeah yep yep um so uh um But yeah, I always talk about just being really careful of about pathologizing and what we have find in DIR is when we join those behaviors that people will say are stimming behaviors for seven of repetitive behaviors that others have said, we want to try to stop when we join those, there's
00:30:40
Speaker
so many times where I'll have a parent or a clinician that, or an educator that tries this on for the first time of truly joining whatever the child does.
00:30:51
Speaker
And the child tilts their head and looks up at them with the eyes of no one ever does this with me. What are you doing? yeah has seen A whole new world, a whole new world of connecting with that human, uh, that little kid.
00:31:07
Speaker
Definitely seen that. Um, And the other piece of it that I think is very interesting and it's a personal story, we started doing, or I would say practicing, Diara, more of how we approach it, in our home about a year and a half ago.
00:31:24
Speaker
And watching my son's play develop and sort of come out into the world in a year later, was amazing.
00:31:34
Speaker
He's always been very good at like you know playing on his own, doing his thing with his cars. He loves cars. He reenacts a lot of TV scenes. But even to the extent where within a year, I think you know i there's a children's museum where Poughkeepsie has a big giant fire truck.
00:31:50
Speaker
And I remember recently taking him And watching him play. And I think I text our mutual friend. It was like, you wouldn't believe this. Like the level at which he is engaging with this fire truck and how much it is very similar to how all of his speaking beers are engaging with it.
00:32:10
Speaker
around him is insane compared to what it was a year ago. Like his play skills just sort of like wrapped themselves up, just sort sort of showed up to an extent, um which I think, and that was not a forced thing. There was no teaching him how to play with the fire truck. It was more just helping him through the various stages that DIR talks about.
Development vs. Learning
00:32:31
Speaker
and it and it And it allows him to have his ideas about how to. Yes, and express them. Yeah. but so to be The ICDL, people often used that the acronym as the International Council on Development and Learning.
00:32:45
Speaker
And there's a difference between development and learning. And you could find it in different ways, but without any question, development is a bottom-up process. it Again, like building that house and um a tree growing a human, like it's it's it's a bottom-up process.
00:33:05
Speaker
A lot of learning is taught to us, is more of a top-down. And I make that distinction because... we need to develop as humans in order to be able to successfully learn as humans and be taught things by other humans and so lot of times what i find happens with kids that have a diagnosis is that people jump to the learning and the teaching and the training
00:33:38
Speaker
and haven't invested in the developmental process. And there's all sorts of challenges in that developmental process. And they're jumping to the teaching and how am I going to get the child to learn this, this behavior or this task?
00:33:53
Speaker
And we know this with typically developing kids. The more that, um you know, a lot of the things in kindergarten readiness, the data that people look at of letters and numbers, and there's so much research showing that those aren't the things to actually measure as the best measurement kindergarten.
00:34:10
Speaker
more long-term success in school and in life. It is much more of those developmental things. And so, um and, and again, it's a little harder because some of those developmental things are a little harder to identify. i It's easy to, he can say his numbers, he can say his letters, and those are easier to see.
00:34:31
Speaker
um but what's capacity for engaging with others in a meaningful way? What's his capacity for shared social problem solving and really being able to engage with someone else's ideas versus just his own ideas and um and really thinking abstractly and holding more abstract concepts in their mind, which is really develops in pretend play with young kids and They develop the ability to hold abstract ideas in their minds, which is essential for more traditional academics. If you're going to do mathematics beyond your 10 fingers, you need to hold abstract concepts in your mind. You need to hold those abstract.
00:35:11
Speaker
And that gets more, even more sophisticated sophisticated when you're talking about other types of learning and social science and and things where you have to hold those abstract concepts. And that all develops in as as humans in life very naturally but we often have to be much more intentional with our kids that have developmental differences because the way that we typically would think about doing it if we're neurotypical may not be the best way to help them um grow and develop and we might have to be more intentional about how we do it but but i make the distinction between development and learning because
00:35:53
Speaker
too often people just bleed it all together and ah and don't absolutely and don't, don't, don't separate out at all. And we have to, and I've said this a few times already in this podcast that we have to develop the human and help human develop before we, we get lost in trying to
Research and Efficacy of DIR
00:36:15
Speaker
teach.
00:36:15
Speaker
And if we develop the human, well, teaching becomes very easy. it's it it becomes so much easier if those core developmental processes are are there um no totally interesting and i think one of the things and part of it's specific to the state that we live into as well is i think so much emphasis gets placed on um learning by a certain system to your point but what i find constantly and the this podcast is evidence of that is that when you move outside of that system, which is primarily the education system, there's a lot of people who are speaking the same language.
00:36:54
Speaker
ah It's just lots of research to support that language. Absolutely. I want to be clear that when we talk about these things, it's not just an opinion of I think this is better.
00:37:05
Speaker
There's clear research to support that developmental process and the need for that developmental process with young kids. And if you look at employers that are hiring college graduates, a lot of what they'll say is What they want the most out of the hires that they get was what they refer to as soft skills. But they'll talk about wanting um new entry-level hires coming out of college that have the ability to think and to reason and engage and problem solve. And what the employers will say is, I know the skill of the job.
00:37:40
Speaker
I can teach them the skill the job, but I can't help them think and reason. Someone else has to do that before they get to me. and And that's kind of analogous of this developmental verse learning process.
00:37:53
Speaker
ah And it's not just a little kid thing. It's, it's a lifelong. It's an everybody thing. When we develop that foundation, we set up that individual for success in life.
00:38:05
Speaker
like And just speaking to the evidence a little bit, I don't know if there's anything else you want to add, but one of the things that I have certainly run into a lot is when I opt out of certain systems I get, but it,
00:38:16
Speaker
this is what's evidence-based. ah And the more you kind of dive in, the more there's evidence in a lot of different things. But can you speak a little bit more specifically to DIR and the clinical studies and evidence?
00:38:31
Speaker
So I'm going to go back a little bit from a history standpoint. DIR as a more process-oriented approach that's not about doing one thing to get a single behavioral or single response. It's not as much about this individual cause and effect process because it's more holistic and it's about the process of the interaction.
00:39:01
Speaker
In many ways, you're doing multiple things by design, doing multiple things at one time to elicit or develop multiple responses, which makes it much harder to do research on.
00:39:15
Speaker
um When you can, researchers like to, or the simplest, clearest research is, how do I create a very individual thing we're going to measure and see the exact response?
00:39:29
Speaker
And and the the more that we can research can bring it down to that one individual thing, you control for um all the other variables. And it just is cleaner, quote unquote, research when we can do that.
00:39:44
Speaker
The challenge with process oriented approaches like floor time is fundamentally it's about doing multiple things at one time and not about breaking it down into individual component parts.
00:39:55
Speaker
And so you can't do research quite as easily. And research generally costs a little bit more money and takes more time. And so what ends up happening is process-oing approaches oftentimes take a little bit longer to build a research base.
00:40:10
Speaker
And that is what has happened with DIR. With ABA, it was much easier, even though there's lots of questions that have come up about the research base ABA. And I don't want to go down that road too far, but don't worry. I have another podcast guest coming for that one. but a bcba by the way But the, it was easier to get that empirical research to say,
00:40:35
Speaker
um and And this will be an opinion way of saying it. Give the cookie and get the behavior right. And you measure that. And and obviously it's it can be more complex than that. And that's a little bit of ah a snide way of saying it. But but it really was about how do you you pare down to that behavior and see the the punishment or the reinforcer and and see the response to whether you extinguish or or reinforce the behavior.
00:41:02
Speaker
um So my the developmental DIR has just it's taken a little bit more time to get the research base. However, um over the last 15 years in particular, while DIR has been around for decades, over the last 15 years in particular, research has become very strong.
00:41:23
Speaker
um the there's multiple randomized control trial studies case studies group design studies um lots of research on dir that's very much supports positive outcomes um and very solid research the other part that i think is important is there's research on other facets of what dir is that really supports the work so for example There's lots of research supporting parent implemented approaches.
00:41:55
Speaker
So DIR is one of those parent implemented approaches. um It's not the only one by any means. But when you look at research on parent implemented approaches, including DIR and all the others that are out there,
00:42:08
Speaker
there is a lot of research to support when I, when parents are empowered and figure out how to do this thing called parenting their kid, yeah their kids do well. And, and, um and interestingly enough, in many cases, including dr even though parents are actively doing the, the therapeutic process,
00:42:36
Speaker
they actually report that their stress level goes down, which is feels a little paradoxical. and and the And many of the earlier research reviewers talked about this, that these parent implemented approach will probably increase parent stress.
00:42:51
Speaker
And it's interesting because essentially the research is finding the exact opposite. is And I think it comes from us as parents. We just want our kids to be happy, healthy, successful, all those things. yeah And it's not so much whether we're exhausted or or fully rested, if our kids are doing well and feeling good, um we'll do all sorts of stuff for them and and and feel really good ah about it.
Parent Empowerment and DIR
00:43:15
Speaker
and So, and the other part that I find interesting is, and this is more anecdotal with work that I've done with parents is, i don't know how many times I've heard from parents in doing DIR, the phrase back of, you gave me permission to be a parent.
00:43:34
Speaker
And that phrase comes from, we're not trying to make any parent into a therapist. It's not about you got to go teach your child this and do while it's therapeutic. It's all about leaning into that relationship with your child or that our, our children as parents that we desperately want.
00:43:53
Speaker
And we want that connection. We want that. um And so it's, it's not about the parent becoming a therapist, It's really about leaning into that natural relationship and supporting that development of that that relationship so parents can be parents.
00:44:12
Speaker
And I would say that was one of the first things that happened with us. is I mean, bit everyone on the podcast probably assumed this at this point, but we pulled my son to homeschool him.
00:44:25
Speaker
And what should have been really stressful was actually incredibly stressful. energizing and relaxing to an extent um because who he was as a kid just came out that much more.
00:44:40
Speaker
um and I would say too, one of the first things I really, that crystallized for me when we started doing DIR was our supervisor walked in and the first like list of stuff she gave us was all of the things he was doing that were absolutely typical for kids his age.
00:44:55
Speaker
like pointed out, oh, his transitions are great. Like that six-year-olds play with cars all the time, all of those different things. And it really became my barometer for knowing who's a good therapist for him, even in other fields like speech and ot Because for the first time, it's like, this isn't about his like list of deficits. Like this is what's just typical childhood happening right in front of you.
00:45:18
Speaker
And the rest of it will work on. And there were even a couple of things that weren't typical, but she was like, ah i wouldn't worry about that right now. but right now. And so it's been very, very interesting.
00:45:29
Speaker
um to sort of take that approach. And I will, and to your point with, you know, evidence-based stuff, you are catching skills a lot more times is what I call it. Like some days we'll be really into cooking and it's cool that you can follow a couple of steps and cook X, Y, Z. And some days suddenly you're just very attuned to your baby sister and taking care of them, but there's no way to like pick, pick the goal.
00:45:53
Speaker
Essentially. It's a lot of like, okay, here's the environment. Let's see what sort of like comes out of it. All right. um Complimentary supports. So i know, you know, everybody usually gets the recipe of speech and OT, um but is there anything specific with DIR that you just want to talk to in terms of additional therapies?
00:46:18
Speaker
So. when When we think about a DIR program, so there's there's DIR floor time as a evidence-based practice that...
00:46:29
Speaker
but parents and clinicians or educators can use and and a lot of that is a specific therapist that could be an ot a speech and language pathologist an educator a mental health therapist an art therapist music there was lots of different folks that could do this that um that provides the floor time in some sessions with the child but also coaches the parents to ah implement it at home um with that said whoever that person is that is is doing that or whatever maybe it's a team of people definitely think of development in a transdisciplinary way in the sense that
00:47:18
Speaker
there's not just one thing to work on. It's not just one therapy or one specific um modality to
Transdisciplinary Approaches and DIR
00:47:28
Speaker
utilize. So when we think about a DIR program more broadly than just the floor time specifically, we want everything addressed that may need to be addressed whether that's more the biomedical things because a lot of our kids on the spectrum have lots of different medical related whether that's seizures or ah allergies or immune differences that all need to be addressed and uh
00:47:55
Speaker
and ah dealt with hopefully our our hope from a dir perspective when it's when we have a family that's um implementing a dir program is to try to find those clinicians just kind of what you were saying of of the type of professional you want working with your family.
00:48:15
Speaker
Find those professionals that are more strength-based oriented, that um will align more with how you're thinking about things developmentally, that aren't just going for normalizing behaviors, but are really about developing the person.
00:48:31
Speaker
um But that would include the speech and language therapy and getting a speech and language therapist that really joins in with the child and whether they're hopefully floor time trained but even if they're not that they're approaching it more about developing communication rather than just teaching words because you can teach words again from the top down and get kids to repeat words or you can develop communication from the bottom up where the individual is communicating in meaningful deep ways
00:49:06
Speaker
And when they learn those words, those words have deep meaning um and meaning to them, the meaning to their.
Addressing Co-occurring Conditions
00:49:15
Speaker
ah So ah definitely OT without any question, I think almost.
00:49:21
Speaker
um Every time the spectrum can benefit from occupational therapy, in my humble opinion. um I have been married to an OT for the last 31 years, so maybe I'm a little biased.
00:49:33
Speaker
But like years years ago, um I could send you the the link and and it's on the Autism Speaks website, but they kind of hid the results um ah shortly after the survey was was put forward or or published.
00:49:49
Speaker
But they did a survey of parents about, didn't fix another organization, did a survey of parents about what was the most important service they received. And I don't know this for sure, but I really believe based on the dynamics of Autism Speaks at the time, a lot has changed.
00:50:06
Speaker
They changed their mission. They changed their vision. They have autistic um individuals on the board now. Steven Shore is a friend of mine and he's on their board and they're like there's things that are happening that are but more positive.
00:50:20
Speaker
But there's for years, very, I think most autistic self advocates did not like autism speaks um because there was so much that was promoting ABA. But they did a survey of parents and I think that they expected that the parents would say ABA was the most important service.
00:50:39
Speaker
And what parents reported was OT was their most um valuable service. And I think ot just has a way of connecting to the developmental process and understanding some of the core challenges often associated with autism, particularly the sensory motor channel of use.
00:50:57
Speaker
um and how we can help that grow and develop and not think of it as ah deficit but think of it as more developmentally so ah that's where i say ot because i there's just so many century motor differences and yeah um ot's are really good at connecting with that uh but it's it's about getting a a team that can share the experience of thinking about the child from a developmental lens and then addressing the things that need to be addressed and whatever that and by addressing i mean you know if there's seizures that that's being addressed and and yes and and focused on if there's um apraxia speech that that's being looked at and focused on and because ah a big an important part of it is that
00:51:50
Speaker
the professionals and the parents don't conflate things too much in the sense of, well, that just is
Success Stories and Positive Impacts
00:51:57
Speaker
autism. Yes. they're Too often un individuals have co-occurring other things going on that people just label as, well, that's part of his autism.
00:52:07
Speaker
um And a lot of times there's other things that are happening that need to be addressed very specifically for that. And it's not the autism it's, they have allergy and we need to address that allergy. Uh, and, and so, I think there's, there's, um, plenty out there to support that autistic individuals generally have, um, more co-occurring other diagnoses than the average person or the average child with other, maybe another diagnosis or other. Right.
00:52:41
Speaker
No, I think that's totally fair. And we get into that a lot. I will say just to backtrack, um, from the very beginning, I remember saying this before I even understood it, was like, the OTs just always seem to get my kid.
00:52:54
Speaker
Like all the way back to early intervention, in the middle of the pandemic, it was virtual. Like, I was like, they just seem to get my kid. ah So that's very interesting that you say that. Any like success stories that you just wanna, or anything you wanna highlight um in terms of these approaches?
00:53:13
Speaker
Um, I mean, from a success story standpoint, I hear things all the time. Uh, and I don't, you know, for example, I had a dad reach out to me, um, just recently who I had done some work with and, um,
00:53:32
Speaker
what he was reaching out to me about was the distinction that I helped him with as far as that development and learning process. And I think culturally, um, uh, his, his culture are focused much more on the learning and the teaching.
00:53:50
Speaker
um and even from a native language standpoint the the the perm development didn't exist quite in the same way as as i was describing but he said that was the most important thing for him and shifting his thinking and he said recently they were at kind of a ah play date type of thing with other kids and he said A lot of the other kids are getting behavioral therapies and his daughter, who they are not doing any behavioral work. It's all really around or yeahr is what they've done.
00:54:23
Speaker
He said she was the best behaved kid in the group. And we hear those things all the time from parents. But I think the challenge is right at the beginning. it can feel really uncertain for parents because there's behaviors that you want to see your child doing or not doing.
00:54:43
Speaker
there There's nothing as parents, we have to, we're entrusted with the obligation to shape our children and help them grow and help them develop. yeah And it can feel hard at the beginning to not be managing it all. And this investment in the developmental process can feel a little bit harder to see where the results are immediately. Um, but I hear from parents all the time when they, when they invest in that, um, what they get and it's not that far down the road. It doesn't mean you're down the road. No.
00:55:20
Speaker
ah Well, and and I would even say to add onto that sometimes there's like, you know, I call it the messy middle, right? Like, um, my son's communication has improved a lot.
00:55:32
Speaker
And his comfort in letting people know he's uncomfortable is improved a lot. So sometimes that looks like just flat out telling me to stop yelling no in certain situation.
00:55:45
Speaker
But a year ago, I didn't have a kid who would do that. He was just sort of like soon under the table with his iPad or whatever. And not he, no one knew he was uncomfortable with a certain situation. so um Sometimes it looks awesome and sometimes it's like, oops, just bear with me. He's finding his voice.
Integrating Behavioral Techniques
00:56:06
Speaker
The voice we worked really hard to get to. um So that's amazing. ah Anything else you want to highlight before we jump off? No, I don't think so. It's been interesting as you've asked about thinking about the developmental versus behavioral. And I think it is interesting an important distinction to make.
00:56:28
Speaker
um I guess the one thing I will say to, i maybe this is more to to parents about this, is that yeah it's not an absolute all or nothing complete black and white.
00:56:44
Speaker
um we Parents will use behavioral techniques all the time. aba is a very um defined systematic way to apply behavioral techniques but if your child has a great day and you go get them ice cream because you're rewarding them for a great day there's nothing wrong with that i would encourage that you'll lean into the relationship and the shared joy of it rather than relying on ice cream is going to get them to do it again
00:57:16
Speaker
because there's only a little bit that that ice cream is going to get them to do it again. But that sure joy is much more powerful and and works much better.
00:57:26
Speaker
ah But i I also just want to make that distinction because I think too often people think if I do anything behavioral, I'm somehow wrong if I if I'm trying to do developmental or then it's we We absolutely can manage behavior sometimes, but we need to focus on developing our little humans and that and we can do it.
00:57:49
Speaker
and so um And I will say sometimes it's fun. Like I was in the last probably six months or so. um There are a couple of things that my son does that I'm like, that is pure behavior being a seven year old kid, like testing a limit.
00:58:07
Speaker
Yeah. I'm like, oh, that's cool. I don't have to worry about trauma. I don't have to worry about it. It's like but we can just deal with this.
Conclusion and Resources
00:58:15
Speaker
Yeah, absolutely. It takes a while to get there. but The other part is developmental approaches are are fun, are engaging. like theyll The last family i worked with, um the most recent family i worked with, i the dad, um ah I met with him and and he had gone through this five-day intensive with us. And he said on the third day he wrote in his journal, I fell madly in love with my son.
00:58:43
Speaker
And like, that is huge. That's huge for all of us. um And it's huge for him. He wrote it about his own experience, but I tell you, it's huger for that kid. He feels that love. He feels that connection.
00:58:58
Speaker
And I'm certain in that process of falling madly in love, it's because he, started to understand his kid more. I started to understand his son more um and who his son was.
00:59:11
Speaker
And his son totally is feeling that. And, yeah know, they went home and everyone around the family said, can't believe how much he's communicating and talking. And, and it was five days of 20 hours of of therapy on that.
00:59:24
Speaker
um yeah that's the main thing cool outcome so cool well thank you for me thank you and everyone can find you on icdl.com anywhere else ah no that's the that's the best place to go there are there are other things out there but that's the best place to go because that's what I've um really dedicated my ah career to at this point and that's my focus is And we'll put resources and links and everything in show notes. So if anyone wants to try and find it super but a DIR supervisor or learn more or take trainings, we'll make sure those are all in there.
01:00:04
Speaker
Excellent. Amazing. Thank you so much, Jeff. I really appreciate it. Thank you for having me. As always, thank you for listening all the way to the end. i hope you enjoyed that as much as I did, and it helped bring a little bit of a better understanding to some of the grounding philosophies that you will see when sifting through therapies for your kid. Linked in the show notes.
01:00:26
Speaker
will be ways you can contact either Jeff and the ICDL or just learn more about DIR floor time. Thank you so much for tuning in and we will see you guys again on Friday. We're going to go back to a Friday drop schedule ah with a whole new episode.