Measuring Effectiveness of Floortime

There is clearly less research on DIR/Floortime than on ABA interventions. ABA has been around for 40 years, while the first published study of DIR/Floortime was 1997. Since that time, more studies have emerged, but there have been few, if any, direct comparisons of ABA and Floortime have been conducted. In my experience, parents often choose a combination of both interventions.

One issue is the method of measuring effectiveness. ABA measures discrete, observable behaviors. Its underlying rationale is the behavior is governed by its antecedents and consequences; all behavior is thought to be governed by the consequences of Attention, Escape, Access to a Tangible or Automatic Reinforcement. Thus, these consequences are manipulated in treatment to motivate or discourage behavior. Behaviors can be counted, measured, graphed, and displayed, showing progress or regression over time.

In DIR/Floortime, child development is the skill or area to be studied. Greenspan and Wieder talk about developmental ‘capacities’, rather than specific behaviors. When I searched for a definition of capacity, I came up with the following:

“the ability to receive or contain; power of receiving impressions, knowledge, etc.; mental ability; actual or potential ability to perform, yield, or withstand; quality or state of being susceptible to a given treatment or action.”

From this, I conclude that a capacity is not a clearly measurable ability or skill; it is a fluid concept or construct. Indeed, it is challenging to try to define these emotional capacities and to measure them. Greenspan and Wieder have developed a Functional Emotional Assessment Scale, but it is designed for young children, not older than 4 or 5, I believe. Thus with older students, there is not a clear-cut way to measure progress.

In my practice, I have pulled out specific components of development (opening and closing circles of communication, imitation, joint attention) to document progress. I am also using a numerical scale to document progress across the Functional Emotional Developmental Levels (The FEDLs in Floortime). I am also writing narrative notes about each child once or twice a week. In short, I am trying to combine behavioral practice with developmental to construct a picture of how the children are changing.

I am hopeful that this is helping!