What is DIR® Floortime?

DIR® has a deep foundation in the science of human development and can sound very technical at times. However, it is also very simple. It is a way to understand our children and each other that builds connections, understanding, love, communication, and engagement. Through this approach, the true potential of each person can be discovered.

Aren’t we over-therapising our children?

In today’s times, children are expected to cope with a huge amount of academic, social and sporting activities. A child who is struggling with development is put at a disadvantage, unnecessarily causing stress and low self-esteem. Now days we have the knowledge and the tools to help these type of children achieve their potential and not be held back. As we learn more about the process of childhood development, we also learn more about how to help those children who have developmental difficulties and rather than just labelling them as lazy, stupid, clumsy or difficult, we are able to provide them with therapy in these critical formative years that have far reaching positive outcomes. It is important to note however, that if you feel your child does not really need therapy, we would encourage you to seek a second opinion in order to clarify your child’s needs.

Will I receive feedback?

Feedback may be given briefly after each session if a parent/caregiver brings the child for therapy.

This may be limited to specific responses and participation in the session itself. Overall feedback on progress will be given in terms of a feedback meeting every few months at appropriate times in the therapeutic process.

How long does my child have to attend therapy?

The time that a child spent in a therapy treatment program depends on the extent of his difficulties.

The average time for a child in therapy is 12-18 months. Some children need ongoing therapy that may last years and some children will require ‘bursts’ of therapy over several years to assist them in dealing with new challenges or demands. Therapy will depend on the child’s diagnosis and severity, how much carry-over occurs at home, how easily the child is able to learn new skills and what the individual goals for the child are.

How do most children respond to therapy?

Parents sometimes worry that their children’s self esteem will be negatively affected by attending therapy.

In fact children’s responses are usually exactly the opposite – they feel more empowered and confident. Therapy is conducted through play and positive reinforcement and is fun and enjoyable.

What does therapy cost?

The cost of therapy will be determined by the type of therapy the child needs.

Costs are based on rates set by leading medical aid schemes. Each medical aid will have their own benefits and limits for the different therapies and you will have to contact your medical aid directly to find out what this is.

What is occupational therapy for children?

Occupational therapy is a health profession where goal is to help people achieve independence, meaning and satisfaction in all aspects of their lives. Occupational therapists may work exclusively with individuals in a particular age group or with particular disabilities.

In schools, for example, they evaluate children’s abilities, recommend and provide therapy, modify classroom equipment, and help children participate as fully as possible in school programs and activities. A therapist may work with children individually, lead small groups in the classroom, consult with a teacher, or serve on a curriculum or other administrative committee.

Early intervention therapy services are provided to infants and toddlers who have, or are at the risk of having, developmental delays. Specific therapies may include facilitating the use of motor, sensory and perceptual skills, promoting skills for listening and following directions, fostering social skills, or teaching dressing and grooming skills.

What is a sensory integration dysfunction?

SID is a complex neurological disorder, manifested by difficulty detecting, modulating, discriminating or integrating sensation adaptively. SID causes children to process sensation from the environment or from their bodies in an inaccurate way, resulting in “sensory seeking” or “sensory avoiding” patterns or ‘dyspraxia,” a motor planning problem, or commonly a combination of these.

Some signs of sensory integrative dysfunction

Oversensitivity to touch, movement, sights, sounds
Under reactivity to touch, movement, sights, sounds
Specific learning difficulties/ delays in academic achievement
Difficulties in making transition from one situation to another
Tendency to be easily distracted/limited attention
Activity level that is unusually high/low
Social and/or emotional problems
Difficulty learning new movements
Delays in speech, language and motor skills
Physical clumsiness or apparent carelessness
Impulsivity, lacking in self control
Inability to unwind or calm self
Poor self concept/body awareness

All children may display some of these behaviours at times. Children may display these traits for reasons other than sensory integrative needs. However, if several of these concerns are noted over a period of time an evaluation may be warranted. A paediatric therapist can assist parents in deciding whether an evaluation is needed.
Go to Sensory Processing Disorder

What is sensory integration?

All human beings receive information from their internal and external environments through the senses: vision, hearing (auditory), touch (somatosensory or tactile), taste (gustatory), smell (olfactory), vestibular (movement), and proprioceptive (joint and muscle). We respond to these stimuli automatically.

The term sensory integration refers to the process by which we receive this information, the central nervous system directs the information to the appropriate parts of the brain, and the information is “integrated” or synthesized, so that we can respond to the stimuli in an adaptive manner. Receiving, organizing and interpreting this information is the first step in learning.

The concept and theory of Sensory Integration comes from a body of work developed by A.Jean Ayres, PhD.

When there is a disturbance in this capacity to automatically integrate sensation and respond adaptively, the individual has a disorder of sensory integration. These disorders can have a negative impact on the child’s capacity to learn, to function in socially appropriate ways, and perform the daily tasks of living.

What is Therapeutic Listening?

This is a program that provides high quality auditory input within the context of sensory integration treatment. It has an impact on sensory function and the nervous system as a whole. It improves auditory defensiveness, communication , new learning and other higher level skills such as attention.
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What is dyspraxia?

These children are often clumsy and awkward in their movements. They have particular problems with new motor skills and activities. They display difficulties with the registration and integration of sensory input, but may also fall under defensiveness and modulation disorders.

Some behaviours that can be observed are:

Very poor fine motor skills such as handwriting, cutting, motor planning skills
Very poor gross motor skills such as kicking, catching, throwing ball, sports are difficult
Difficulty imitating movements such as “Simon Says”
Trouble with balance, sequences of movements and bilateral coordination
May appear oblivious to certain touch/tactile input such as not noticing food left around their mouth when eating, not noticing dirt/uncomfortable textures against their skin, seem to have a high threshold for pain or not feel cold as readily as other children

What are fine motor skills?

Fine motor skills can be described as the development of small muscles, usually in the hands, in coordination with the eyes. Fine motor abilities develop over time starting with primitive reflexes, such as grabbing, and then turning into more precise activities that involve eye-hand coordination. All fine motor activities are built upon four important abilities: Grasping objects, reaching out to objects, releasing objects deliberately, and turning the wrist in various directions. The term “skills” indicates a movement which involves precision in the controlling of the small muscles in the hand, fingers, and thumb. The development of these skills allows a child to complete tasks such as writing, drawing, and buttoning.

Developing fine motor skills during a child’s foundation stage is of vital importance. The reason for this is that as they grow older they will become much more dependent on these skills in order to complete scholastic- and functional tasks successfully and independently.

How old should a child be to benefit from play therapy?

Children from the age of 3 years are able to benefit from play therapy. Once a child is past the age of playing comfortably (about 8 or 9 depending on the child) other methods of therapy are used including drawings, puppet work, art therapy, talking therapies and sand tray work.

How do I know that my child needs play therapy?

If there has been a change in normal behaviour your child may benefit from play therapy. This may also be true if there has been a change in life circumstances or if there has been a traumatic experience.

Too young for OT?

Development and learning in the first 3 years of life occurs at an exceptional rate that will never again be matched.Not only is this an important time to lay the foundations for all other development, but studies have also found “window” periods in this developmental stage where certain skills need to be acquired or are “lost”. In other words, small problems, which are easy to address at this stage, can become big problems, which are difficult to fix in the later years. A proactive approach of early intervention can prevent or minimize physical, academic or social problems that could negatively affect your child well into adulthood.