What it means to be a Greenspan (DIR) Therapist or Professional

To be a Greenspan (DIR) Professional it means that whether you are a Speech Therapist, Occupational Therapist, Special Educator, Mental Health Professional, or other professional doing Floortime that in addition to taking into consideration individual curriculum goals for each child you also have to set goals in accordance to the Greenspan Model, and these goals are the applicable developmental milestones. When achieving curriculum based goals one cannot overlook the developmental goals, and as matter of fact the developmental goals need to take priority before we work on the skill based goals. This “Bottom Up” approach of developing regulation, shared attention, engagement, interaction, etc. is imperative to the overall success of the child and this will eventually help them want to achieve and perform during different skill based activities. However, if we find that we are pushing too hard on certain individualized skill based tasks such as fine motor work, and the child is disengaged or not interacting with us during these activities, then the child will not achieve their developmental goals at the same time.

The only way to truly be a Greenspan Professional is to achieve both. If it is difficult to achieve both we have to go back and establish the developmental goals first. This is a bottom up approach, and the developmental goals within the model need to take priority. This also applies for example in a speech setting. If a child needs to work on verbal communication, but has yet to establish or master their gestural and physical communication patterns, then we have to go back and help them learn to, or strengthen, their physical and gestural communication before we are going to be able to start teaching them words.

In addition, to working with the developmental milestones of the Greenspan (DIR) Model we have to acknowledge the “I”; each child’s Individual Differences or their sensory processing and sensory modulation. In order to do this we have to understand sensory integration and modulation regardless of our background and training.  Especially if we are in a field that doesn’t train in sensory integration, like mental health, speech, or education, it is up to us to learn about it. Understanding each child’s sensory profile is crucial because we may need to decrease the amount of stimulation in their environment, or give them more, so that they can be as productive as possible during our sessions, and during the rest of their day.   By decreasing the stress in their lives so they can feel more organized and calm we need to make sure that we understand what sensory inputs their body needs, craves, and seeks out in order to perform optimally.  For example, many children have sensitivities to visual, auditory, and sometimes tactile stimulus and we need to be cautious of environments rich in these stimuli, while at the same time these children may also need proprioceptive, vestibular, and some tactile stimulus in the form of moving, squishing, and different types of touch. By providing children with the sensory inputs they need and limiting the sensory inputs they are sensitive to we are helping children maintain a state of sensory regulation.  However, in order to be a Greenspan Professional it is not just about giving them the sensory input they need, it’s about making positive emotional interactions around the sensory inputs they need.  This is because WE NEVER sacrifice the developmental milestones, like engagement and interaction, to work on a more specific goal. Each child’s sensory system and emotional system have to be be addressed the entire time.

The last piece of the Greenspan Model are the relationships. This is the most difficult and the most important piece for all professionals working with children within the Greenspan Model. In order to be a Greenspan Professional the most important thing is to build a trusting positive relationship with a child, and their family. In order to do that the professional must take a number of factors into consideration. First, what is the profile of the child? Do I need to be going slow and gentle and easing myself in, or does this child need a lot of stimulus and do I need to be loud and animated and excited? Secondly, what kind of person am I? What type of emotional state am I in so that we can understand how to modify our own emotional state to facilitate the best relationship for the child depending on our own natural personality? If we are more a subdued person, then we need to take that into consideration. If we are more excited person, then we need to take that into consideration. In either case we need to make sure that we are constantly modulating our own emotions and energy level to match that of what the child’s needs. But the relationship is not just about the child, it is also about the family. The Greenspan Floortime Approach® is a family approach. We cannot negate the important work with the parents. We have to be modulating our own energy and emotions when working with the parents as well because we have to build a positive and trusting relationship with them.  In addition to working with the parents we have to help the parents learn about themselves so that they can provide their child properly modulated support at home.

The Greenspan Model is a comprehensive holistic approach that address the entire child.  This means working within each environment a child might be spending time. Helping the parents understand their role, through reflective conversations, is a crucial ongoing piece to being a Greenspan Professional. Asking the right open ended questions, helping them reach their own conclusions versus lecturing them about they need to be doing, are important ways of helping them reach these conclusions on their own. This will take time and often you’ll need to set aside individual sessions to discuss the child’s progress and the situation at home with the parents without the child.

Using the techniques outlined in The Greenspan Floortime Approach® is essential to achieving both sets of the above goals.  Without using these techniques it’s unlikely that a professional will achieve both the Greenspan goals and their therapeutic curriculum goals.  To understand these techniques and goals please go to www.stanleygreenspan.com and learn from The Floortime Manual or the professional course.