Dir support group notes for wed 3 5 08

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Hi DIR Support Group:

Our most recent meeting was on March 5, 2008, a combined meeting with professionals and parents. WHERE WE ARE We talked about the course of the year to date in our studies of the underpinnings of the DIR®/Floortime model:

1. growth enhancing relationships (see Floortime.org web radio from August 2007 through September 2007) 2. the effect of our past relationships on what we bring to our work with each other (see the late Selma Fraiberg's article Ghosts in the Nursery). 3. the protective and healing effect that interactions and relationships can have on the expression of genetic conditions such as ADHD, Schizophrenia, and others (Google GxE in the medical-psychiatric literature: the most recent issue of JAACAP has such an article) 4. the importance of Joint Attention / Engagement as the main focus of our efforts (of the growing research on this, a good example is the recent article by Delincolas and Young, “Joint attention, language, social relating, and stereotypical behaviours in children with autistic disorder.” In Autism: SAGE Publications and The National Autistic Society Vol 11(5) 425–436, 2007). 5. the need for Wraparound, i.e., having everyone on the team: parents, teachers, and other providers communicating, cooperating, adn working in the same effort to woo our family members into engaged relating. 6. our next task this year is to look at our Finest Moments, i.e., sharing, as appropriate, our successes with DIR®/Floortime and related interventions (my article is an example: Case Studies of Graduate Students Implementing DIR Programs, Travis Bradberry, M.S. and Josh Feder, M.D. THE JOURNAL OF DEVELOPMENTAL AND LEARNING DISORDERS Volume 6, 2002). OUR METHODS


Our local DIR professionals have been looking at several relationship based or relationship related intervention models, including The Miller Method, Hannen More Than Words, and ABLC.


We talked about DIR and related therapies, and here is the promised comparison: Therapy

Affective (emotional) focus

Individualized treatment

Developmental ‘bottom – up’ progression

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Follows the lead of the child +

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Playfully ‘getting in the way’ of the child ++

ABLC – Diane Lewis (parent of speech therapist does this – detailed manual available on icdl.com)) Miller Method (therapist works with child parent often present) Hanen More Than Words (Parents trained by Speech Therapists certified in the method) DIR®/Floortime (coach whole team, incl. family and school, to engage child in continuous flow of interactions).

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Speaking of Finest Moments, we next looked at looked at two DVDs of some of our icdl faculty. First we saw frequent guest faculty member Dr Arnold Miller's work, circa 1988-1989, with a child with significant challenges in relating and communicating and sever perseverative symptoms. He uses a combination of following the child's lead and attention to several areas


of motor and sensory function to build elements of interaction and communication. Dr Miller's use of elevated planks is a remarkable and distinguishing feature of his work. Our group member Lana Randall is bringing Dr Miller to San Diego for a conference this month on March 29-30 at ACES downtown. Go to http://millerinsandiego.org/ for more information. Dr Miller will be using OUR KIDS as case examples. There is no charge to have your child evaluated, as a public case example, by Dr Miller but spaces are limited, so contact me or go to the website for more information. This was a big day as we next saw ICDL Faculty master clinician speech therapist Sima Gerber, PhD, CCC on part of her recently distributed DVD. We are trying to get more copies of her DVD for mass distribution in our area. It gives clear and excellent explanations of the history of relationship-based understanding of communication development, compares typical development with developmental challenges, and demonstrates evaluation and intervention in engagement and communication. For example, Dr Gerber describes the components of Engagement: shared attention, shared intention, and affective reciprocity. The scenes of therapy show the challenges and also show successes with all the elements of Daniel Stern’s ‘vitality affects’ as the parents and therapists ‘shimmy and squeal’ (move and respond in an engaged, co-regulated manner) in reciprocal interactions with the child in the DVD. I can’t wait to show the entire DVD to more and more of us in town! Following Feder: I have a number of speaking engagements coming up over the next three months. The invited audiences are somewhat varied, and I hope to reach out to more parts of our community: 1. March 18 - San Diego ASA talk, 630 pm - An Open Forum: Dreams and Nightmares in the World of Autism. Will we survive? Can we thrive? (open to the public) 2. March 25 – Rady Children’s Hospital Autism Research Workgroup: the Thimerisol and Vaccine Controversy, an Explanation and Update (for local professionals who join the workgroup) 3. April 11 - IEP Day: Two session: Biology vs. Behavior: An Interactive


Seminar, and Dual Diagnosis: When there is a psychiatric disorder 4. on top of a developmental or learning disorder (sign up through www.iepday.org) 5. May 30 – UCSD Child Psychiatry Grand Rounds: “BEYOND MEDICATION AND BEHAVIORAL THERAPY: THE CASE FOR USING A RELATIONSHIP-BASED FRAMEWORK FOR THE TREATMENT OF PERSONS WITH AUTISM SPECTRUM DISORDERS” (open to UCSD School of Medicine Students, Faculty and Related departments). The April Conference in Seattle with Rosemary White is being postponed due to issues with the venue. It probably will be rescheduled in the fall of 2008, so stay tuned.

ICDL CONFERENCES AND TRAINING: The biggest Announcement is… The Infancy and Early Childhood Training Course Taught by Stanley I. Greenspan, M.D. Comes to You - ONLINE! For the first time, THE BASIC COURSE ON THE DIR®/FLOORTIME™ MODEL will be available online to registered participants for a two-week period from April 25 through May 9, 2008. There will also be a Post-Conference Workshop on REGULATORY SENSORY PROCESSING DISORDERS Taught by Rosemary White OTR/L and Stanley I. Greenspan, M.D. Go to www.ICDL.com for more information. The DIR®/Floortime™ Institute is Pleased to Announce Five Programs for 2008, July 7- 11, 2008 National Conference Center, Lansdowne, VA There are five different programs this year for professionals seeking DIR® certification at various levels and in different disciplines, including administrators of programs. Prerequisites include supervised work in DIR®/Floortime or attendance at the Basic Course of an equivalent training course. Go to www.ICDL.com for more information. Also, many local people are considering the new ICDL Graduate School, Ph.D. program in Infant and Early Childhood Mental Health and Developmental Disorders. The ICDL Graduate School offers a PhD program in Infant and Early Childhood Mental Health and Developmental Disorders through a distance learning format for qualified applicants throughout the United States and abroad.



Our next meetings of the DIR速/Floortime Support Groups are on April 9, 2008, 91030 am for professionals and 1030 am - noon for parents. Hope to see you there! Dr Feder


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