Clinician's Digest


Clinician's Digest

By Garry Cooper

July/August 2007


Few would argue that without early therapeutic family interventions and psychoeducation, infants with serious developmental disorders like autism will lag further and further behind in developmental growth, but psychiatrist Stanley I. Greenspan insists that the vast majority of "normal" infants and their parents could also use early guidance. The explosion of knowledge about how the earliest parent-child interactions shape neurobiological development and children's social, cognitive, and emotional abilities gives us an unprecedented opportunity to prevent many cases of future distress and full-blown disorders and syndromes, he says.

Greenspan, a clinical professor at the George Washington University Medical School in Washington, D.C., has developed the DIR/ Floortime Approach, which uses parent-child interaction and play for observation, assessment, and intervention. The approach rests upon a comprehensive biopsychosocial model, specifically the Developmental, Individual-Differences, Relationship-Based Approach (DIR), which looks closely at the physical, communication, emotional, and information-processing levels of each child, and at how the parents interact (or don't) to facilitate the child's growth. It also explores family relationships to see how they enhance or constrain the child's progress through six essential stages of early emotional and intellectual development.

"The children lead the way by demonstrating their natural emotional interests," says…

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