DIR/Floortime: Otizm Spektrum Bozukluğunda Bir Erken Müdahale Modeli

Bu derleme çalışmasında Otizm Spektrum Bozukluğu olan özellikle erken çocukluk döneminde çocuklara müdahalede sunulan DIR/Floortime modelinin kuramsal temelleri, uygulama basamakları, temel yapısı, pratik bilgiler ve yapılmış araştırmalara yer verilmiştir. DIR/Floortime hem uzmanlar hem de aileler tarafından uygulanabilecek, ilişki temelli ve çocuğun bireysel farklılıkları üzerine yapılandırılmış müdahale modelidir. Floortime modelin müdahale yöntemidir ve temel olarak çocukla yarı yapılandırılmış oyunlar yolu ile çocuğun işlevsel, duygusal gelişim kapasitelerini geliştirmek ve tipik gelişim seviyesine yükseltmek amaçlanır. Oyunlar sırasında çocuğun önderliğini takip etmek, art arda iletişim döngülerini açıp kapatmak ve yaklaşık 20-25 dakikalık aralıksız oyun zamanları ile etkili Floortime zamanları oluşturulur. Türkiye’de DIR/Floortime’in Otizm Spektrum Bozukluğu olan çocuklara etkisi üzerine bir çalışma yapılmamıştır. Türkiye dışında yapılan çalışmalar incelenmiş ve DIR/Floortime’in özellikle erken dönemde kullanılması durumunda oldukça etkili bir müdahale yöntemi olduğu gözlenmiştir. Bu modelin sistematik kullanılarak etkisini araştıran çalışmaların yapılması beklenmektedir. Bu derleme çalışmasının yapılacak çalışmaların özellikle kuramsal temellerine ışık tutması amaçlanmıştır.

DIR/Floortime: An Early Intervention Model in Autism Spectrum Disorders

In this review, the theoretical foundations, practice steps, basic structure, practical information for the practitioner, and related studies about DIR/Floortime model which is delivered as an early intervention for children especially in the early childhood period with Autism Spectrum Disorder (ASD) are given. DIR/Floortime is an intervention model that is relationship-based and constructed on individual differences, can be used by both professionals and families. Floortime is the intervention method of a model and basically, it is aimed to develop a child’s functional emotional developmental capacities and increase them to typical development level by semi-structured plays with the child. Effective Floortime sessions are created by following the child, creating a continuous circle of communications, and ongoing approximately 20-25 minutes lasting playtimes. There was no research investigating the effect of DIR/Floortime on children with ASD in our country. Studies that are conducted out of our country have been analyzed and it is seen that DIR/Floortime is an effective intervention method especially if it is used in early childhood. It is expected that this model is used more systematically, and more research is being made to search for its effectiveness. It is aimed that this review will also contribute to the theoretical foundations of research which will be conducted in our country

PDF

___

APA. (2013). Diagnostic ans statistical manual of mental disorders-DSM-5. Washington: American Psychiatric Publishing.
Binns, A. V. ve Oram-Cardy, J. (2019). Developmental social pragmatic interventions for preschoolers with autism spectrum disorder: A systematic review. Autism & Developmental Language Impairments Volume, 4(1), 1-18.
Carpente, J. A. (2016). Investigating the effectiveness of a developmental, individual difference, relationship-based (DIR) improvisational music therapy program on social communication for children with autism spectrum disorder. Music Therapy Perspectives, 35(2), 160-174.
Casenhiser, D. M., Shanker, S. ve Stieben, J. (2013). Learning through interaction in children with autism: Preliminary data from a social-communication-based intervention. Autism, 17(2), 220-241.
Davies, L. N. (2016). An evaluation of the use of a DIR/Floortime intervention model in a specialist school setting. Yayımlanmamış doktora tezi, Cardiff University Enstitute. http://orca.cf.ac.uk/95849/1/FinalSubmissionThesis-c1057756%20%281%29 %20with%20amendments%203.pdf
Dionne, M. ve Martini, R. (2011). Floor time play with a child with autism: a single-subject study. Canadian Journal of Occupational Therapy, 78(3), 196-203.
Greenspan, S. I. (1992). Reconsidering the diagnosis and treatment of very young children with autistic spectrum or pervasive developmental disorder. Zero to Three, 13(2), 1-9.
Greenspan, S. I. ve Wieder, S. (2005). Can children with autism master the core deficits and become empathetic, creative and reflective? The Journal of Developmental and Learning Disorders, 9, 39-61.
Greenspan, S. I. ve Wieder, S. (1997). Developmental patterns and outcomes in infants and children with disorders in relating and communicating: A chart review of 200 cases of children with autistic spectrum diagnoses. The Journal of Developmental and Learning Disorders, 1(1), 87-141.
Greenspan, S. I. ve Wieder, S. (1998). The child with special needs: Intellectual and emotional growth. Reading, MA: Addison Wesley.
Greenspan, S. I. ve Wieder, S. (2005). Can children with autism master the core deficits and become empathetic, creative and reflective? A ten to fifteen year follow-up of a subgroup of children with autism spectrum disorders (asd) who received a comprehensive Developmental, Individual-difference, Relationship-based (DIR) Approach. The Journal of Developmental and Learning Disorders, 9, 39-61.
Greenspan, S. I. ve Wieder, S. (2006). Engaging autism: Using the Floortime Approach to help children relate, think and communicate. Cambridge, Ma: Da Capo Press.
Greenspan, S. I., Wieder, S. ve Simons, R. (1998). The child with special needs: Encouraging intellectual and emotional growth. Reading, MA: Addison Wesley.
Hess, E. B. (2013). DIR Floortime DIR®/Floortime™: Evidence based practice towards the treatment of autism and sensory processing disorder in children and adolescents. International Journal of Child Health and Human Development, 6(3), 267-274.
Horn, S. E. (2011). DIR/Floortime model: Using relationship-based intervention to increase social-emotional functioning in children with autism. Research Papers. Paper 67. http://opensiuc.lib.siu.edu/gs_rp/67
Ingersoll, B. R. (2010). Teaching social communication: A comparison of naturalistic behavioral and development, social pragmatic approaches for children with autism spectrum disorders. Journal of Positive Behavior Interventions, 12(1), 33-43.
Lal, R. ve Chhabria, R. (2013). Early intervention of autism: A case for Floor Time Approach (chapter 29). In M. Fitzgerald (Ed), Recent advances in autism spectrum disorders-Volume I (pp. 691-717). INTECH Open Access Publisher. ISBN 978-953-51-1021-7.
Liao, S. T., Hwang, Y. S., Chen, Y. J., Lee, P., Chen, S. J. ve Lin, L.Y. (2014). Home-based DIR/Floortime intervention program for preschool children with autism spectrum disorders: preliminary findings. Physical & Occupational Therapy in Pediatrics, 34(4), 356-367.
Nee, J. E. (2013). Behavior & developmental treatment models for autism spectrum disorders: factors guiding clinician preference and perceptions. Master of Social Work Clinical Research Papers. Paper 238. http://sophia.stkate.edu/msw_papers/238
Ospina, M. B., Krebs Seida, J., Clark, B., Karkhaneh, M., Hartling, L., Tjosvold, L., Vandermeer, B. ve Smith, V. (2008). Behavioural and developmental interventions for autism spectrum disorder: a clinical systematic review. PLoS ONE 3(11), 1-32. Doi: 10.1371/journal.pone.0003755
Öncül, N. (2014). Türkiye’de erken çocuklukta özel eğitim ile ilgili yapılmış makalelerin gözden geçirilmesi. International Journal of Early Childhood Special Education (INT-JECSE), 6(2), 247-284.
Pajareya, K. ve Nopmaneejumruslers, K. (2011). A pilot randomized controlled trial of DIR/Floortime parent training intervention for pre-school children with autistic spectrum disorders. Autism, 15(5), 563-577.
Pajareya, K. ve Nopmaneejumruslers, K. (2012). A one-year prospective follow-up study of a DIR/Floortime parent training intervention for preschool children with autistic spectrum disorders. Journal of the Medical Association of Thailand, 95(9), 1184-1193.
Pilarz, K. (2009). Evaluation of the effıcacy of a seven week public school curriculum based dir/floortime parent training program for parents of children on the autism spectrum. Yayımlanmamış doktora tezi, Temple University Enstitute. https://digital.library.temple.edu/digital/collection/p245801coll10/id/16852/
Prizant, B. ve Wetherby, A. (1998). Understanding the continuum of discrete-trial traditional behavioral to social-pragmatic developmental approaches in communication enhancement for young children with autism/PDD. Seminars in Speech and Language, 19(4), 329-353.
Simpson, R. L. (2005). Autism spectrum disorders: Interventions and treatments for children and youth. Thousand Oaks, CA: Corwin Press.
Solomon, R., Necheles, J., Ferch, C. ve Bruckman, D. (2007). Pilot study of a parent training program for young children with autism: The play project home consultation program. Autism, 11(3), 205-224.
Solomon, R., Van-Egeren, L., Mahoney, G., Quon-Huber, M. ve Zimmerman, P. (2014). PLAY Project home consultation intervention program for young children with autism spectrum disorders: randomized controlled trial. Journal of Developmental and Behavioral Pediatrics, 35(8), 475-485.
Wieder, S. ve Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435.