A state-funded Los Angeles treatment center will continue to offer an autism therapy some consider experimental — perhaps providing it to more children than ever before — under a preliminary court settlement.
Last year, the Eastern Los Angeles Regional Center stopped offering a therapy known as “DIR” or Developmental, Individual Difference, Relationship-based treatment after a change in California law barred state-funded centers from using “experimental treatments.” But a group of families sued arguing that the method is the only one that works for their children.
Now under a preliminary settlement expected to be finalized in September, the center will be required to offer DIR to anyone they serve with an autism diagnosis — whether or not they previously received the treatment.
DIR is the basis for a technique called Floortime, whereby therapists follow a child’s lead to encourage socialization through play. Though the method has been used for years, little clinical research exists to support its efficacy as compared to some other therapy approaches.
The Eastern Los Angeles Regional Center, which provides state-funded autism therapy to children living in certain Los Angeles neighborhoods, is believed to be the only facility in California to discontinue DIR as a result of the change in state law.
I think this is a more humane therapy than the various behavior modification schemes that sometimes result in the child seeing the teacher as an enemy. Pushing relationship rather than command following for hours and hours on end seems like it would be more effective and would be more likely to develop the whole child. Skinnerian type behavior mod seems over done. In any case with a complex condition with many causes and manifestations, such as autism, it is only reasonable that different methods would work for different people. Maybe it is time to encourage autistic kids to be kids. Demanding research driven methods only parallels the “drill and kill” test preparation that has so damaged education in America. Both regular and special education need to loosen up and recognize the art as well as the science employed by well educated, successful career educators and ensure that they are the ones directing the services. All children, including autistic children are more than bundles of behavior to be “managed”.
I hope someone has designed a study and will take useful data so that we can make some judgements as to the therapeutic value of this method.
How does FloorTime compare to methods like Brain Balance or NeuroNet? Isn’t it more child-led and much less structured? As with any child, some methods will probably work better for certain children than other methods. My daughter craves constant structure, but I’m sure that’s not true of all children on the spectrum.
Applied Behavior Analysis (ABA) is currently the only evidence-based treatment for individuals with autism spectrum disorders. If it is implemented correctly by trained professionals, and if children are able to participate early enough, then extraordinary gains can be made. I think people veiw ABA and other behavior modification therapies as insensitive or that they don’t allow kids to be kids. But, as mentioned before, if it is done correctly, then “good” ABA should combine discrete trial training, naturalistic instruction, incidental teaching, etc.. ABA uses discrete trial training initially in order to teach children on the spectrum readiness to learn skills. The one-on-one “drill” method is meant to be faded as soon as the child is able to learn in a natural/group environement.
Also, what people don’t realize is that Floortime (DIR) uses many principles of ABA, such as naturalistic instruction, incidental teaching, shaping, prompting, etc. However, professionals implementing Floortime do not use any form of data collection to monitor progress, and Floortime relies on case studies rather than single-subject or even true experiemental design. If Floortime would research their methodology thoroughly, perhaps it could become an evidence-based practice.
Furthermore, I think that people get so caught up with being in their separate camps. If professionals from each field would acknowledge the benefits and the similarities of different approaches and work together, then perhaps more laws would get passed requiring insurance coverage of more treatments for individuals with autism.