Following the Child’s Lead

At times I see posts that criticize Floortime stating it is focused on normalization as a goal.  This is not the case.  So, I want to take this opportunity to explore this topic a bit in the context of one of the tenets of Floortime which is to “follow the child’s lead.” 

First of all, it is important to consider the history of Floortime.  The development of Floortime goes back 50 years to Dr. Greenspan’s early writings on child development.  While he was a child psychiatrist presenting his ideas from a deficit-based medical model lens of the time, in many ways he was challenging that model from the inside-out and presenting a much more strength-based perspective.  He was incredibly progressive in his thinking and approach.  The development of the model has continued over time with the strength-based aspects becoming stronger.  ICDL has embraced the neurodiversity movement and lessons learned along the way to continually develop Floortime.  Simply put, even though you can find some deficit-based language in past writings about Floortime, it was never focused on normalization as a goal.  Furthermore, our focus on the development of the model over the years has been increasingly focused on being strength-based and embracing neurodiversity.  As Dr. Greenspan stated in his Great Kids book, “All children have within them the potential to be great kids. It's our job to create a great world where this potential can flourish.”  Our job isn’t to “normalize” the child, but rather to create the opportunities for them to flourish.

One of the tenets of the Floortime approach is that we “follow the child’s lead.”  What does this mean?  Many initially think of it as simply a technique, but it is much more than that.  It is a philosophical value of how we think people should be treated.  If we follow a child’s lead we are inherently being strength based.  We are following the child’s interest and the child’s strengths.  There are two words that Dr. Greenspan said very often about the therapeutic process, “Expand” and “Elaborate”.  Why are these two words so important?  Well, if we are helping the child expand and elaborate what they can do, then we are building from the child’s own interests and strengths.  One of my favorite Dr. Greenspan quotes is “Let’s help our children become the poets of their inner lives.”  This is a beautiful way of stating that we want to support each person’s own personal development of self.  We are not defining what that should be or predetermining a “normal” definition of any kind.  Our goal is to follow the child’s lead to help them become the poets of their inner lives. 

John Elder Robison spoke at an ICDL conference a few years ago.  He made a statement as he talked about his own personal journey becoming a self-advocate and embracing neurodiversity.  In it, he acknowledged the many ways autism and other developmental differences can be disabling and he stated the goal should not be normalization but rather to “help the child emerge from disability.”   I like this framing because by helping a child “emerge” we are not defining who they are or who they should be.  We are simply creating the best opportunity for them to flourish in their own way. 

Another part of Floortime to consider is that originally it was not designed as an intervention for autism. It has become an established evidence-based intervention for autism, but that is not what the core of the model is all about.  The core of the model is about how we can effectively help promote positive social-emotional development and help any child (or adult for that matter) develop the core capacities to engage and relate, communicate, and think and reason.  A meaningful development of these capacities can help all of us be more successful in life and to more successfully manage the challenges life brings.  It is not about normalizing.  It is about growing and developing.  Furthermore, that growth and development is done in the context of following the child’s lead and helping them expand and elaborate on their interests and strengths.

Floortime continues to progress and has developed over the years.  While it was never about normalization, you can find more deficit-based language in past writings about Floortime than you will find now.  As our understanding of child development continues to expand and our perspectives on autism has grown from awareness, to acceptance, and now to appreciation, the focus of intervention has grown as well.  We still follow the child’s lead, we still focus on promoting growth and development, we still honor individual differences, and we still are relationship-based because relationships fuel development.  None of that has changed.  However, we have taken the progressive strength-based philosophy Dr. Greenspan started with “following the child’s lead” and continued to progress as we have embraced neurodiversity and increased our overall appreciation for each person's and families' own culture and way of being.  We also have expanded the idea of “following the child’s lead” to “following their lead”, whomever they may be and whatever their age may be. 

I look forward to hearing others thoughts on this all.  In my leadership role, I have continually worked to grow and develop the model in a way that is consistent with the latest research and the latest input from the autistic community.  I am proud to be leading an organization that promotes a developmental approach that is joyful, respectful, and “follows the lead” of those that we are serving and supporting.