Autism and Floortime

     One of the myths of autism is that it is incurable. So called experts have for many years insisted there is no hope for these children. The best they might ever do is habituate to their condition. Even today I regularly see reports from prominent scientists describing it as genetic. It begins in the womb and is a lifelong disorder. The myth is slowly being debunked. There are a still small but growing number of physicians and psychologists who report genuine improvement in children with autism and in some cases even cures. Not all of them are wishful thinking parents who have children with autism themselves.
     Most clinicians refer to what is commonly called autism as Autism Spectrum Disorders or ASD. There is severe withdrawal and inability to communicate at one end and high functioning autism or Asperger’s Syndrome at the other. Dr. Stanley I. Greenspan makes the extraordinary claim that he has treated thousands of children and adults with ASD and has never seen one that could not be moved forward on the spectrum, not even one. In many cases they have been be able to join their peers in full healthy emotional and intellectual lives.
     Dr. Greenspan is no quack. He is Clinical Professor of Psychiatry and Pediatrics at George Washington University Medical School. He and a colleague, Dr. Serena Wieder, Ph.D., have spent the last twenty five years developing an approach they call Floortime. Their thesis is that all learning begins with emotion. The tiniest infant typically bonds and begins to communicate with its mother because it finds that communication pleasurable and desirable. Each little step in the process represents a foundational building block required for the next step. Children with autism have missed some of those building blocks. The idea behind Floortime is to meet the child wherever she is emotionally. Find what the child likes to do. Join her in the activity. Follow her lead and establish an emotional bond that can be used to communicate in a way the child finds pleasurable. That in turn can allow her to put some of the missing foundation in place. Over time the child moves up on the spectrum.
     I find Dr. Greenspan’s success stories inspirational. Weston Roberts has made remarkable progress in the two years since he was diagnosed with autism. He plays with his peers, makes strong eye contact, and laughs with his dad. But for the past six months or so he seems to be stuck on a language plateau. He hasn’t regressed, but beyond asking for what he wants he is distressingly quiet, rarely engaging in conversation though he loves to sing. And his stimming has gotten worse. Don’t bother to look it up. You won’t find it in Webster’s, not even in the unabridged edition. It’s what Greenspan calls self-stimulation and Weston’s mother calls sensory overload. Weston dances on his toes in what Mom and Dad call his happy dance. He also paces incessantly back and forth in a little trot. He is excessively excited and that appears to be interfering with his therapy. If I understand Greenspan, he would see it as an opportunity. Weston does that because it makes him feel good. So dance with him, sing with him and if he wants to trot, trot. Let him share his pleasure with you. Turn it into a game. It could be a non-verbal game that would help him develop an appreciation for non-verbal cues such as tone of voice, body language, even flirting. It just might add a foundation building block. That would be a wonderful thing.