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circlestretch

Help the child be…

• Calm enough to interact
• Truly connected to others
• In a continuous expanding
balanced
back and forth flow of
interaction
“Go for that gleam in the eye!”
http://www.circlestretch.blogspot.com
Connecting kids II:
In-Class Examples
of
DIR/Floortime®
Joshua D. Feder M.D.
Faculty, Interdisciplinary Council on Developmental and Learning Disorders
Assistant Clinical Professor, Department of Psychiatry
University of California at San Diego School of Medicine

Alice Prince, MA (?)
RSP, Solana Santa Fe Elementary School, Del Mar, CA

December 17, 2008 Solana Santa Fe Elementary School
Warning: this will go fast

• All the slides will be posted on
www.circlestretch.blogspot.com
Taking Notes?
• One word: ENGAGEMENT

• One phrase: Engagement goes
beyond compliance.
Definition of Relationship Based Intervention:

Relationship based intervention is the use of ongoing affective connected interaction to promote
developmental progress, focusing on co-regulation, engagement, and social reciprocity.
This is done in a context of a well rounded biopsychosocial understanding of the person,
and carried out throughout the day by caregivers who are guided and supported as they
develop growth producing relationships.

WE USE EMOTIONAL CONNECTION
TO FOSTER DEVELOPMENT

WE TAKE INTO ACCOUNT THE
PERSON’S INDIVIDUAL ABILITIES
AND CHALLENGES

WE WORK WITH FAMLY AND OTHERS
TO MAKE THIS HAPPEN ALL THE
TIME
circlestretch
Help the child be…

• Calm enough to interact
• Truly connected to others
• In a continuous expanding
balanced
back and forth flow of
interaction
“Go for that gleam in the eye!”
http://www.circlestretch.blogspot.com
Quick Review of
Functional Emotional Developmental
Levels
• I – co-regulation, ability to attend
• II – engagement, gleam in the eye, warmth
• III – circles of interaction
• IV – flow/ behavioral organization in social
problem solving
• V – symbolic thinking (critical to
tolerating affect)
• VI – logical connections between ideas
• VII – multicausal thinking
• VIII – grey area thinking
• IX – reflective thinking, stable sense of self,
and an internal standard
Solving in-class problems
at various levels: Co-
Regulation
• Problem: LOUD voice, directed at his
paper: 'I don’t how to do this..’
• Approach: make a ‘space’ for you and
him
• talk w/ him about it
• visual cuing icons for: ‘We can figure
this out’, ‘shhh’ and a 'raise your hand'
• how to get him looking up and keeping
others in the visual field - if all were up
on stools and drafting tables…
Solving in-class problems
at various levels:

Engagement
Problem: distracted; no interest in guest
speaker, trouble answering in class; if not
feeling it he doesn’t connect (remember dual-
coding?)
• Approach: instead of using prompt e.g.'eyes
down please' do something else to engage him
in the communal moment - ‘this story is so
cool’ – ‘we are getting to think about this
together’
• anticipatory guidance – ‘I wonder what you
think about it...’
• rule: find the fun – for each student
• HISTORY CHANNEL, live
• find, maybe write down, stuff the speaker wants
you to think is interesting or funny 
Solving in-class problems
at various levels: Circles
• Problem: struggling w/ joining in and
communication - counter-intuitive to have chit
chat in class, although with class moving on
had to stop at times
• Approach: do it in a non-verbal manner, cuing
to see what others are doing; solving problems
non-verbal, engaging non-verbally
• Problem: not bringing in his own ideas; sits and
says he doesn't know what to
• Approach: using statements - works well in
getting him to express himself, better feedback
when she uses statements
• Result: writing independently, w/ a writer's
voice, more than he has to - HUGE, HUGE,
HUGE!; part is 'I thought to myself...' - thinking
about thinking -
Avoiding Questions
Feder’s Tip of the Century

• Questions are top-down, ‘Guess what
I’m thinking’
• Questions put people on the spot,
and make them more likely to get
upset and close up or act mad
• Statements create social ‘problems’
that the other person can ‘solve’
• Try it out. It’s hard, but worth the
work.
Solving in-class problems
at various levels: Flow
• Progress on the playground
• friends asking him to play: ’Come
play with us!’
• Coaching, OT/ APE effort paying off -
how to run, how to look up, etc.
• arguing re the rules in sophisticated
way - shoulder to shoulder, hashing it
out - great!
Solving in-class problems
at various levels: Symbolic
and Logical Thinking
• Problem: math – must ‘do it right’;
frustrated; takes too long
• Approach: symbolic concept
‘impossible problems’
• Logic = faith in the process (Star
Trek falling hammer)
• Logic = self-advocacy, asking for
help when appropriate
Marilee Sheet on Math
Following his lead: ‘I must do it Joining: ‘Of course we want to
right’
Circles: statements that build do
Setitthe
right’
environment: making a
ideas, e.g., ‘I’m not sure what space (Like ER or on a date)
makes this so hard for us.’
Expanding the concept: Broadening Emotional
Impossible problems, then sorting themes: from intense reaction to
easy, hard, & impossible. stepping back, less intense,
curiousity; from perseverative
angst to calm perserverance
Individual Differences: reactive Working Multiple Levels:
to busy environments, poor motor Co-reg: space
planning, trouble reading cues, Engage: joining him
trouble expressing himself Circles
including loud voice, visual figure Flow: working problems together
ground difficulties, poor planning, Symbolic: ‘impossible…’
sequencing, execution, and Logic: ‘We can do this’, right =
adaptation; perfectionistic and showing what info isn’t needed,
reactive. right = showing your work
Critical Benefits of Symbolic
Thinking
• Expand his thinking so that he are not stuck
in the black and white, all or nothing world
• compare w/ others so he knows he isn’t
doing badly
• Tolerating a difficult moment with
confidence that he can get through it – like
being stuck in a haunted house –
uncomfortable in the moment – like four
square – that’s part of the fun –
• it helped that day when they were explicit –
not saying just fine but acknowledging that
it is hard, he can be proud of it when he is
done (COMPETENCE) –  
How’s the tracking going?
• Do we agree more on what co-
regulation looks like?
• Engagement?
• Reciprocity?
circlestretch
Help the child be…

• Calm enough to interact
• Truly connected to others
• In a continuous expanding
balanced
back and forth flow of
interaction
“Go for that gleam in the eye!”
http://www.circlestretch.blogspot.com
Data Tracking Sheet
 
Date: _____________ Student: _______________ Person Recording: _________________

In Class am Recess In Class Lunch Afternoon
Time: _________ Time: ______ Time: _______ Time: _______ Time: _______
Co-Regulation

Is he calm enough
and settled to attend
to an interaction?
Are you ‘tuning in’ to
near where he is
emotionally to help
him join in?
Examples of not
regulated:stretching,
distracted, staring
off, eyes not on the
group/activity,
over/underactive for
the situation
Engagement
Gleam in the
eye?
Is he “on the same
page” , paying
attention to the same
thing the “group” is?
-eye gaze to peers
and eye gaze to
activity/items that
the group is
interacting with…
visually and/or
verbally referencing
peers Social

Reciprocity
(Circles, Flow)
True Back and Forth
in speaking and
listening interactions
-opening (initiating)
and closing (ending)
circles of
communication
verbally or
nonverbally
School Data Tracking Sheet
instructions and comments

* *Fill in #minutes/15 minute sample for tracking co-regulation and
engagement

**Use hash marks to count number of times the child initiates or
responds appropriately for social reciprocity

**Complete one data sheet per week during all kinds of activities
including class time, free choice, recess, and lunchtime
 
Comments:______________________________________________________
  
________________________________________________________________
 
________________________________________________________________
 
________________________________________________________________
A General Plan for the
Management of Difficult
Moments *

• Have a plan ahead of time
• Adjust the environment
• Soothe
• Talk
• Anticipate
*reference:
A Bioethical Approach to Overcoming Problems with Aggression and Misbehavior in Schools,
Stanley Greenspan, M.D.
ICDL 12th Annual International Conference
November 7-9, 20082008 ICDL Fall Conference, Washington, D.C.
circlestretch
Help the child be…

• Calm enough to interact
• Truly connected to others
• In a continuous expanding
balanced
back and forth flow of
interaction
“Go for that gleam in the eye!”
http://www.circlestretch.blogspot.com
Thoughts and Questions
• Next meeting is 3/18/09
• Use circlestretch
• Great Kids