DIR(R) Functional Emotional Developmental Levels 5-9

Transcription

1 DIR(R) Functional Emotional Developmental Levels 5-9 Presentation by Senior Faculty, Profectum Foundation Griffin Doyle, PhD Lisa defaria, LCSW, BCD Monica Osgood, Executive Director Profectum Foundation Contributions from Ricki Robinson, MD, MPH, Medical Director Profectum Foundation Karen McDowell, Lead Teacher, Celebrate the Children PART 2 PART II: DIR FUNCTIONAL EMOTIONAL DEVELOPMENT LEVELS (FEDL) 5-9 With the foundations of the lower levels of development in place, children with ASD and related disorders are often: warm engaging intentional able to solve problems beginning to have their own ideas These capacities provide the foundation for higher level thinking, expanding on their ideas, reasoning, abstraction and reflection 1 Copyright

2 PART II: DIR FUNCTIONAL EMOTIONAL DEVELOPMENT LEVELS (FEDL) 5-9 Developing these higher level capacities enables the child to: deepen the quality of his or her emotional relationships move beyond polarized thinking into more flexible modes of thinking regulate his or her impulses and moods use more complex thinking to support richer academic abilities 2 PART II: DIR FUNCTIONAL EMOTIONAL DEVELOPMENT LEVELS (FEDL) 5-9 Level 5: Symbolic Thinking/Language/Emotions: The child begins to use symbols (language) to express and share ideas. In play at first, the child mimics daily life; begins moving to more original imaginary ideas and actions dramatizing a widening range of child's reallife issues. Level 6: Building Bridges/Abstract Thinking: Can connect ideas logically and give reasons behind ideas (answer "why questions"); discovers new organizing concepts by connecting symbolic ideas which in turn more complex, fuller, emotionallycharged plots. 3 Copyright

3 PART II: DIR FUNCTIONAL EMOTIONAL DEVELOPMENT LEVELS (FEDL) 5-9 Level 7: Multi-causal, Comparative, and Triangular Thinking: The child is able to give multiple reasons behind ideas and use this flexible thinking to support modulation. The child also begins to understand how one relationship may impact other relationships. Level 8: Comparative and Gray Area Thinking: The child is not stuck in polarized thinking, but can understand varying degrees of emotions, ideas, etc. (e.g., "I am only a little mad"). They can also make comparisons between ideas and support their ideas in logical ways (e.g., "I like this cookie better than that one because this one has more chocolate chips"). This comparative and gray area thinking supports the child's ability to begin to understand social hierarchies. Level 9: Reflective Thinking/Growing Sense of Self/Stable Internal Standard: As the child approaches puberty they become more self reflective, can consider more than one frame of reference and begin to consider the past, present and future. 4 Symbolic Thinking/Language/Emotions I HAVE AN IDEA! The child s ability to form ideas develops first in play.through idea-laden play and expanding use of words the child is learning that symbols stand for things. Each symbol is an idea, an abstraction of the concrete thing, activity or emotion with which the child is concerned." ~Stanley Greenspan, MD & Serena Wieder, PhD, Engaging Autism, Copyright

4 Level 5 Symbolic Thinking The child begins to separate actions from perceptions and hold images in their minds. Language begins to evolve as the child is able to code these mental images into words and phrases that tells the meaningful experiences in their lives. This allows the child to share their ideas with others. The child has the capacity to communicate and share ideas with others The child is able to think about, imitate and represent activities from their daily life in their pretend play As the child s ability to symbolically represent ideas through pretend play grows more robust, the play themes broaden and become an expanding sequential narrative, depicting conceptually meaningful themes of life, while demonstrating through play the child s wishes, motives and fears. 6 CORE ACTION OF LEVEL 5 The child acquires the ability to delay gratification and modulate impulses as they now have the ability to access mental images and can use "thinking" as a means of regulation Verbal children begin using words as encoded symbols for ideas. Nonverbal children use gestures, affect, eye gaze to communicate ideas and share with others 7 Copyright

5 CORE ACTION OF LEVEL 5 (CONTINUED) Children begin to express their own ideas in play and play is communicative and functional, embedded with basic emotional themes such as happy, sad, etc. The child s play is moving into the pretend realm, beginning to act out ideas from every day life symbolizing familiar activities, such as cooking, baby care, etc. This is simple not complex play 8 K-BABY DOLL 9 Copyright

6 What we saw in this video Levels of Functioning: The child is showing emerging levels of symbolic thinking in her ability to imitate real life, meaningful experiences The right pacing allowed the child to stay in the interaction and continue to expand the play in her own way The child and caregiver share the experience around the theme of nurturing 10 L-ERIC AND ABBY 11 Copyright

7 What we saw in this video Levels of Functioning: The child is engaged, intentional and able to sustain interactions. However, using novel ideas is challenging in daily life, academics and play. In this highly motivating play he is able to: solve problems that allowed him to move away from his script use novel ideas in response to the spontaneous opportunities he was provided and begin to sequence and connect ideas as he was encouraged to solve problems and elaborate on ideas most importantly, he was driven by his own emotionally charged motivation 12 Building Bridges/Abstract Thinking At this stage, the child is able to express a wide range of emotions in play, and through experimentation, begins to recognize more and more what makes me. She can even predict some of her feelings- if Mommy leaves, I will be scared. She can answer what, when and why questions, enjoy debates and logically articulate an opinion and begin the long journey to higher levels of abstract thinking. Both verbal and spatial problem-solving abilities rest on emotional problem-solving skills." ~Stanley Greenspan, MD & Serena Wieder, PhD, Engaging Autism, Copyright

8 Level 6 Building Bridges/ Abstract Thinking A child is able to make connections between different internal representations or emotional ideas ( I m mad because you re mean. ). He or she is able to bridge ideas logically and demonstrate emotional awareness of themselves and others. He or she is able to explore the how, what, where, why of a situation. This takes into account time, spatial and causal relationships between themes. The capacities at this level are the foundation for higher level thinking, problem-solving and such capacities as: separating fantasy from reality modulating impulses and mood learning to concentrate and plan 14 CORE ACTION OF LEVEL 6 The child can connect ideas logically and better discriminate fantasy from reality He or she is able to use reasoning to support ideas, increase flexibility, bring down anxiety and support regulation Higher coordination of gesture, movement, affect, thinking, and language broadens portrayed emotional issues in play 15 Copyright

9 CORE ACTION OF LEVEL 6 (CONTINUED) Interactions and pretend play of Level 5 are now becoming more elaborate and complex, with more expansive emotional range, and themes that move beyond their everyday life Characters have increasingly complex motives, differing perspectives ( theory of mind ) which deepens the narrative The consequences of actions are derived and anticipated 16 M- ZACK AND BEN 17 Copyright

10 What we saw in this video Levels of Functioning: The boys are able to sustain interactions, problem solve and use ideas. However connecting ideas logically around an emotional situation needs facilitation. Principles to Support Development: The activity doesn't matter, the interaction does/taking advantage of spontaneous interactions Helping to bridge between ideas Drawing attention to the other child's emotion 18 Level 7 Multi-causal and Triangular Thinking The child or pre-adolescent is able to: explore multiple reasons behind ideas compare feelings understand triadic interactions among feeling states ( I feel left out when Susie likes Janet better ) The child or pre-adolescent becomes more interested in how he or she fits into the larger world which now has much more meaning to him. Understanding the three person system the child becomes interested in all facets of their world: sex, death, where did I come from?, etc.. It is common for some children to experience fear and anxiety dealing with this. 19 Copyright

11 CORE ACTION OF LEVEL 7 Multi-Causal Thinking The child has a more sophisticated emotional problemsolving capacity and can invest emotionally in more than one possibility He or she can move beyond black and white thinking and demonstrate the ability to think of 3 or more possible solutions to the same problem This flexible thinking allows the child to regulate mood and impulses 20 CORE ACTION OF LEVEL 7 (CONTINUED) Triangular Thinking The child or pre-adolescent is able to find an indirect road to problem solve, (e.g.: John wants to be Sarah s friend. He sees that Tom is Sarah s friend, so John becomes Tom s friend). This type of thinking is more expansive and even a little manipulative. He learns to work the crowd to satisfy his social needs. Go to Mom if Dad says no because Dad is softer than Mom (the child can make comparisons) The child is able to understand the dynamics of relationships beyond their immediate needs and desires 21 Copyright

12 N-KRISTEN AJ 22 What we saw in this video Levels of Functioning: Initially the child was reacting purely from her perspective. She was not able to connect ideas logically and access the emotional context of the experience. With scaffolding, she was able to think about other reasons/motives for the incident rather than just seeing it from her own perspective. She was able to make emotional connections to the motives behind the interaction She had the emerging ability to think about how this new understanding may support her emotional regulation in the future. 23 Copyright

13 Issue: Pro: I m Santa Claus and I do exist Con: Santa Claus is a fable 24 O- SANTA 25 Copyright

14 What we saw in this video Levels of Functioning: The students were working at multiple levels at a time Students were being challenged to come up with multiple reasons to support an idea They were required to take another person's perspective Challenges in flexible thinking prohibited some students from creating a logical argument 26 Level 8 Emotionally Differentiated Gray-area and Comparative Thinking Gray-area Thinking The child or pre-adolescent moves beyond black and white thinking and is able to understand shades and gradations among differentiated feeling states (e.g., is able to describe degrees of feelings about anger, love, excitement, disappointment, for example, I m a little mad, very mad, etc. ) As the adolescent is able to see the shades of gray this allows them to be more flexible and more successful problem solvers. He or she can also see consequences of behavior. 27 Copyright

15 Level 8 Emotionally Differentiated Gray-area and Comparative Thinking Comparative Thinking He or she can make comparisons between objects, their feelings, events, character traits of self and others, etc. He or she also develops the capacity to rank people, situations and events in order of preference or importance, (e.g., Jo is the best, I'm the second best, and John is the worst. ) With these new capacities the adolescent begins to know where they fall on the social ladder. He or she begins to define himself by how he is accepted by his peer group 28 CORE ACTION OF LEVEL 8 Gray-area Thinking The child or pre-adolescent expresses his or her emotions in degrees (how happy or sad they are: "forgetting my lunch makes me a little angry, being yelled at makes me very angry, being touched when I don t want to be touched makes me furious") He or she can determine the degrees that two people are similar or different, ("I am the same as Billy in that we both enjoy video games and dislike sports, but we are different in that he learns well by listening and I don t") 29 Copyright

16 CORE ACTION OF LEVEL 8 (CONTINUED) Comparative Thinking/Rank Order The child or pre-adolescent an make comparison between things in degrees/rank order ("the most significant causes of wars in order are #1 land, #2 resources, and #3 religion") Social Hierarchy Can understand their relative standing in various social hierarchies ("I m the best of the group at soccer but I m one of the ones that has the most trouble with math problems") 30 P-DESERT ISLAND POKÉMON 31 Copyright

17 What we saw in this video Levels of Functioning: Initially the child could rank the Pokemon, but not support the decisions with reasons. She was stuck in concrete thinking and resisted going deeper. As the interaction progressed the child moved into much higher levels of thinking, became more flexible and was able to provide logical and meaningful evidence for her ideas. 32 Level 9 Intermittent Reflective Thinking, a Stable Sense of Self, and an Internal Standard The teenager becomes self reflective and can evaluate his or her own ideas, actions, behavior and feelings/judge their own experiences. He or she is able to see beyond the immediate situation and think in more than one frame of reference at a time. He or she can reflect on feelings in a relationship to an internalized sense of self ( It s not like me to feel so angry or I shouldn t feel this jealous ). 33 Copyright

18 Level 9 Intermittent Reflective Thinking, a Stable Sense of Self, and an Internal Standard The teenager begins to internalize values and develops a greater sense of self that can t be broken down by lack of acceptance by peer group, e.g., "Sally was mean to me because she was having a bad day, but I m still a good person." The abilities at this level allow the teen to think about the past, consider the present and dream about the future 34 CORE ACTION OF LEVEL 9 The teen can reflect upon their personal strengths and weaknesses ("It is really hard for me to spell and listen to directions but I m great at helping the younger children and writing creative stories") He or she can objectively evaluate their own performance and work, objectively summarize their work ("I feel that while I had lots of details and backed up my opinion, my overall presentation lacked three of the required components") The teen can establish and their own personal opinions on issues ("I feel that the war is sometimes just and necessary") 35 Copyright

19 CORE ACTION OF LEVEL 9 (CONTINUED) The teen can differentiate between how they feel in the moment and their more stable character traits, feelings, etc. (e.g., "I was mean to Kathy today, but I'm not a bad person, I am just feeling bad because I failed my math quiz") The teen can consider the past as a factor in the present ("I didn t accept the extra help I really needed in writing last year and now it is causing me to feel I am behind my classmates") Has an ability to reflect on their own future ("I would like to have a career that allows me to spend time with my family as well as earn a good living") 36 Q-MIKE ON KATIE 37 Copyright

20 What we saw in this video Levels of Functioning: Initially, the young man was polarized in his judgement of himself based on the immediate experience His emotional reality was only in the here and now With encouragement he was able to reflect on his real character traits and realized he was just having a bad day It was his idea to apologize and truly cared about his peer's feelings 38 Functional Emotional Developmental Levels (FEDL) The DIR FEDLs represent nine essential developmental capacities which provide the core foundation every child needs for optimum growth and development Typical chronological measurements of a child s development are one dimensional. They miss the interplay between developmental systems at work in the emerging growth of a child The developmental systems at work include: Regulation, sensory-motor, visual-spatial, social-emotional, communication and language, cognition, health and well being. 39 Copyright

21 FEDL ~ continued These systems or lines of development are intertwined and interdependent among each other to generate and advance a child s developmental capabilities Delays in one, will impact progress in another Quality of functioning depends on: 1) The integrity and strength of each system 2)How harmoniously these unite into a whole person.to think about function is to think about potential. We look not just at what functioning is under the child s control, but also at what influences the child ~ Greenspan/Wieder, Conclusion The FEDL is a dynamic paradigm both a theory and practice. The FEDL is continually evolving, as do we, in our growth as practitioners and parents, and as new research informs the DIR model. 41 Copyright

22 THANK YOU We want to thank Serena Wieder, PhD and the late Stanley Greenspan, MD for pioneering this model and deeply enriching our understanding of child development, the child with special needs and the importance of relationship. We would also like to thank the DIR faculty for their multi-disciplinary contributions to the model and recognize that these contributions are reflected in what the model is today. Finally, sincere gratitude to all the families who have taught us so much and allowed us to share some of their precious moments in this presentation! 42 References Greenspan MD, S., Lewis, N. (2000). Building Healthy Minds: The Six Experiences That Create Intelligence And Emotional Growth In Babies And Young Children. Cambridge, MA: De Capo Press. Greenspan MD., S., Wieder PhD., S.. (2006). Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate, and Think. Cambridge, MA: De Capo Lifelong Books. Greenspan MD., S., Wieder PhD., S.. (2003). Infant & Early Childhood Mental Health: A Comprehensive Developmental Approach to Assessment and Intervention. Zero to Three. Greenspan MD., S., Wieder PhD., S.. (1998). The Child With Special Needs: Encouraging Intellectual and Emotional Growth. Reading, MA: Perseus Books. Robinson MD., R. (2011). Autism Solutions: How to Create a Healthy and Meaningful Life for Your Child. Ontario, Canada: Harlequin. The Interdisciplinary Council on Developmental and Learning Disorders. (2000). Clinical Practice Guidelines: Redefining the Standards of Care for Infants, Children and Families with Special Needs. Bathesda, MD: ICDL. Some videos were supplied by Celebrate the Children School, NJ~ 43 Copyright