Often children who have been derailed by developmental delays like autism present for treatment with very poor or no apparent play skills. There is an equally low level of interest in engaging with play partners. This has led to a pessimistic view by psychiatric clinicians of the play capacities of children with developmental challenges.

While currently there is no cure for autism, a neurological disorder that can impact multiple systems in a child's neurophysiology, and which, according to the Center for Disease Control and Prevention, impacts 1 in every 91 children, there is hope. DIR/Floortime is a developmental play therapy technique that has the capacity to reach a variety of children impacted by autism.

Stanley Greenspan, a child psychiatrist in the Washington, D.C. area, designed a modern developmental/relationship-based model that helps chil- dren with a variety of problems. He called it DIR (developmental, individual-differences, relationship-based model) or, in practice,”Floortime” and made the approach available to the public with his colleague Dr. Serena Wieder in their book The Child with Special Needs (1998). In it, Drs. Greenspan and Wieder emphasize that success with any child is based on the ability of the play partner to meet the child on his developmental level, strengthen potential underlying neurological elements that may be impeding development and emphasize the critical emotional connection between the impacted child and the other player.

The term Floortime refers to the actual process through which therapists, parents, and other caregivers make a special effort to tailor interactions to meet the child at his unique functional level and within the context of his processing difficulties. Greenspan's model clarifies the basis of children's behaviors, while Floortime sessions support the reciprocal relationship between child and caretaker. The technique involves having play partners get down on the floor and follow the child's lead to encourage the child's initiative and purposeful behavior, deepen engagement, lengthen mutual attention, and develop symbolic capacities.