DIR Method and Autism Ranking: Limited positive evidence

Key Features

The DIR Method (also known as Floortime, DIRFloortime or the Developmental, Individual Difference, Relationship-Based Model) is a comprehensive, multi-component intervention used to help children with autism and other developmental disabilities.

The DIR Method is based on the idea that some children have difficulty reaching certain developmental milestones (such as two-way communication) and can be helped to meet those milestones through playful, structured interaction with an adult.

The DIR method allows carers to use a wide range of techniques and other interventions – such as speech and language therapy – alongside the core element of ‘Floortime’.

There are several programmes (such as the MEHRIT program and the Play and Language for Autistic Youngsters (PLAY) Project Home Consultation program) which are based on the DIR Method. There are also a number of other multi-component programmes (such as the Children's Toddler School Program in the US) which incorporate elements of the DIR Method alongside elements from other approaches.


‘Floortime’ is a series of interactive exercises that are designed to help the child master key developmental milestones. As the name suggests, most of the exercises take place on the floor.

The carer follows the child's lead and plays at whatever captures his interest but does so in way that encourages the child to interact with the carer. The role of the carer is to be a constructive helper and, when necessary, provocateur by doing whatever it takes to turn the child’s activity into a two-person interaction.

For example, if the child wants to roll cars, the carer rolls cars with him, offering him a faster car or a competitive race or, if necessary, crashing his car with the carer’s – whatever it takes to create an interaction.

By creating these interactions, over and over again, the carer builds on and develops the child’s interests and capabilities until the child is enticed into the world of ideas and logical thinking.

Floortime exercises

The exercises are based around five key steps.

  • Step 1. Observation

The partner listens to and watches the child to determine how best to approach him or her.

  • Step 2. Approach – open circles of communication

The partner approaches the child using appropriate words and gestures based on his or her mood and communication/behaviour style.

  • Step 3. Follow the child’s lead

The child establishes the tone, guides the activity and creates ‘personal dramas.’ This helps the child experience feelings of warmth, connectedness and being understood by the partner.

  • Step 4. Extend and expand play

The partner makes encouraging comments about the child’s play. This helps the child to express ideas and emotions.

  • Step 5. Child closes the circle of communication

The child makes comments and gestures of his or her own.

31 Oct 2017
Last Review
01 Mar 2016
Next Review
01 Mar 2019