Integrating Floortime and ABA

Interview with Melissa Willa, M.A., BCBA
Gateway Learning Group

When I first contacted Melissa Willa a little more than a year ago, I was extremely nervous and skeptical about whether behavioral therapy, specifically, Applied Behavior Analysis (ABA), would be a good choice for Isaac.  I was worried that it would be too rigid and that it would conflict with the more child-led DIR/Floortime approach we were taking.  Melissa and her team proved me wrong.  They are respectful of Isaac, tuned into his personality, strengths and challenges, and are able to bring out his joy in learning.  Then about a month ago at the Jumpstart Conference, I learned that eclectic approaches to therapy are becoming more common.  So I asked Melissa to share her point of view on how to make an integrated ABA and Floortime program work.

Can DIR/Floortime and ABA be integrated?
Definitely. The field of ABA has evolved over the past ten years; there has been a "leftwards" movement toward a more developmental approach.  Ten years ago, most ABA providers were still very traditional. Sessions were largely adult-directed, and it was rare to see teaching sessions conducted using more naturalistic approaches. Natural environment techniques were always included to some degree; however, these tactics often took the back seat to more structured "discrete-trial" learning opportunities. Today we're seeing a movement toward more naturalistic, developmentally appropriate behavioral interventions.  What this means is that instead of ABA sessions being 90 percent adult-directed, sessions are conducted with a more natural back-and-forth flow of adult-led and child-led activities. Instructional activities are more play-based, centering on the unique interests of each child. If you look at the Floortime model, it's maybe 90 percent child-led. In the past, there used to be a real disparity between these approaches; now they are closer together.  So Floortime and ABA can be integrated into a child's overall program, just like speech and occupational therapies. And if Floortime and ABA therapists collaborate within a session, each can pick up some techniques from the other.

So how does this work?
You really do need to have providers who are willing to work together. It's true that there are folks who feel these methods to be mutually exclusive, and they don't need to be. So look for people who are open to collaborating, and who see the other approach as having value to the family.

What do you do when there's a conflict between DIR/Floortime and ABA approach within a session?
Talk about it. That's why it's so important to have team meetings monthly, or for therapists to touch base over the phone when they can't meet in person.

Can you give an example?
Sure. I had a situation where a child was having a challenge mastering a new skill. The Floortime therapist felt that the child needed to be provided with more "wait time" after being given the direction, while our ABA team felt that an "errorless learning" prompting approach was necessary. Historically, ABA has developed a bad rap for making kids prompt dependent. So we had a dialogue about that. I asked the Floortime therapist why she felt the child needed more time to figure it out on his own, and I explained why we felt that we should prompt him--to help him respond correctly, in order for the child to receive lots of positive feedback without practicing the skill incorrectly. When we talked about it, we came to the conclusion that it made sense to give the child extra time on skills that he had already demonstrated independently, but for new skills, we would help him sooner--to reinforce a sense of accomplishment. So both of us learned something through that experience.

Do you have any other advice for parents who are trying an integrated ABA/Floortime approach?
I think that the use of videos--videotaping portions of sessions and being able to share those--are really valuable. Video enables you to see something, pause the tape, and talk about how you might approach a situation differently. This is becoming more and more possible as video becomes more accessible. It isn't that commonplace now, but Dr. Lynn Koegel uses this technique at her clinic in Santa Barbara, and we try to use it whenever possible.  Don't be afraid--ask your therapists for permission to videotape the sessions. Both sides will discover great new ways to reach the child.

If you have a question for Melissa, please leave a comment here or email her directly at: melissa [at] gatewaylg [dot] com.

Comments

[Vicki Forman]

Oh, terrific post. I will be bookmarking this one. Thanks so much.

[Curran Pope, MS Ed.]

I recently read your posting and wanted to comment that I am very much in agreement and am truly pleased to see that the integration of ABA and Developmental Theory are being talked about more and more. I am always trying to find new ways to explain to families how important this methodology is for young children and how much more effective the use of a combination of theory is. I have many parents who have heard of ABA and want ABA but do not always know about DIR/Floortime.

I work for Easter Seals in NH as an autism consultant for early intervention. Although my formal training was in applied behavioral analysis my belief is that you cannot teach young children how to truly acquire, learn and use new skills without a combination of structured teaching, behavioral management and opportunities for generalization in a more natural environment.

I train all the support staff I work with to use the following continuum of teaching when they are with the young children they see. Prepare the child to learn by reinforcing or managing behaviors. When they are ready to learn, first teach new skills in isolation and then immediately move toward generalization by using that new skill in a vairety of new ways with different people and materials whenever possible.

I find that these children retain and use the new information more fluidly and independently than when they are engaged in repeated trails alone. Thanks for your encouragment and for getting this important message out.

Curran Pope MS Ed
Certified Educator and Autism Support Specialist, Easter Seals NH

[risa]

You mentioned that the floortime method is 90% child directed. Yes, the floortime technique of the DIR model is primarily child directed, however, this is just one component of the DIR model. Quoted from the ICDL website:

"Floortime™ is a specific technique to both follow the child’s natural emotional interests (lead) and at the same time challenge the child towards greater and greater mastery of the social, emotional and intellectual capacities. The DIR®/Floortime™ Model, however, is a comprehensive framework which enables clinicians, parents and educators to construct a program tailored to the child’s unique challenges and strengths. It often includes, in addition to Floortime™, various problem-solving exercises and typically involves a team approach with speech therapy, occupational therapy, educational programs, mental health (developmental-psychological) intervention and, where appropriate, augmentative and biomedical intervention."

[Bridgestocommunication]

Melissa (and Susan), this is a great post. I can't believe you posted this in 2007. I love the video of going over the mountain. So many approaches are really integrated here; dir/floortime, aba, speech and language approaches and aspects of the Hanen approach (i.e., using new labels to expand language). No wonder we love working with Gateway learning group!

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