**6. Research support for floor time**

The Floor time approach examines the functional developmental capacities of children in the context of their unique biological profile and their family relationships and interactive pat‐ terns. A longitudinal study [15] was conducted to determine if children with ASD could overcome the core deficits in social behavior and become empathetic and reflective with floor time intervention. A follow-up study of 16 children diagnosed with (ASD) revealed that with the DIR/Floor time approach, a subgroup of children with ASD can become empa‐ thetic, creative, and reflective, with healthy peer relationships and solid academic skills. This suggests that some children with ASD can master the core deficits and reach levels of devel‐ opment formerly thought unattainable with a family-oriented approach that focuses on the building blocks of relating, communicating, and thinking [16].

In another study undertaken by Greenspan and Weider [15] where the progress of 200 chil‐ dren who had earlier received Floor time sessions, was reviewed showed that majority of the children learned to relate and engage with warmth, trust and intimacy; they were able to interact, read and respond to social signals; a subgroup of children developed the capacity for imaginative play, creative use of language and reflective thinking. This sub group was included in mainstream schools where the children developed meaningful relationships with peers.

Josefi and Ryan [17] conducted a case study on a 6 year old boy with severe autism. Video recordings of 16 sessions of play therapy with the child were analyzed qualitatively and quantitatively. The study concluded that this child was able to enter into a therapeutic rela‐ tionship and demonstrated attachment behavior towards the therapist. Key areas of im‐ provement were in the child's development of autonomy and pretend play, while ritualistic behaviors showed only mild improvement. Changes were also noted in the boy's behavior at home of increased independence and empathy. One implication of this preliminary re‐ search is that non-directive play therapy may enhance and accelerate emotional/social de‐ velopment of children with severe autism.

Children with ASD differ from one another—in the ways they engage, relate, and communi‐ cate and in the ways they respond to sensations, and plan and sequence their actions. These differences mean that each child requires an intervention approach tailored to his unique‐ ness, an intervention that must also consider the home setting. According to Costa and Wit‐ ten [18] the goals of such a program, regardless of the approach used, must be to strengthen the child's core deficits, namely: building the foundations for relating, communicating and thinking. The DIR/Floor time Model is especially beneficial to children with ASD and other developmental and/or emotional challenges.

Solomon et al [19] published an evaluation of The PLAY Project Home Consultation, a wide‐ ly disseminated program that trains parents of children with autism spectrum disorders in the DIR/Floor time model. Sixty- eight children, 2 to 6 years old (average 3.7 years) complet‐ ed an 8–12 month program where parents were encouraged to deliver 15 hours per week of 1:1 interaction. Pre/post ratings of videotapes by blind raters using the Functional Emotional Assessment Scale (FEAS) showed significant increases in child subscale scores. That is, 45.5 percent of children made good to very good functional developmental progress. Overall pa‐ rents' satisfaction with program was 90 percent.
