Playing with Elisha

Motivating children and adults on the spectrum is a complicated matter. Generally speaking, motivation is more intrinsic for us than for other groups. It is very hard for me to be motivated extrinsically, I’ve known that about myself for a long time, but there are studies that speak of this phenomenon, it is not just my belief.

It is true for my son as well.

I’ve been searching for various keys to unlock his inner spark, and I’ve needed all the help I could, which is why I’ve recently gravitated towards floortime or playtime therapy.

I will describe this therapy in a moment but first I should note which interventions I am not trying. I have never tried nor am I planning to try a behaviorist approach with my child.

I will not speak at any length here about ABA (Applied Behavior Analysis) which is polarizing in the autistic community. A therapist we work with now suggested that clinicians who employ ABA should themselves be in therapy for the abuse they inflicted. I find this language to be extreme and unhelpful.

I am skeptical of ABA, but as someone committed to rigor I can’t ignore the many hundreds of studies that show that it can be effective for certain populations, nor can I ignore the very limited number of studies showing that it causes harm. What underlies my skepticism of ABA type therapies is that behaviorist approaches depend to a great extent on affecting behavior from the outside, in other words extrinsically, and as I just noted, for so many of us on the spectrum extrinsic motivation is not as effective.

My skepticism is not informed by the rhetoric I find among activists regarding ABA. I refuse to be affected by the extremes of activist rhetoric when it comes to my child, and will always gravitate towards what works for him.

Floortime therapy was pioneered by psychologist Stanley Greenspan and is referred to by several names, but the most common among them is floortime. This intervention is often done at home, and is characterized by the practitioner seeking to insert themselves into the child’s natural play environment, and through a personal connection with the child expose them to a greater range of emotional language and behaviors, and stimulate them to behave in new ways, and thus develop resilience.

This improved communication is essential to discovering why a child does what he or she does, and gives one a better chance to stimulate their intrinsic motivation. This is its great promise.

Unfortunately, there are not that many studies proving the efficacy of floortime despite it having been around for awhile now. The measures they assess are on the social-emotional spectrum, and these are difficult to quantify. It is even more difficult to measure its effect on math and reading.

Difficult, does not mean impossible, however, and I believe that such studies should be undertaken, so the field of developmental education of neurodiverse people can move forward.

Ultimately, I believe that the effectiveness of a particular methodology can be very dependent on who the clinician is. In the five weeks with our therapist I have seen marked development in Elisha’s interactions with us. Elisha hasn’t been the only one learning, so have we, and that is very special.