Developmental Interventions

Introduction

Mother and child sitting on the floor Developmental interventions (also known as the Developmental Social-Pragmatic Model, the DSP model, the interactive model, or the child-oriented approach) are a wide group of interventions designed to target the core difficulties faced by each child rather than his or her outward behaviours.

Developmental interventions are derived from research on typical child development that indicates a relationship between caregivers' responsivity and their child's level of social communication development.

According to Ingersoll et al (2005) Developmental interventions share several common characteristics

First, teaching follows the child's lead or interest; the adult engages in child-initiated interactions that are based on the child's interests and attention.
Second, the adult arranges the environment to encourage initiations from the child. Common strategies include playful obstruction (that is, briefly interrupting an activity the child is doing)
Third, all communicative attempts, including unconventional communication, are responded to as if they were purposeful.
Fourth, emotional expressions and affect sharing are emphasized by the adult. The adult exaggerates his or her affective gestures and facial expressions and labels the chil'ss emotional response.
Fifth, language and social input are adjusted to facilitate communicative growth.

In practice, developmental techniques are often used alongside other techniques such as Behavioural Interventions and also within many Educational Interventions.

Evidence

Some high quality evidence shows that autistic children have difficulty reaching certain developmental milestones associated with the development of social communication skills and social interaction. Some very limited research evidence shows that some developmental interventions, such as the DIR method, may provide some benefits for some autistic children. Determining if other developmental interventions, such as intensive interaction, have any benefits is not currently possible. We must wait for further research of sufficiently high quality to be completed.

Risks and safety

No risks are known for most developmental interventions.

Specific developmental interventions

DIR Method

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

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

The key technique used within the DIR Method is a series of 'Floortime' exercises in which the carer takes an active role in spontaneous and fun activities that are directed by the child's interests and actions.

The DIR Method is usually delivered by parents, helped by a DIR Method consultant, who develops and oversees a programme personalised to the needs of the family, and with input from other professionals as necessary.

More Information

Please see

Intensive Interaction

Intensive interaction is an approach based on natural conversations at a level that a person can understand and join in with. This is achieved by following the individual's lead and mirroring his or her behaviours and vocalisations.

Once an individual's attention has been gained a sequence of interactions begin which build over time. During the interactions the individual learns the fundamentals of communication (getting a response and responding, reading and using facial expressions, body language, eye contact, turn-taking, vocalising).

One of the most important things an individual learns through the process is that other people are good to be with and that other people enjoy being with them.

More Information

Please see publications on Intensive Interaction

Relationship Development Intervention

The Relationship Development Intervention (also known as RDI) is a parent-led approach which focuses on a child's difficulties with flexibility of thought, emotional regulation and perspective-taking.

RDI is based on the idea that children with autism have missed key developmental milestones (such as social referencing, joint attention) that enable them to think flexibly, regulate their emotions, and understand social situations.

RDI seeks to give children another chance to master these milestones in the same way that they are mastered by typically developing children: through their relationship with their parents.

An RDI consultant guides the parent to change their communication and interaction style so that they can support their child to fill in the developmental gaps they missed. This is done through everyday activities such as washing up, cooking, going for a walk, etc (some of which are video recorded and shared with the family's consultant who then provides feedback on progress).