If you work in a play-based practice, you’ve probably heard of DIRFloortime®, but you may still be wondering what it really looks like in action. In this interview from The Play Conference, pediatric occupational therapist Kerri Ciskowski shares how the DIRFloortime model helps clinicians and families understand each child’s unique developmental journey – especially for autistic children.
DIRFloortime offers a child-led, relationship-based, developmentally grounded framework that guides us in understanding each child’s unique strengths and challenges. By supporting growth through emotional connection, co-regulation, and play, we can help children progress across their developmental capacities in a way that feels safe and motivating.
At its heart, the DIR model helps us focus on three key components:
D – Developmental capacities: the nine foundational emotional and cognitive milestones
I – Individual differences: the unique ways each child experiences and processes the world
R – Relationship: the trusting, responsive connections that make learning and development possible
When these elements come together through Floortime – that is, play that follows the child’s lead – growth happens organically. As Kerri explains, “When you follow a child’s lead and do things that they are emotionally invested in, you always get exponential growth.”
The Nine Developmental Capacities
DIRFloortime is built around nine developmental capacities. These aren’t “levels to move through,” but dynamic capacities that children revisit as they grow and interact.
- Regulation
Everything begins with regulation. If a child walks into a session feeling tense or overwhelmed, our first goal isn’t to teach or redirect – it’s to co-regulate. We slow our own movements and tone, adjust the environment (dim lights, reduce noise, or use a favorite sensory tool), and join the child where they are.
Example: Kerri describes lying on her stomach next to a child, speaking softly and simply being present until the child begins to calm. Once regulation is restored, engagement naturally follows. - Social Engagement
When regulation is in place, connection can emerge. Engagement is about shared attention – those moments of mutual joy, eye contact, or shared focus that say, “I see you, and you see me.” It’s about the felt sense of connection. - Simple communication or reciprocity
Reciprocity doesn’t have to be verbal. It could be a shared gesture, a turn-taking exchange, or a moment of matching rhythm. The therapist (or parent) offers something – and waits for the child’s response. The idea is that when you do something, the child then has a contingent response to that.
- Complex Communication
Once simple reciprocity is established, interaction becomes richer. The child and therapist begin to solve problems together and you are now expanding on that initial communication and connection. - Symbolic Play
Symbolic play reflects the child’s growing ability to use imagination. A simple pen can become a bat or a musical instrument for example. In DIRFloortime these moments are encouraged because they allow children to explore emotional themes, experiment with social roles, and connect thoughts with feelings.
Example: When a child starts to turn a simple object into something imaginative, the therapist joins in – not directing, but expanding the child’s ideas in playful, meaningful ways.
- Logical and Emotional Thinking
This capacity is about how children begin to connect ideas and emotions. They can express cause and effect, consider others’ perspectives, and recognize that feelings can be understood and managed. It’s connecting your ideas to someone else’s ideas or linking a thought to a feeling - Multi-Causal Thinking
As children reach this stage, they begin to understand that there can be more than one reason or solution for a problem. Instead of thinking in simple cause-and-effect terms, they can consider multiple perspectives. This helps them become more flexible thinkers – able to see that people can act differently for different reasons. - Gray-Area Thinking
Life isn’t always black and white, and this capacity reflects that growing awareness. Children start to recognize that situations, feelings, and relationships can hold mixed emotions or conflicting truths. For example, something can be both exciting and a little scary. Developing this kind of nuanced thinking is essential for emotional regulation and empathy. - Standard of yourself
At the highest capacity, children develop a clearer sense of who they are – their preferences, emotions, and values. They can reflect on their experiences, understand how their actions affect others, and express individuality within relationships. This stage represents a more integrated self, built upon all the earlier capacities of regulation, engagement, communication, and connection.
Each of these higher capacities builds upon the foundations laid earlier. It’s normal to move back and forth between capacities. A session may reach complex communication and, after a moment of frustration, drop back to regulation. This fluidity is part of development – not a setback.
Therapists are constantly observing: What does this child need right now to feel safe and connected? By meeting those needs moment to moment, we help them build stronger foundations for growth.
Ready to see how these ideas look in action? Click here for Part 2 where we learn about Strength-Based Approach in DIRFloortime
DIRFloortime gives clinicians a roadmap for understanding and supporting developmental growth through connection and play.
Want to hear Kerri’s full case studies and examples?
About Kerri Ciskowski
Kerri is an enthusiastic Pediatric Occupational Therapist with 19 years of experience, including expertise in DIRFloortime. She is a dedicated lifelong learner who thrives on in-depth knowledge and strives to exceed expectations for the families she supports. She lives an active and fulfilling life in New Jersey with her husband and three energetic boys, enjoying a busy (and often loud) household.
Learn more about Kerri’s work at https://therapykeeper.com/