DIRFloortime® is a strength-based, relationship-driven framework that honors each child’s individuality. Rather than focusing on “fixing” behaviors, therapists use emotional attunement and play to build trust, safety, and motivation – creating the conditions for growth.
In our Play Conference interview with OT Kerri Ciskowski, we explored how DIRFloortime helps therapists and families move away from compliance-based approaches and toward true connection.
Following the Child’s Lead
“When you follow a child’s lead and do things that they are emotionally invested in, you always get exponential growth.”
Unlike more structured or compliance-driven methods that can create stress or resistance, DIRFloortime invites the therapist to follow rather than direct.
Imagine walking into a session with a child who’s usually cheerful and engaged, but today seems tense and withdrawn. Instead of pushing forward with your plan, you slow down – noticing their cues, adjusting the environment, and co-regulating before doing anything else.
You might lie on the floor beside them, soften your tone, or mirror their movements. Once the child feels regulated and secure, you can begin to engage perhaps by joining in their play with a simple object they’re interested in, like a piece of paper. These small acts of following the child’s lead build connection and open the door to development.
The Therapist’s Role: Guiding Families Toward Co-Regulation
DIRFloortime recognizes that development happens within relationships, and this is not only between child and therapist but also includes the vital relationship between parent and child. Because children learn to regulate through their relationships, a key part of a therapist’s role is to model co-regulation and help parents understand how their own emotional state can influence their child’s.
Co-regulation means staying calm and connected when a child is struggling – offering regulation rather than joining the dysregulation. In contrast, when a parent’s stress or frustration rises alongside their child’s, both become caught in a cycle of co-escalation. The goal is to help parents notice when this is happening and give them the tools to shift the dynamic.
Often, this starts with self-reflection. Therapists can guide parents to explore their own individual profiles – their sensory needs, emotional triggers, and stress responses -so they can recognize when their reactions may be adding tension rather than easing it.
Part of a therapist’s role when working with families is recognizing that parents often have the right intentions, but may not yet have the most effective tools to support their child. It’s the therapist’s responsibility to gently guide and model what those supportive strategies look like in practice. In this way, the therapist is not only helping the child, but also coaching and empowering the parent.
Everyone’s shared goal is the child’s development but that growth can only happen within a supportive and regulated family system. By teaching parents to use co-regulation instead of co-escalation, therapists help families find moments of calm and connection, even in challenging situations.
A Framework for Every Discipline
DIRFloortime isn’t limited to occupational therapy. Speech therapists, psychologists, educators, and even parents can integrate its principles. Each discipline brings its own lens, but the shared foundation remains the same – meeting the child where they are and building from their strengths.
DIRFloortime is more than a method – it’s a mindset. It teaches us to slow down, connect first, and trust that true development happens through relationships. When we honor each child’s unique journey and engage with them playfully and authentically, we help them move through the developmental capacities with confidence and joy.
Want to explore the nine developmental capacities behind the DIRFloortime approach? Click here for Part 1
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/