D.I.R. MODEL
GUIDELINES
Developmental, Individual, Relationship-Based (D.I.R.) Model

The basis of D.I.R., or Greenspan/Wieder approach, is to help children with learning difficulties connect ideas and develop a logical understanding of the world. Dr. Greenspan states that teaching children to become independent thinkers enables them to do anything. The way to do that is to respect the child interest while challenging her/him to become more logical and better adept at abstract thinking.

Often we focus on changing specific behaviors, or teaching very specific skills. Children may memorize these skills, but if they cannot "think on their feet" their ability to use and generalize this skills will be limited. Children with developmental challenges often favor rotes ways of thinking,, and rote learning only compounds the problem.

DIR uses emotional and motivating experience-based learning to improve social skills, language, independence, and teach specific concepts and academics.

Annually over 1,000 professionals and parents attend the DIR training course seminar given by Dr. Greenspan and Dr. Wieder in Washington D.C.

Most commonly, the loss or lack of progress in developing a continuous flow of reciprocal emotional cueing is seen between eight months and eighteen months.

1. Functional Developmental Evaluation.
1) Developmental history.
2) Observation of family patterns
3) Biomedical assessment
4) Review of current functioning
5) Observations of child/caregiver interactions.
6) Review and/or observation of educational program and peer interactions.
7) Assessment of auditory processing and functional language skills.
8) Assessment of motor and perceptual motor functioning.
9) Assessment of sensory modulation.
10) Assessment of sensory processing.

2. Developmental Profile.
1) Biomedical factors
2) Individual differences in Auditory Processing, Visual/Spatial Processing, Motor and Perceptual Motor Functioning, Sensory Modulation and Processing.
3) Functional Developmental Capacities. (Attention, Engagement, Purposeful Gestures, Complex Problem Solving Interactions, Creative Use of Ideas and Symbolic Play, Logical Thinking).
4) Caregiver/child interactions and Family Patterns.
Description of current patterns and description of optimal patterns tailored to functional developmental capacities and individual differences.

3. Comprehensive Functional Developmental Intervention Program.
1) Family Support
2) Biomedical Interventions
3) Specific Therapies As Required (Speech and Language Therapy, Occupational and/or Physical Therapy, Perceptual Motor Interventions, Visual/Spatial Interventions).
4) Home Program
5) School Program

4. Home Program.
1) Semi-structured problem solving interactions involving cognitive, language, social and emotional skills. Six or more 20 minute sessions per day are recommended.
If the child is able to imitate readily and use complex problem solving gestures, then semi-structured learning should focus on dynamic problem-solving interactions orchestrated by the caregiver to enable the child to master specific cognitive, social or educational goals.
If the child is not yet able to imitate readily and use complex problem-solving gestures, consider more structured exercises to teach specific cognitive, language, social, and emotional skills. The initial goal should be mastery of gestural, problem solving interactions and complex imitation. This often requires work on motor planning and sequencing, visual/spatial processing, as well as affect gesturing. Use augmentative communication strategies and consider TEACCH, the Miller Method, ABA, and exercises focusing on imitative skills and motor planning sequencing.
2) Spontaneous, developmentally appropriate interactions mobilizing the six functional developmental capacities (floor time). Often recommended eight or more 20 minute sessions per day.
3) Motor, sensory, and visual spatial activities. Often recommended: three or more 20 minute sessions per day. Include the following elements:
- Sensory Integration occupational therapy exercises (running, jumping, spinning, firm tactile pressure).
-Perceptual motor exercises (throwing catching, kicking, tracking)
-Visual/spatial problem solving (hide-and-seek, treasure hunt, flashlight games)
- Once child can answer "why" questions, consider adding visual/spatial thinking activities.
If the child is verbal and getting ready for school, consider adding pre-academic, conceptual reasoning, reading, and math exercises.

5. School Program

1) Spontaneous, developmentally appropriate interactions mobilizing the six functional developmental capacities (floortime). Includes social interactions with teachers and peers, social games, and play dates with "expert peers."
2) Semi-structured problem solving interactions involving cognitive, language, social and emotional skills.
If the child is able to imitate and use complex problem-solving gestures, then semi-structured learning should focus on dynamic problem solving interactions orchestrated by the educator to enable the child to master specific cognitive, social or educational goals.
If the child is not yet able to imitate and use complex problem solving gestures, consider more structured exercises to teach specific cognitive, language, social, and emotional skills. The initial goal should be mastery of gestural, problem solving interactions and complex imitation.
A cognitive curriculum should involve pragmatic conversation groups, cooperative learning, and social stories.
3) Motor, sensory, and visual/spatial activities. Often recommended: three or more 20 minute sessions per day.
- Sensory integration occupational therapy exercises (running, jumping, spinning, firm tactile pressure).
-Perceptual motor exercises (throwing catching, kicking, tracking)
-Visual/spatial problem solving (hide-and-seek, treasure hunt, flashlight games)
-Once child can answer "why" questions, consider adding visual/spatial thinking activities.
Once ready for preacademic work, consider adding pre-academic, conceptual reasoning, reading, and math exercises.
4) Class structure.
A. Inclusion or Regular School Program with an Aide.
If preschool child is able to use complex gestures to problem-solve and is beginning to imitate or use words, priority should be given an inclusive preschool program or a regular preschool (with an aide).
B. Inclusion or Special Needs Class
If the child is not yet using complex gestural problem solving and imitating words, priority should be given to a program where there is a 1:1 ratio of teacher or aide to student in either an inclusive or special needs class.


5) Additional Educational Strategies.
A. PECS.
When language lags behind visual/spatial thinking, consider PECS to augment communication. Visual communication aids should be used as part of the 3 elements of dynamic education program.
B. ABA
Structured exercises to facilitate imitative skills and basic motor planning and sequencing in children who have difficulty learning imitation skills dynamically.
C. TEACCH
Use TEACCH visual communication strategies to establish routines and reduce frustration. TEACCH educational approaches are especially useful when language is very delayed and motor planning challenges impede gestural communication.
D. Miller Method.
Structured and semi-structured exercises to master early basic cognitive capacities.
E. Visual Spatial Thinking, Perceptual Motor Exercises, and Visualization-Based Concept Building.
For children with challenges in these areas who have progressed to being able to understand and follow directions and answer "why" type questions.
F. Augmentative Communication Strategies. As needed.