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The DIR Model (Developmental, Individual Difference, Relationship Based): A Parent Mediated Mental Health Approach to Autism Spectrum Disorders

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Encyclopedia of Autism Spectrum Disorders

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Definition

The Developmental, Individual Difference, Relationship-Based model of intervention (DIR) provides a developmental framework for interdisciplinary assessment and parent-mediated intervention for autism spectrum and related disorders. This comprehensive model utilizes affect-based interactions and experiences tailored to individual differences to promote development. “D” refers to developmental capacities for shared attention and regulation, engagement across a wide range of emotions, two-way communication, and complex social problem solving which underlie the development of symbol formation, language, and intelligence. Intervention starts with pleasurable synchronous interactions between children and parents, the heart of relationships, which support progress. “I” refers to individual differences related to sensory reactivity and regulation, visual-spatial and auditory/language processing, and purposeful movement. Challenges in these neurobiological factors can make it...

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References and Reading

  • Capps, L., Sigman, M., & Mundy, P. (1994). Attachment security in children with autism. Development and Psychopathology, 6, 249–261.

    Article  Google Scholar 

  • Casenheiser, D. M., Shanker, S. G., & Stieben, J. (2011). Learning through interaction in children with autism: Preliminary data from a social-communication-based intervention. Autism, published online 2011.

    Google Scholar 

  • Casenhiser, D. M., Binns, A., McGill, F., Morderer, P., & Shanker, S. G. (2014). Measuring and supporting language function for children with autism: Evidence from a randomized control trial of a social-interaction-based therapy. Journal of Autism and Developmental Disorders, 45(3).

    Google Scholar 

  • Dawson, G., & Galpert, I. (1990). Mother’s use of imitative play for facilitating social responsiveness and toy play in young autistic children. Development and Psychopathology, 2, 151–162.

    Article  Google Scholar 

  • Gernsbacher, M. (2006). Toward a behavior of reciprocity. Journal of Developmental Processes, 1, 139–152.

    PubMed  PubMed Central  Google Scholar 

  • Green, J., Charman, T., McConachie, H., Aldred, C., Slonims, V., Howlin, P., Le Couteur, A., Leadbitter, K., Hudrey, K., Byford, S., Barrett, B., Temple, K., Macdonald, W., Pickles, A., & The PACT Consortium. (2010). Parent-mediated communication-focused treatment in children with autism (PACT): A randomized controlled trial. Lancet, 375, 2152–2160.

    Article  PubMed  PubMed Central  Google Scholar 

  • Green, J., Wai Wan, M., Gulraud, J., Holsgrove, S., McNally, J., Slonims, V., Elsabbagh, M., Charman, T., Pickles, A., & Johnson, M. (2013). The BASIS team. Journal of Autism and Developmental Disorders, 43, 2502–2514.

    Article  PubMed  Google Scholar 

  • Green, J., Pickles, A., Pasco, G., Bedford, R., Wai Wan, M., Elsabbagh, M., Slonims, V., Gliga, T., Jones, E., Cheung, C., Charman, T., & Johnson, M. (2017). Randomised trial of a parent-mediated intervention for infants at high risk for autism: Longitudinal outcomes to age 3 years. Journal of Child Psychology and Psychiatry, 58, 1330–1340.

    Article  PubMed  PubMed Central  Google Scholar 

  • Greenspan, S. (1992). Infancy and early childhood: The practice of clinical assessment and intervention with emotional and developmental challenges. Madison: International Universities Press.

    Google Scholar 

  • Greenspan, S. (2004). Greenspan social-emotional growth chart: A screening questionnaire for infants and young children. Bulverde: The Psychological Corporation.

    Google Scholar 

  • Greenspan, S. I., & Lourie, R. S. (1981). Developmental structuralist approach to the classification of adaptive and pathologic personality organization: Application to infancy and early childhood. The American Journal of Psychiatry, 138, 725–735.

    Article  PubMed  Google Scholar 

  • Greenspan, S., & Shanker, S. (2004). The first idea: How symbols, language and intelligence evolved from our primate ancestors to modern humans. Reading: Perseus Books.

    Google Scholar 

  • Greenspan, S., & Wieder, S. (1997). Developmental patterns and outcomes in infants and children with disorders in relating and communicating: A chart review of 200 cases of children with autistic spectrum diagnoses. The Journal of Developmental and Learning Disorders, 1, 87–141.

    Google Scholar 

  • Greenspan, S., & Wieder, S. (1998). The child with special needs: Encouraging intellectual and emotional growth. Reading: Perseus Books.

    Google Scholar 

  • Greenspan, S., & Wieder, S. (2000). Principles of clinical practice for assessment and intervention. Developmentally appropriate interactions and practices. Developmentally based approach to the evaluation process. In Interdisciplinary council on developmental and learning disorders clinical practice guidelines (pp. 261–282). Bethesda: Interdisciplinary Council on Developmental and Learning Disorders.

    Google Scholar 

  • Greenspan, S., & Wieder, S. (2005). Can children with autism master the core deficits and become empathetic, creative and reflective? A ten to fifteen year follow-up of a subgroup of children with autism spectrum disorders (ASD) who received a comprehensive developmental, individual-difference, relationship-based (DIR) approach. The Journal of Developmental and Learning Disorders, 9, 39–61.

    Google Scholar 

  • Greenspan, S., & Wieder, S. (2006). Engaging autism: The Floortime approach to helping children relate, communicate, and think. Cambridge, MA: DaCapo Press/Perseus Books.

    Google Scholar 

  • Greenspan, S. I., & Wieder, S. (2011). Relationship-based early intervention approach to autistic spectrum disorders: The DIR model 1068. In D. G. Amaral, G. Dawson, & D. H. Geschwind (Eds.), Autism spectrum disorders (pp. 1068–1080). New York: Oxford University Press.

    Chapter  Google Scholar 

  • Greenspan, S., Wieder, S., Lieberman, A., Nover, R., Lourie, R., & Robinson, M. (1987). Infants in multirisk families: Case studies in preventive intervention. Clinical infant reports: No. 3. New York: International Universities Press.

    Google Scholar 

  • Greenspan, S., DeGangi, G., & Wieder, S. (2001). The functional emotional assessment scale (FEAS) for infancy and early childhood: Clinical and research applications. Bethesda: Interdisciplinary Council on Developmental and Learning Disorders.

    Google Scholar 

  • Gutstein, S. (2005). Relationship development intervention: Developing a treatment program to address the unique social and emotional deficits of autism spectrum disorders. Autism Spectrum Quarterly (Winter), 8–12.

    Google Scholar 

  • Gutstein, S. E., & Sheely, R. K. (2002). Relationship development intervention with young children: Social and emotional developmental activities for Asperger syndrome, autism, PDD and NLD. London: Jessica Kingsley.

    Google Scholar 

  • Jones, E. H., Dawson, G., Kelly, J., Estes, A., & Webb, S. J. (2017). Parent-delivered early intervention in infants at risk for ASD: Effects on electrophysiological and habituation measures of social attention. Autism Research, 00, 1–12.

    Google Scholar 

  • Kasari, C., Freeman, S., & Paparella, T. (2006). Joint attention and symbolic play in young children with autism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47, 611–620.

    Article  PubMed  Google Scholar 

  • Kasari, C., Freeman, S. F. N., Paparella, T., & Jahromi, L. B. (2008a). Language outcome in autism: Randomized comparison of joint attention and play interventions. The Journal of Clinical Psychiatry, 76, 125–137.

    Google Scholar 

  • Kasari, C., Paparella, T., Freeman, S., & Jahromi, L. B. (2008b). Language outcome in autism: Randomized comparison of joint attention and play interventions. Journal of Consulting and Clinical Psychology, 76(1), 25–137.

    Article  Google Scholar 

  • Koegel, R. I., Koegel, L. K., Harrower, J. K., & Carter, C. M. (1999). Pivotal response intervention1: Overview of approach. Journal of the Association for Persons with Severe Handicaps, 24, 174–185.

    Article  Google Scholar 

  • Lewis, J. D., Evans, A.C., Pruitt, J.R., Botteron, K.N., McKinstry, R.C., Zwaigenbaum, L., Estes, A., Collins, D.L., Kostopoulos, P., Gerig, G., Dager, S.R., Paterson, S., Schultz, R.T., Styner, M.A., Hazlett, H.C., Piven, J., for The Infant Brain Imaging Study Network (2017). The emergence of network inefficiencies in infants with autism spectrum disorders. Brain Psychiatry, 82, 176–185.

    Google Scholar 

  • Lord, C., & McGee, J. (2001). Educating children with autism. Washington, DC: National Research Council National Academy Press.

    Google Scholar 

  • Mahoney, G., & Perales, F. (2005). A comparison of the impact of relationship-focused intervention on young children with pervasive developmental disorders and other disabilities. Journal of Developmental and Behavioral Pediatrics, 26, 77–85.

    Article  PubMed  Google Scholar 

  • Miller, L. J., Coll, J. R., & Schoen, S. A. (2007). A randomized controlled pilot study of the effectiveness of occupational therapy for children with sensory modulation disorder. American Journal of Occupational Therapy, 61, 228–238.

    Article  PubMed  Google Scholar 

  • Mostofsky, S., Dubai, P., Jerath, V., Jansiewicz, E., Goldberg, M., & Denckla, M. (2006). Developmental dyspraxia is not limited to imitation in children with autism spectrum disorders. Journal of International Neuropsychological Society, 12, 314–326.

    Article  Google Scholar 

  • Mostofsky, S. H., Burgess, M. P., & Gidley Larson, J. C. (2007). Increased motor cortex white mater volume predicts motor impairment in autism. Brain, 130, 2117–2122.

    Article  PubMed  Google Scholar 

  • Mundy, P., Sigman, M., & Kasari, C. (1990). A longitudinal study of joint attention and language development in autistic children. Journal of Autism and Developmental Disorders, 20, 115–128.

    Article  PubMed  Google Scholar 

  • Oppenheim, D. (2009). Maternal insightfulness and resolution of diagnosis are associated with secure attachment in preschoolers with autism spectrum disorders. Child Development, 80, 519–527.

    Article  PubMed  Google Scholar 

  • Pfeiffer, B. A., Koenig, K., Kinnealey, M., Sheppard, M., & Henderson, L. (2011). Research scholars initiative – effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. American Journal of Occupational Therapy, 65, 76–85.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pickles, A., Le Couteur, A., Leadbitter, K., Salomne, E., Cole-Fletcher, R., Tobin, H., Gammer, I., Lowry, J., Vamvakas, G., Byford, S., Aldred, C., Slonims, V., McConachie, H., Howlin, P., Parr, J., Charman, T., & Green, J. (2016). Parent-mediated social communication therapy for young children (PACT): Long term follow up of a randomized controlled trial. Parent mediated communication-focused treatment. Lancet, 388, 2501–2508.

    Article  PubMed  PubMed Central  Google Scholar 

  • Prizant, B., Wetherby, A., Rubin, E., & Laurent, A. (2003). The SCERTS model: A transactional, family-centered approach to enhancing communication and socioemotional abilities of children with autism spectrum disorder. Infants and Young Children, 16, 296–316.

    Article  Google Scholar 

  • Profectum Parent Toolbox, 2017. www.Profectum.org.

  • Rogers, S. J., & Dawson, G. (2010). Early start Denver model for young children with autism. New York: Guilford.

    Google Scholar 

  • Rogers, S., Herbison, J., Lewis, H., Pantone, J., & Reis, K. (1986). An approach for enhancing the symbolic, communicative, and interpersonal functioning of young children with autism and severe emotional handicaps. Journal of the Division for Early Childhood, 10, 135–148.

    Article  Google Scholar 

  • Rogers, S. J., Ozonoff, S., & Maslin-Cole, C. (1993). Developmental aspects of attachment behavior in young children with pervasive developmental disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 1274–1282.

    Article  PubMed  Google Scholar 

  • Schreibman, L., & Koegel, R. L. (2005). Training for parents of children with autism: Pivotal responses, generalization, and individualization of intervention. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatment for child and adolescent disorders: Empirically based strategies for clinical practice (pp. 605–631). Washington, DC: American Psychological Association.

    Google Scholar 

  • Seida, J., Ospina, M., Karkhaneh, M., Hartling, L., Smith, V., & Clark, B. (2009). Systematic reviews of psychosocial interventions for autism: An umbrella review. Developmental Medicine and Child Neurology, 51, 95–104.

    Article  PubMed  Google Scholar 

  • Siegel, D. (2001). Toward an interpersonal neurobiology of the developing mind: Attachment, “mindsight,” and neural integration. Infant Mental Health Journal, 22, 67–94.

    Article  Google Scholar 

  • Siller, M., & Sigman, M. (2002). The behavior of parents of children with autism predict the subsequent development of their children’s communication. Journal of Autism and Developmental Disorders, 32, 77–89.

    Article  PubMed  Google Scholar 

  • Solomon, R., Necheles, J., Ferch, D., & Bruckman, D. (2007). Pilot study of a parent training program for young children with autism: The P.L.A.Y. project home consultation model. Autism: The International Journal of Research and Practice, 11, 205–224.

    Article  Google Scholar 

  • Solomon, R., Van Egeren, L. A., Mahoney, G., Quon Huber, M., & Zimmerman, P. (2014). PLAY project home consultation intervention program for young children with autism spectrum disorders: A randomized controlled trial. Journal of Developmental and Behavioral Pediatrics, 35(8), 475–485.

    Article  PubMed  PubMed Central  Google Scholar 

  • Spreckley, M., & Boyd, R. (2009). Efficacy of applied behavioral intervention in preschool children with autism for improving cognitive, language, and adaptive behavior: A systematic review and meta-analysis. Journal of Pediatrics, 154, 338–344.

    Article  PubMed  Google Scholar 

  • Torres, E. B., Smith, B., Mistry, S., Brinckner, M., & Whyatt, C. (2016). Neonatal diagnostics: Toward dynamic growth charts of Neuromotor control. Journal Frontiers in Pediatrics, 4, Article 21.

    Google Scholar 

  • Vismara, L., & Rogers, S. J. (2009). Can one hour per week of therapy lead to lasting changes in children with autism? Autism, 13(1), 93–115.

    Article  PubMed  Google Scholar 

  • Wallace, K. S., & Rogers, S. J. (2010). Intervening in infancy: Implications for autism spectrum disorders. Journal of Child Psychology and Psychiatry, 51(12), 1300–1320.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wetherby, A. M., Prizant, B. M., & Hutchinson, T. (1998). Communicative, social-affective and symbolic profiles of young children with autism and pervasive developmental disorders. American Journal of Speech-Language Pathology, 7, 79–91.

    Article  Google Scholar 

  • Wieder, S. (1996). Climbing the "symbolic ladder": Assessing young children's symbolic and representational capacities through observation of free play interaction. In S. Meisels & E. Fenichel (Eds.), New visions for the developmental assessment of infants and young children (pp. 267–287). Washington, DC: Zero to Three.

    Google Scholar 

  • Wieder, S. (2011). DIR: Developmental, individual-difference, relationship-based model: A dynamic model for the 21st century. In D. Zager, M. Wehmeyer, & R. Simpson (Eds.), Research-based principles and practices for educating students with autism (pp. 82–98). New York: Routledge/Taylor & Francis.

    Google Scholar 

  • Wieder, S., & Greenspan, S. (2001). The DIR (developmental, individual-difference, relationship-based) approach to assessment and intervention planning. Zero to Three, 21, 11–19.

    Google Scholar 

  • Wieder, S., & Greenspan, S. (2003). Climbing the symbolic ladder in the DIR model through floortime/interactive play. Autism, 7, 425–436.

    Article  PubMed  Google Scholar 

  • Wieder, S., & Wachs, H. (2012). Visual spatial portals to thinking, feeling and movement: Advancing competencies and emotional development in children with learning and autism spectrum disorders. Mendham: Profectum Foundation.

    Google Scholar 

  • Williams, D. L., & Minshew, N. J. (2007). Understanding autism and related disorders: What has imaging taught us? Neuroimaging Clinics of North America, 17(IV), 495–509.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zwaigenbaum, L., Bryson, S., Lord, C., Rogers, S., Carter, A., Carver, L., et al. (2009). Clinical assessment and management of toddlers with suspected autism spectrum disorder: Insights from studies of high-risk infants. Pediatrics, 123, 1383–1391.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Profectum Foundation, Mendham, NJ, USA

    Serena Wieder

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  1. Serena Wieder
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Correspondence to Serena Wieder .

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  1. Yale Child Study Center, New Haven, Connecticut, USA

    Fred R. Volkmar

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Wieder, S. (2018). The DIR Model (Developmental, Individual Difference, Relationship Based): A Parent Mediated Mental Health Approach to Autism Spectrum Disorders. In: Volkmar, F. (eds) Encyclopedia of Autism Spectrum Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6435-8_615-3

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  • DOI: https://doi.org/10.1007/978-1-4614-6435-8_615-3

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