What is DIR / Floortime? Occupational Therapist Rosemary White Explains

gender nonconformity kids
Are you curious to better understand what DIR / Floortime is? My guest this week is Rosemary White, an Occupational Therapist trained in neurodevelopmental therapy, sensory integration and DIR (Floortime). Rosemary owns and operates Pediatric Physical & Occupational Therapy Services in Seattle, Washington, where we were lucky enough to cross paths as Asher went to Rosemary’s practice for a number of years. I look back on that time as a magical one of learning and growth for our family.

Rosemary is passionate about working in collaboration with parents and finding the joy in supporting each parent and child in their relationship with one another to promote development. Rosemary is a Profectum Foundation Senior Faculty Member and has taught, consulted and provided supervision to professionals in the United States as well as Canada, Europe, United Kingdom, Turkey, Israel, South Africa, Brazil, Uganda, Taiwan, Peru, Ukraine, Russia & Australia.

During this conversation, Rosemary explains what DIR Floortime therapy is and what it looks like in practice, the involvement of parents in their child’s sessions, why some kids need to move and what is really going on when they do, and how we can push to get DIR Floortime into more schools. I love Rosemary’s approach of recognizing the individual and tailoring the approach to best support each child and their family.

About Rosemary White

Rosemary completed her Occupational Therapy Degree in Australia. She received her Neurodevelopmental Therapy training in London with the Bobaths, Sensory Integration training in Los Angeles with Dr. A Jean Ayres as an OT in her clinic & her training in DIR (Floortime) with Stanley Greenspan, MD & Serena Wieder, PhD & the Faculty of ICDL. She owns & operates Pediatric Physical & Occupational Therapy Services in Seattle, Washington, the Offices of Rosemary White and Associates. She is passionate about working in collaboration with parents and finding the joy in supporting each parent and child in their relationship with one another to promote development. DIR Floortime in conjunction with her background in sensory and motor development has made this possible.

Rosemary loves to teach others and has done this both nationally and internationally. She is an Adjunct Instructor at the University of Washington in the Infant Mental Health Certificate Program, Faculty of Fielding University in their on-line PhD in Infant and Early Childhood Development. Rosemary is a Profectum Foundation Senior Faculty Member. She brings a wealth of clinical experience to every presentation she teaches for professionals as well as parents. She has taught, consulted and provided supervision to professionals in United States as well as Canada, Europe, United Kingdom, Turkey, Israel, South Africa, Brazil, Uganda, Taiwan, Peru, Ukraine, Russia & Australia. Her goal is to create a meaningful & functional learning experience for all.


Things you’ll learn from this episode

  • How a positive relationship between parents and occupational therapists can support the best outcome of therapy sessions
  • What DIR / Floortime therapy is and what it looks like in practice
  • What tools Rosemary uses and how they support a child’s development
  • What is really happening when a child needs to do certain movements to help them feel more “organized”
  • What happens when our bodies’ systems aren’t integrated and how that can create challenges for children
  • How parents can advocate for the use of DIR Floortime in schools
  • Avenues for finding DIR Floortime resources, in the US and beyond


Resources mentioned for DIR / Floortime


Episode Transcript

Rosemary White  00:00

The shift from sensory integration where I was just looking on adaptive motor responses, DIR has now led me to really thinking about that social emotional development. And that’s what I want to sort of give to parents, that it’s not just fixing the sensory, but it’s really supporting the overall development of the child, and you and your relationship with your child.

Debbie Reber  00:27

Welcome to Tilt Parenting, a podcast featuring interviews and conversations aimed at inspiring, informing and supporting parents raising differently wired kids. I’m your host Debbie Reber. My guest this week is Rosemary White, an occupational therapist trained in neurodevelopmental therapy, sensory integration, and dir Floortime. Rosemary owns and operates Pediatric Physical and Occupational Therapy services in Seattle, Washington, where we were lucky enough to cross paths as Asher went to Rosemary’s practice for a number of years and I just have to say I look back on that time as a truly magical one of learning and growth for our family. Rosemary is passionate about working in collaboration with parents and finding the joy in supporting each parent and their child and their relationship with one another. To promote development. Rosemary is a perfected Foundation, senior faculty member and has taught, consulted and provided supervision to professionals in the US, as well as Canada, Europe, the UK, Turkey, Israel, South Africa, Brazil, Uganda, Taiwan, Peru, Ukraine, Russia and Australia. During this conversation, Rosemary explains what dir Floortime therapy is, and what it looks like in practice, the involvement of parents in their child sessions, why some kids just need to move and what is really going on when they do and how we can push to get dir Floortime into more schools. I love Rosemary’s approach of recognizing the individual and tailoring the approach to best support each child and their family. Before I get to that, a quick note for listeners in the Seattle area, Bridges Academy, the unique school for twice exceptional learners in Los Angeles, is going to be opening their second school in Seattle for classes beginning next fall 2022. If you’re interested in learning more about bridges Academy, their educational model and how they serve our incredible two kids. They’re holding three open houses in February, one for elementary, one for middle school and one for high school. To attend. Visit the show notes page for this episode, which is at tilt parenting.com/session280 And you’ll find registration links there or you can visit Tilt Together on Facebook and find the Bridges Open House threads or go to Bridges website. Lastly, as you may know, I’ve been working to create some self study programs for parents and caregivers who are looking for specific support. And last fall I shared my first new mini course called The Emergency Reset. And this week, I am excited to announce something I’ve been working on for months, I have just launched a self-study version of my Differently Wired Club. So this is a 12 month program each month focused on a different theme featuring videos, worksheets, accountability challenges, deep dive resources and weekly emails to keep you on track. I tried to take the best of the club and reformat it in a way that works for busy parents who don’t have time for live calls and engagement, but would benefit from the club content. To check it out visit courses.tiltparenting.com Or go to Tilt Parenting and click on courses in the main menu. Thanks so much. And now here is my conversation with Rosemary.

Debbie Reber  04:06

Hey, Rosemary, welcome to the podcast.

Rosemary White  04:08

Hi Debbie! Wonderful to be here.

Debbie Reber  04:11

I’ve been wanting to do this for a couple of years. I just realized I think we saw each other at the Profectum conference. Maybe three, two and a half years ago.

Rosemary White  04:19

That was 2019.

Debbie Reber  04:20

Wow. Well, anyway, I’m so happy this is happening. You are someone who has been in my life peripherally for a very long time. But I would love it if you could take a few minutes. So I’ve already read your bio, but if you could just tell us a little bit about yourself, what you do, and maybe your personal why, for the work that you do.

Rosemary White  04:40

Well, I’m an occupational therapist, and have always had a passion for working with children and their families. And so even as a very young age I wanted to become an OT, and really was fascinated by forming relationships with children and their families or even when I was in training with adults who had strokes and other neurological disorders. So I think I’ve put relationships in the forefront. But I also really am passionate about neurobiology. And so really trying to understand how we take in the world, and what it makes, contributes to us being the unique beings who we are. And so, you know, as a very young therapist, when I graduated, I went to the UK and did a graduate course in the treatment of children with cerebral palsy. And so I was passionate about that, and then I discovered, became more and more well versed in sensory integration, and had the good fortune to work with both of the individuals who develop those theoretical models. And so what was really powerful about that was it sort of gave me a theory and something solid behind just the work and, and playing with children and their caregivers. And so, you know, as I moved on, and started working more and more, I started to sort of see how, when we work, we were really supporting children, their families, not just to coordinate their bodies better or take in the world. But really, it was a platform to move forward into social interaction. And so for the last 20 years, 21 years, I have become involved with the perfect gym, and the work of Stanley Greenspan and Serena Wieder, which really sort of pulled the motor and sensory development into what I think is the most important thing. And that’s really how we are able to be individuals who have successful relationships with one another. So because it’s through relationships, that we really learn and grow, no matter what you’re trying to learn, we never really learn in isolation, we learn in relationships with others, and we sometimes that relationship might be just a one on one relationship. Or it might be in a, you know, a group.

Debbie Reber  07:13

Yeah, and so full disclosure for listeners. So Rosemary white, when when Asher was very young, maybe four, and someone said the word sensory processing disorder to me, I read Carol Kranowitz’s book, The Out-of-Sync Child, and then your name Rosemary kept coming up, because I was living in Seattle at the time, oh, you got to go to Rosemary White, oh, Rosemary White. So we were on a waiting list for quite a while. And then we got in. And we ended up working with a therapist who I still just love and adore Kris Johnson for many years. And there’s so many aspects of that time that have stayed with me, and that I think were so unexpected, and have really kind of changed how I parent and the relationship piece is a big part of that. I remember sitting just having the worst day, right and showing up to OT and then Kris was checking it on me. And she was kind of explaining what she was doing and looping me into the play and that I wasn’t expecting that. Can you talk more about that relationship with parents? Because I think so often we just like, Okay, you do this with my kid? And then let me know how it goes?

Rosemary White  08:23

Well, I think it’s really very important that, you know, if we’re seeing an OT for an hour, the child’s seeing an OT for an hour, out of 7… 24 sevens, that’s not much. And unless we include the parent, and make it a collaborative process, so I’m not going to move into do this, do that, or here’s your series of acts of activities to do, we want to really make it a dynamic process. So, you know, when I had my first private practice, which was in California, the parents were always sitting in on the sessions. And at that stage, I was doing more of the direct therapy and feeling that the parents could learn through observing. But as I became more and more involved with DIR/Floortime, it became much more of a collaboration with the parents, and that it was the child and the parent who were the ones interacting, and I’m there in a way in the sidelines, or sometimes as the third person, and we’re really supporting this flow of interactions. And you know, things about that, you know, each one of us processes things in a different way. So we have to tailor our interactions according to that individual. So it may be that you need to slow your pace down. Or I was just working telehealth yesterday with a lovely family with a little girl who’s three. And really, Mom was doing this lovely interaction of she was in mom’s lap and mum was tickling her and just bringing her hands up up her trunk to tickle her face. And the pacing is so important that then she can feel that sense of, oh, Mommy’s hands coming up, I and the information comes in, and she starts to know, I know what’s going to happen. That’s like, you start to make sense of the world and predict what’s going to happen. So some of those early games, like this little piggy, or, you know, there’s one from Australia round around the garden, like a teddy bear one, step two, step ticularly, under there, so we think about all of those games are about relating with your child, but it’s also that your child is staying to say, Mommy, or daddy is interacting with me, and I know what’s going to happen. So you transfer that to being 12. And I’m taking in what’s going on around me. And I’m able to take in the sights and the sounds in the action of the world, and make a prediction about what’s going to occur. And then I can adapt accordingly. So when I look at development, I look at this continual process, and my passion is to support social interactions.

Debbie Reber  11:08

So fascinating. So you mentioned DIR / Floortime. And that is something that, you know, I had never heard of before. And it’s often brought up in my Tilt Together group where people are getting information about their kids maybe being autistic or having sensory issues, and they get recommendations for different types of therapy. DIR Floortime is the one most parents are like, this is the one so can you tell us more about what that actually means and what it looks like in practice?

Rosemary White  11:39

Well, the acronym DIR stands for it’s a developmental approach. That is really considering the individual profile of the child and the caregiver. And that it is relationship based. So that’s the DIR and the, but in a way it should be. It’s a relationship based approach to treatment that is really tailored to the individual profile of the child. And I explained that a bit to support what we call the functional emotional development. So we’re thinking about relationships, and everybody’s relationship is different. So we have to really understand those rhythms of the relationship, the eye is talking about the individual profile, so how the child and the caregiver taking sensory information, the sights and the sounds and the action of the world around them, and also their own body, as well to what we experience in our own body, our actual physical compatibilities and motor control, and also what we call motor planning. So I can have an idea, I then will have that idea, then I have to sort of access my, my image of my body to be able to say, okay, in order to make this idea or goal come to fruition, I have to organize my body in a way that’s going to sequence to be able to meet thee then to execute it, and but also to be able to adapt my plan. So what I’ll give you an example of this is, you know, say I wanted to bake a cake. Well, I could think about, I’d really love to have made a chocolate mousse. So then I’m going to think about what I have in terms of the ingredients? So that would be the planning? And then what step am I going to need to do first, second, or third? And so I have to think about the sequence of what to do. And then I have to think about, Well, how am I going to actually physically put these ingredients together. And then I start to put it all together. And I realize that maybe I don’t have let’s see what I’m drinking every week, my daughter just made a chocolate mousse, but she uses the aquafaba from garbanzo beans because she can’t use eggs. So there she’s adapting the recipe accordingly, right. So I may not have egg, so I’m going to go and open a can of garbanzo beans to use that fluid to be able to make the eggs. And so then I say I’m making it. And I’m whipping it so fast that some of the material, some of the ingredients will be out that I’m going to have to, you know, capture the ball a little bit. So we’re constantly adapting. So that might be me making a chocolate mousse. But what if I was interacting with another child, and we were both going to play chess, and we’re getting out the chessboard, then I’m going to have to organize my actions in relation to my partner, or, you know, I run summer camps. And so we do a lot of supporting social interaction that way. And it’s supporting children, as they’re on a climber. And they’re going up on the climber, but they have to take in what’s going on around them. Or it could be and so we might use our effort to go things like Oh, he comes Johnny. So that you’re using your effort to help the child who may be really focusing on what they’re doing to be able to go, oh, somebody is coming close, how do I go to adapt to that, too. So, you know, there’s that piece too. So I’ve sort of digress a long way. But having the parents involved in the sessions from the very beginning, is really powerful, because we’re really sort of sharing our knowledge in terms of sensory processing, motor control, motor planning, communication, and being able to help them develop those beautiful rhythms of interaction with their child. And I have to say that it’s a very strength based approach. So we’re looking at the strengths of the child to really be able to support you and access those strengths to support the challenges. So it’s not coming in and saying you’re failing at this, you’re failing at that you’re failing at that it is much more about this is what I see and your child in choosing a new direction, when you come in very slowly, and you’re just, you know, drinking in what he’s doing. You can just see that light up on what we call that gleam in his eye. That was beautiful. Parents want to hear what they were doing that was beautiful, not like, Okay, you need to stop doing this. And you need to stop doing that. It’s much more about, that was a beautiful moment. Because that’s what you come away with afterwards.

Debbie Reber  16:37

And gosh, I’ve been flooded with memories right now. I love the strength based approach. That’s, you know, certainly what I believe in. But at Tilt Parenting, that’s really the core of so much of what I’m hoping to share with parents is to start with the strengths. And I do want to just give a shout out to Mona Delahooke, who has been on the show, she’ll be on the show, actually the same season as this interview, talking about her new book, Brain Body Parenting, but I met Mona at the Profectum conference. And that’s when I was introduced to her work. And I hear so much of that look at the individual that child that we have, and how important that is, and the playfulness in which all of this work happens. I have a question then about tools, I’m thinking when I first went with Asher, again, I think that they were four or five. And it was like a whole new world to me. I was like, Oh my gosh, first of all, I didn’t even understand what we were doing. I didn’t understand what proprioception was, or that there were tactile sensory things going on. And I also didn’t know I’m like, Well, those are some interesting stretchy hammocks and you know, different fabric, there are just so many tools, can you talk about some of the types of tools that that you rely on, and maybe give us an example of one or two and how they support our kids development.

Rosemary White  17:56

Okay, but then this sort of comes from my sensory integration background. And so it’s not so much the tools themselves, as it is, is how we relate to the child and the caregiver with those materials. So, you may have a child who, you know, even though they move around, they don’t have a very clear map of their body. So if you just saw your listeners, just close their eyes, and you can picture yourself, I can picture myself with my eyes closed, that I’m sitting in a chair, and then I’ve got my legs crossed, I’m not looking. But all the messages inside my body come up to this motor part of my cortex, that gives me this updated map. Now, some children that we work with, if you look at Carol Kranowitz’s book, The Out of Sync Child, what we’re really talking about there is that all of the sensory systems are firing at the same time. And there they have what we call this beautiful interconnectivity. So my vision talks to my body, which talks to what I’m hearing, and it comes together. But what if one of those or a number of those sensory systems where one was lagging a millisecond behind the other, which is what the research is showing us for some children? Then what are we going to do? How are we going to create an environment that really sort of increases that awareness of the body so we might have, we might set up that hammock club I have a lot of, you know, not climate hammocks that I bought in Brazil. So they’re those lovely B club hammocks that individuals in Brazil sleeping and, and it may be that a child and their caregiver might get inside that and then wrap themselves up so that you’re, you’re forming this beautiful connectivity, but you’re also mapping the child’s body to give more fuel to that proprioceptive or muscle and joint fire, to marry, what we’re feeling from our gravity receptors and from vision, but also tied in with emotion. So you’re doing that, or it might be that, you know, some children really need to move. It really helps their body feel organized. And when they do move, they’re able to organize their thoughts. So instead of saying, Would you stop moving, we might do things like I notice, when you move around, you’re sharing your ideas in such a great way I can follow it. So you’re, you’re, you’re acknowledging this is what’s important for an individual, I use my hands the whole time, when I’m talking, if somebody told me to put your hands down and keep them down, my thought process is going to be a little bit more disorganized. So we want to really highlight those strengths. And notice what it supports in terms of development.

Debbie Reber  21:00

So I love the word organized. And that’s something I remember Kris saying, which I didn’t really quite grasp at the time was that for Asher? Spinning was a really organizing activity. For me, I can’t even watch because I get motion sickness. But can you say a little bit more about what exactly is happening like a child who needs to spin or to swing or do a movement? When you say organize what’s really happening?

Rosemary White  21:26

Well, I think you, again, you’re pacing in a way that you bring about that interconnectivity. So it may be that a child who wants to spin, maybe what happens is around your ears, you have these very tiny organs called your vestibular organs. And they’re like a gyroscope in your ear, and you have a one on the left side and on the right side, and that vestibular organ supports you to be able to know where you are in space, if you tip into the left or to the right. And if you’re rotating, and when you stop, so that you’re getting all of this information from little hair receptors inside there, that gives you millisecond by millisecond information about where your head is in space, where your body is in relation to the pull of gravity. And so one of the things that’s important is that that information from our muscles and joints comes up, and it goes to a part of our brain called the vestibular nuclei. And there the information from those gravity receptors gets married, us we’re married, gets married, or connected to the body inflammation, and also vision before you’re even consciously aware. And so if one system is lagging a millisecond behind the others, then you may be trying to seek out ways to reorganize that. Now a baby at about 18 months, when they’ve just learned how to walk and get that rotation in their body, they will spin themselves around and spin themselves around to be able to then stop and say in their mind, gravity, I’ve got more power over you, I’m not going to fall over. So if you have a 21 month old grandson, and the last month, he’s been spinning himself around, and then he’ll stop and look at everybody, like, do you see what I’m able to do? Okay, so he’s, he’s organizing his body, to be able to have mastery of it. So if things were not quite in sync for a child, and that connectivity was not as robust, I may seek out doing those sorts of activities to really work towards having that mastery. And so, but the most important thing is not spin, spin, spin, spin, spin, but it’s just like the baby does, he spins, and then he stops, so that you’re really giving fuel to those systems. And then you’re stopping. So I might be playing with a parent. And I’d say, Okay, let’s just go with the movement. I’ve got one child who loves to be in a hammock and dad to do like, a really pretty wild ride. But then you want to stop. So you reorganize the system, and he’s able to have mastery of it.

Debbie Reber  24:27

Such a great explanation. Thank you for walking us through that. I’m wondering what is the relationship between, for example, a sensory seeker or or a child whose proprioception isn’t completely connected in the way that we’d like to see. Why is that a problem? I imagine most parents are coming to you because of intense behavioral challenges related to and maybe they may or may not be autistic or have ADHD or other things, but what is the cost of not doing this work to integrate these systems?

Rosemary White  25:03

Well, I want to come back to dir because I think the D of DIR is really important. And that is that we’re thinking about one of the things you have the most importance, early beginning for us, as individuals, as we’re interacting today is sharing attention. We’re both sharing attention around a common theme or interest. But we’re also co regulating, which means I’m altering my actions in relation to your responses, you’re altering your actions, really in relation to mind. And so if you think about early development, co regulation is the caregiver relating with that infant, but then it’s the toddler, the preschooler, the elementary school, the adolescent adult, we’re always reading the cues of other people to be able to know how I’m just going to tweak my interaction to help sustain the engagement. So that’s the next thing: being able to be engaged across a wide range of emotions, to then be able to show my ideas and intentions and read the intentions of other people. So that’s, again, the dance of social interaction, to then be able to stay in a long continuous flow of interaction, to be able to feel power, both physically and emotionally. And to be able to also engage in shared social problem solving, not necessarily just physical, but also how do I stay in that interaction. And then the next and the next crucial part of that is being able to organize my actions and behavior in relation to the social environment, impulse control, being able to become a member of my home community, my extended family, extended family, my school community, and the greatest social world. So those are the early developmental stages that actually emerge in the first year of life and become more and more refined over experience. And then we move into more of a symbolic world, where children now are able to move into play, which is representative of their own internal experience, emotional experiences, but also to explore through play. How are they going to navigate social interactions? How are they going to navigate emotion? So a great idea, we have a lot of toys in our practice, which are things like dinosaurs and dragons. And we’re not going to say, Oh, they’re only nice dragons, we’re going to tell children that they need to be able to, through their play, work through aggression. They have to work through navigating joy, and frustration. And so the sensory integration world was really just that sensory piece of equipment that might really navigate the owner ghosts. nurture the way to be able to get that body piece organized. But then we really want to think about how that body piece moves into social interaction, as well as independence in my own self help skills. So a child might come in under the auspice of the umbrella of sensory processing disorder. And the child may have challenges in terms of clothing preferences, they may only want to wear sweats, we, I mean, children come to our practice, and we’ll be looking down the hallway, because they’ll take off their shoes. Most of them have rain boots, a lot of them were rain boots, or crocs because they feel more comfortable on their feet. So instead of saying, you’ve got to wear tennies, I’m going to say, you know what’s comfortable on your feet. Or if they only want to wear sweats and don’t want to wear jeans, you know what’s comfortable. So it’s a flip in that way. But the other part about it is that we want to look beyond, we want to look beyond if the if you just take care of the sensory, everything’s going to be fixed up. Because as you’ve so brilliantly written in your book, and as you shared on tilt parenting, it’s about the relationship and supporting that developmental process that really brings about, you know, the the ability to be able to really think about things in terms of being able to what we call a have elaboration of ideas, to be able to have interactions in play that have a logical flow, we were able to reflect on what, what’s going to be the outcomes of things and what are the motives of why people do things, then moving up into higher levels, which you described so beautifully with Asher in tune, hinking about multi causal thinking that things can occur from many different reasons. And then being able to appreciate that other people might have different perspectives to you. And then being able to, you know, really think about not only different perspectives, but also value systems, the value systems of what I might prefer in relation to somebody else. So that’s sort of a continuum in terms of the developmental levels. And so the shift from sensory integration, where I was just looking on adaptive motor responses, dir, has now led me to really thinking about that social emotional development. And that’s what I want to sort of give to parents, that it’s not just fixing the sensory, but it’s really supporting the overall development of the child, and you and your relationship with your child.

Debbie Reber  30:59

I love that so much. And it’s such an important thing. I think that, you know, we can talk about this enough on the show, I think so many parents come to my work and probably come to your center, looking to fix problems, looking to address tricky behaviors, and red flags at school. And this is such a, you know, as you’re describing it, it feels so hopeful and positive. And as you said, strengths based. It’s also not a quick fix, this takes a long time, because we’re really investing in the relationships and parents are guided often in more behaviorist approaches to a lot of these challenges that they might be facing at school or at home. But really doing this deeper work, how the child benefits, I just can’t either. I don’t think there’s any, you can’t even compare the two.

Rosemary White  31:53

Mm hmm. And I think the the big thing is that it’s really highlighted on what happens in development, and no two individuals development is identical. And so we have to really think about how do we tailor the interactions to each individual to and, and, and, and really listen to the parents, I think that’s another really, really big thing too. You know, if you look at it, when an infant is born, we’re waiting for when they’ll walk and talk. And that takes 12 months to 14 months to walk. So what’s been going on in those first 12 months, and to talk, you know, round 18 months, you’re starting to hear some words, but what’s been going on in those 18 months. And that takes a long time. And so we’ve got to think about that, as everything takes a long time. It’s not as though it’s going to happen straight away. But if we’re just looking at the moments to moments and supporting those moments to moments, you create this wonderful foundation. And I suppose for me, it’s very exciting to read about Asha. And you but also, I’ve had a number of clients that I started seeing when they were three, and they all have just graduated from high school and going off to college. And you know, each one has had a different experience and where they’re going to is different. But it’s just really lovely to see that, you know, for a number of children, that’s where they’re, it’s the journey that helps them know, that supports them to reach what their goals are as a graduate out of high school and moving forward. And some need more support than others. And we’re going to be able to, you know, work together to be able to find what is going to be the best road for each child.

Debbie Reber  33:48

I wanted to ask you. There was a conversation I think it was in my Tilt Together Facebook group, just about the limitations in terms of insurance. And the challenge is actually a interview an expert in advocating for universal design for learning in schools and really getting rid of ableism in schools and talking about the importance of getting new modalities accepted and used in schools over ABA are these approaches do have a sense of where we are and what needs to happen in order for us to get DIR Floortime more utilized in schools systems.

Rosemary White  34:28

It’s an interesting factor too, because there are a number of schools, number of schools that are dir informed schools, and they’re very much relationship based, and really working a lot in terms of putting those foundations of shared attention, co regulation to support regulation, engagement, intentionality. And so you’re going to really make the curriculum or design the curriculum to meet The needs of the children as opposed to making the children meet the needs of the curriculum. So that’s one thing. There has also been in relation to insurance. Medicaid has been approved for DIR Floortime in, let’s see, New Jersey, Florida, I believe Illinois, and this work in California, with regional centers, there’s a lot of funding for DIRFloortime as well, too. But there’s more. One of the beliefs is that if things move forward in terms of the work in New Jersey, and it gets your, it’s really showing that this work costs less, because we’re doing so much more support to the parents than an ABA program. And the outcomes are more positive than it will be more hopefully nationally covered. In Washington State, that’s not the case. But we’re working as OTS providing support for children and their families. So your clients are covered by their insurance. But if you’re an educator, or another professional, sometimes it’s more dicey. What I was going to say, though, too, is that perfect, um, has just begun now a power of professional training. So we just did the first one in November. And basically, were you to be able to provide DIR Floortime, in home or in the schools, we want to train paraprofessionals. So this might be somebody who has a bachelor’s degree or an associate degree. And we’re going to be training them to be able to support children understanding the individual profile, the developmental process, but they would then be under the supervision of a an individual who has done at least the set what’s called the level two training in dir and perfect and so I do training of level one and level two and perfect and where we’re getting deeper and deeper into understanding our work with children and their families. And so, though, the people who’ve graduated from co2 would be able to then supervise paraprofessionals. And, you know, in the state of Washington, for the last 21 years, I’ve been doing summer camps, and I’ve been training paraprofessionals in those summer camps. And it’s the fact it’s, it’s wonderful, it opens up the door to this really exciting work for college students. And I even have high school students who’ve worked with me, and many of them have gone on to become special ed teachers, OTs speech and language pathologists psychologists.

Debbie Reber  37:57

That’s great. And can you just take a minute and tell listeners what perfect them is? Because also parents can do training through Profectum? Correct?

Rosemary White  38:05

Yes, that’s correct. Profectum began in 2011. And prior to that, we were with another group called ictal ICDL, which was the interdisciplinary council for developmental and learning disorders. And it also does training as well too. And I’m actually a train of, you know, Certified Trainer and Profectum and began under the guidelines of Serena Wieder, who is the clinical director who developed DIR Floortime with Stanley Greenspan. And then we have a faculty of psychologists, OT, speech and language language pathologists, educators, music therapists, and therapists and other individuals working with children with autism and other challenges in relating and communicating. And we developed a training module, which we began in 2011. And there’s webinars within that that are designed to for the individuals in the courses to watch the webinars then we meet for discussion, reflecting on the webinars, and then we provide tutoring, but we also through perfect gym have what we call the perfect and parent toolbox, which is a free resource. And you just go to perfect and.org and register. And it’s a series of webinars that were put together with Serena Wieder, Ricki Robinson, who is a pediatrician. And Serena waiter is a clinical psychologist, Ricky Robinson is a pediatrician with Sherri Cawn, who’s a speech and language pathologist, Monica Osgood, who’s an educator who runs a wonderful school called Celebrate the Children and then myself, and it’s it’s a series in four units, that is 37 webinars. With over 150 video clips, and it’s designed to have like 30 minute webinars for parents to watch and reflect on in relation to their own child. And it has a workbook that goes with it as well, too. And it’s been translated into Spanish, and I believe Mandarin.

Debbie Reber  40:19

Such a great resource listeners, definitely check that out. I’ll have links to all of this in the show notes pages. But I was really floored by the perfect community. When I had the honor of speaking at a Profectum conference and spending a few days with just the loveliest humans like it was just such a great community very supportive, very child focused, play focused, strengths focused. So listeners, if this is kind of peaking your interest, definitely check out those resources. And I just wanted to ask, we do have a lot of international listeners. So you just mentioned translations of DIR Floortime used in other countries, like what is the international reach?

Rosemary White  40:59

Broad, very broad. In the US, throughout Europe, there are many individuals providing floor time. I do a telehealth support group on Fridays since we began in court with COVID. And I have people who come from Argentina, Brazil, South Africa, Turkey, Ukraine, Italy, Malta, and then and then there’s obviously I’m Australian, there’s a whole DIR community in Australia. I’m currently training a group in New Zealand. I also work with a group in Singapore, Russia, Georgia. So yeah, it’s in the UK, Wales, Ireland, as well, too. So yes, there’s many people from all over, all over the world. And I’ve had the good fortune to go and work in Brazil, Peru, Taiwan. Russia, Ukraine, Italy, the UK, and South Africa. That’s another big group in South Africa as well, too. And just all over the place, too.

Debbie Reber  42:12

That’s fantastic. You’re reminding me that I think last time we talked about getting you on the show, I think you were going to Russia, or you had just come back. So that’s so cool. As a way to wrap up, if there are listeners who are really interested in exploring this modality for their child, is Profectum the place to go, how can they tap into or find resources where they live for their child?

Rosemary White  42:36

Well, I think there’s a couple of ways to go to Profectum is a great resource. And there is like a parent module as well to the other, you know, going to ICDL. And looking there, there’s directories for both of them. So you could go and you know, put in the state that you live in and the area of your way, where your resource would be the other. The other part about it is I think just going to Profectum and the Parent Toolbox, and going through that as another resource, because we really wanted to design it. If you live in a place where there isn’t a perfect isn’t a DIR Floortime professional, I’ll say that you would be able to really go through this and think about your own child. So that’s another resource as well, too.

Debbie Reber  43:28

Fantastic. Well, Rosemary, I just want to say thank you, I am just grateful for the work that you do. I’m so happy our paths crossed so many years ago, and when we left Seattle to go to Amsterdam, saying goodbye to Kris and to the other therapists we work with was one of the harder goodbyes that we had to make. It was like the end of such a magical time of learning and growth for our whole family. So I just wanted to say that and thank you so much for everything that you shared today and the work that you do.

Rosemary White  44:00

And I just want to say it’s wonderful to be here. And just, you know, I have followed you since you were at the office. And just it was so exciting to read your book and to look at your journey in Amsterdam and then coming back to the United States. And I don’t know if you remember when Kris went on maternity leave. I treated Asher, which was a joy for me too. It was a treat is not the right word. I joined Asher in the play.

Debbie Reber  44:27


Rosemary White  44:28

Yeah, I think that’s a better way of saying it too.

Debbie Reber  44:31

Awesome. Well, thank you so much. Thanks again for coming by the podcast.

Rosemary White  44:34

Thank you for having me.

Debbie Reber  44:39

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