Pajareya, K., & Nopmaneejumruslers, K. (2011). A pilot randomized controlled trial of DIR/Floortime™ parent training intervention for pre-school children with autistic spectrum disorders. Autism, 15(5), 563–577. https://doi.org/10.1177/1362361310386502

Type of Study: Randomized controlled trial
Number of Participants: 32

Population:

• Age — 24–72 months (Mean=51.5–56.6 months)
• Race/Ethnicity — Not specified
• Gender — 28 Male and 4 Female
• Status — Participants were children who met clinical criteria for autistic disorders.

Location/Institution: Thailand

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test the efficacy of adding the home-based Developmental, Individual-Difference, Relationship-Based (DIR)/Floortime™ [now called DIRFloortime®] intervention to the routine care of preschool children with autistic spectrum disorder. Participants were randomly assigned to typical treatment or treatment groups which added DIR/Floortime™ to typical treatment. Measures utilized include the Functional Emotional Assessment Scale (FEAS), the Childhood Autism Rating Scale, and the Functional Emotional Questionnaire. Results indicate that after the parents added home-based DIR/Floortime™ intervention at an average of 15.2 hours/week for three months, the DIR/Floortime™ group made significantly greater gains in all three measures employed in the study. Limitations include, the results could have been affected by involving families that were particularly interested in learning this new intervention, there was some contamination with varying types and amounts of interventions in the control group, small sample size, and lack of follow up.

Length of controlled postintervention follow-up: None.

Pajareya, K., & Nopmaneejumruslers, K. (2012). A one-year prospective follow-up study of a DIR/Floortime™ parent training intervention for preschool children with autistic spectrum disorders. Journal of the Medical Association of Thailand, 95(9), 1184–1193. https://pubmed.ncbi.nlm.nih.gov/23140036/

Type of Study: One-group pretest–posttest study
Number of Participants: 34

Population:

• Age — 2–6 years (Mean=50.6 months)
• Race/Ethnicity — Not specified
• Gender — 30 Male and 4 Female
• Status — Participants were children diagnosed with autistic spectrum disorders.

Location/Institution: The National Institute for Child and Family Development

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to determine the results of a 1-year Developmental, Individual-Difference, Relationship-Based (DIR)/Floortime™ [now called DIRFloortime®] parent training in developmental stimulation of children with autistic spectrum disorder (ASD). Parents were encouraged to deliver 1:1 interaction according to their child’s developmental level, as they were modeled and coached. Measures utilized include the Functional Emotional Assessment Scale (FEAS), the Functional Emotional Developmental Questionnaire (FEDQ), and the Childhood Autism Rating Scale (CARS). Results indicate that adding home-based DIR/Floortime™ intervention at the average of 14.2 hours per week for one year could help 47% of the children to make good improvement, with 23% making fair progression, and the last 29% making poor progression. There were significant increases in children’s total FEAS, and FEDQ scores and there was a significant decrease in the CARS scores. Results also indicated that fidelity of the parents, severity of the children, and baseline developmental status might affect the outcome. Limitations include lack of control group or randomization; small sample size; and lack of generalizability due to most parents being socially advantaged, well-educated, and having one parent who was not working outside the home.

Length of controlled postintervention follow-up: None.

Liao, S., Hwang, Y., Chen, Y., Lee, P., Chen, S., & Lin, L. (2014). Home-based DIR/Floortime™ intervention program for preschool children with autism spectrum disorders: Preliminary findings. Physical & Occupational Therapy in Pediatrics, 34(4), 356–367. https://doi.org/10.3109/01942638.2014.918074

Type of Study: One-group pretest–posttest study
Number of Participants: Children: 100% Male; Parents: 100% Female

Population:

• Age — Children: 45–69 months (Mean=55.9 months); Parents: Mean=35.7 years
• Race/Ethnicity — Not specified
• Gender — Children: 100% Male; Parents: 100% Female
• Status — Participants were children with autism spectrum disorder (ASD).

Location/Institution: Taiwan

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to investigate the effects of the Developmental, Individual Difference, and Relationship-Based DIR/Floortime™ [now called DIRFloortime®] home-based intervention program on social interaction and adaptive functioning of children with autism spectrum disorder (ASD). Mothers were instructed on the principles of the approach by an occupational therapist. All children and their mothers completed the 10-week home-based intervention program, undergoing an average of 109.7 hours of intervention. Measures utilized include the Functional Emotional Assessment Scale (FEAS), the Vineland Adaptive Behavior Scales (VABS-II), and the Parenting Stress Index-Short Form (PSI/SF). Results indicate that children made significant changes in mean scores for emotional functioning, communication, and daily living skills. Moreover, the mothers perceived positive changes in their parent-child interactions. Limitations include a sample of convenience, lack of a control group, lack of randomization, lack of follow-up, and the effect of maturation and other services and supports were not controlled.

Length of controlled postintervention follow-up: None.

Pacheco, P., Pacheco, M., & Molini-Avejonas, D. (2021). Study of 18 months of follow up dDIR/Floortime intervention in preschool children with autism spectrum disorder (ASD). European Psychiatry, 64(S1), S503–S503. https://doi.org/10.1192/j.eurpsy.2021.1346

Type of Study: One-group pretest–posttest study
Number of Participants: 15

Population:

• Age — 2–6 years
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were children with autism spectrum disorder (ASD).

Location/Institution: Two private DIR Floortime Model service centers in Brazil

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to determine the results of 18 months of DIR/Floortime™ parent training for an additional benefit in encouraging children with ASD climbing the developmental “ladder”. Measures utilized include the Functional Emotional Assessment Scale (FEAS) and the Functional Emotional Developmental Questionnaire (FEDQ). Results indicate that at the first month of assessment the children showed lack of self-regulation, social interaction, and engagement with their parents in a symbolic, sensory, and motor play setting. At the following evaluations, they showed increase of social interaction and engagement in the same play setting. Besides the high affect of the parents during the play time promoted a two way purpose communication and behavioral organization. Limitations include lack of randomization, lack of control group, and lack of follow-up.

Length of controlled postintervention follow-up: None.