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Albania 2008

Floortime Conference
for Professionals and Parents

Transcript of the address given by Pim Donkersloot to the conference delegates at the Floortime Conference, which was held in Albania in September 2008.

"Good afternoon. I hope you've had a good lunch and are energized and eager to absorb this second part of the conference.

Before we introduce ourselves we would like to hear whom of you are physicians, paediatricians, educators, and/or working in the Mental Health are. Whom of you are also parents of children with special needs? Children under the age of ten? Above ten? Thank you, it gives us an idea with whom we are dealing with.

My name is Pim Donkersloot. I am a child psychologist, specialized in autism, a journalist, an author and the father of two children on the autistic spectrum. I am also the director of the ChildCenter, a foundation based in Amsterdam which provides therapeutic treatment for young children diagnosed with autistic spectrum disorders, and provide help for their parents.

The ChildCenter relies on the expertise of a team of therapists - music, speech, occupational, play, social skills - who use the DIR approach (Developmental Individual differences Relationship based model ) pioneered by doctors Stanley Greenspan and Serena Wieder in Washington, DC, and developed by their collegues. One such colleague is Ruby Salazar. And together with Marius de Vos they will elaborate on this model in their presentations.

From left: Marinus, Ruby Salazar and Pim
at the Albania Conference

Let me take this opportunity to introduce each of them: Ruby Salazar is a child and family psychotherapist who has worked with children and families for over thirty years. She is the founder and director of Salazar Associates, a private, family-focused practice of developmental and mental health professionals, located in Pennsylvania, USA. Mrs. Salazar is currently on several faculties, including the Interdisciplinary Council for Developmental and Learning Disorders, in short ICDL. She has been associated with Interdisciplinary Council for Developmental and Learning Disorders since 1992 and is an Advisory Board Member and Senior Faculty.

In a nutshell, mrs. Salazar is a nationally and internationally renowned mentor , trainer, and program developer who has been a leader in program development in the United States of America. Currently she is directing a comprehensive ASD assessment research project, and refining early signs of autism and differential diagnostic matters for young children. Mrs. Salazar was the first recipient (2000) of The Zero to Three Sally Provence Award for Excellence in Infant/Family Practice.

Marius de Vos, a psychologist and the co-parent of an Albanian boy with autism, worked in special education in London as a teacher for children with profound and multiple disabilities. Since relocating to Amsterdam, The Netherlands, some 8 years ago, Marius has worked as a play therapist with children on the autistic spectrum. He has also established a much needed school for children with autism which became operational this year.

Marius and I also work together to train, advise and help parents to find constructive and interactive ways of playing and communicating with their autistic child, as well as how the parents can support one another.

We are delighted to be able to participate in this first international conference on autism to be held in Albania. I would like to thank Dr. Liri Berisha and the Albanian Children Foundation for having included us in this important and groundbreaking initiative. We do realize that in this first conference we can only give you a glimpse of how we are working with autistic children and their families, but we are more than happy to come back to provide extensive training, coaching and programming.

During the next two sessions, presented by Ruby Salazar and Marius de Vos, we will focus on the Realities and possibilities for Families living with Autism and other Challenges of Relating and Communicating. We want to share with you information about a dynamic approach to treating Autistic Spectrum Disorders which emphasizes the inclusion of parents in the treatment, and makes them part of the process.

Why do we think this is so important? We believe that everything a child does and thinks as he/she is developing, is based largely on emotions. Reasoning is driven by emotion in childhood as well as in later life. Listen for example to a passionate conversation between two grown men about soccer, and observe how well their memory functions when they have to recall names of the players from years ago!

Emotion or affect, motivation, and contact, is vital to cognitive development, to meaningful intellectual learning.

For instance, when a child is learning concepts of quantity, he does not first understand it conceptually, he understands it emotionally. To clarify this with a practical example: What is a lot to a young child? It is more than he expects. What is a little? It is less than he wants. Children apply to the physical world what they have already learned emotionally; they are not, as previously assumed, introduced to abstractions by the physical world. The first lesson in causality happens in the first weeks of a baby's life when it is pulling his mother's heartstrings with a smile in order to receive one back.

By observing the dysfunction of autistic children we can see that they don't have a clear understanding of themselves - a connection among feelings, actions and ideas. Autistic children will not understand abstractions until they understand their own emotions.

With its focus on affect, emotion and relating, the emotional development of the child is the cornerstone of the Developmental Individual differences, Relationship model , in short the DIR-model. According to this view, without fundamental relatedness to significant others, language and cognition - for example - will not develop normally. If we try to do the speaking and thinking without specifically spontaneous and meaningful interaction, it will not go as well, and the child may end up with a bunch of splinter skills. He may produce words, but the words have hardly or no meaning for him. Thus, emotions form the basis of all developmental milestones.

So, we believe that the growth of the mind and brain in the early years is directly related to a child's interactions with caregivers, naturally most of all the parents. The brain and the mind can be developed by wooing -enticing the child into an emotional relationship. That is why we strongly believe that a therapist alone cannot teach an autistic child to come out of his/her world; the parents (or someone else with an emotional connection to the child) will have to be involved. The foundation of healthy development needs to be laid at home.

Thus, the best opportunity for stimulating emotional and mental growth of the child on the autistic spectrum is in the home environment. This is where meaningful actions take place, and therefore we emphasize that any approach to any treatment must include the participation of the family. We as professionals are the experts in our field, but parents are the experts on their own child and this vital resource must not only to be recognized but must be utilized. Parents and therapists must be partners in helping the child. Parents see their child's reactions to therapy as well as to other experiences. Parents can tell therapists what is helpful and what is not. They can provide feedback about their child's progress and well being, which can be used by the therapist in fine tuning the treatment. The role of the therapist is to support the relationship between parent and child, and to give parents energy, hope and tools to interact in a more meaningful way with their autistic child.

We cannot treat the individual child in a vacuum, in isolation. An autistic child only has a communication disorder in relation to others. If I were to speak to you in Dutch, I am certain that I would have trouble communicating with you, although I understand what I want to say. In other words, we as therapists need to go deep into the autistic child's world in order to understand and decode their unique language of communication.

We need, as dr. Afrosini Kalyva from Greece and others this morning already emphasized, to look at family dynamics - how to integrate parents into the treatment process, because we believe emotional bonding is the key to development. In a few moments Ruby Salazar will elaborate on the possibilities and realities for families living with autism and other challenges, while Marius de Vos will focus on the bonding aspect between caregiver and child through a specific form of play therapy known as floortime. I would like to conclude by saying that we would welcome the opportunity to cooperate with the Albanian Children Foundation and all of you, in order to ensure that children with autism and their families get the help and care they need and deserve.

Thank you for your attention."