Therapy Decision Guide
DIR/Floortime can be funded through OAP when delivered by regulated health professionals (e.g., occupational therapists, speech-language pathologists) or BACB-certified practitioners. Coverage depends on how the service is framed within the clinician's regulated scope.
Ask any prospective provider which of these credentials they hold, and confirm the credential with the relevant regulatory college before starting.
DIR/Floortime is built on the premise that emotional development drives cognitive and social growth. The "D" stands for Developmental — addressing six functional emotional developmental capacities from self-regulation through abstract thinking. The "I" stands for Individual Differences — recognizing each child's unique sensory processing, motor planning, and language profile. The "R" stands for Relationship-based — using the warmth of human connection as the vehicle for growth.
During a Floortime session, the adult literally gets down on the floor and follows the child's lead. If a child is lining up cars, the therapist joins in and gently introduces interactive elements — perhaps a car "wants" to go somewhere new. The goal is to open and close "circles of communication," building longer chains of back-and-forth interaction that develop engagement, problem-solving, and symbolic thinking.
Ontario families often combine DIR/Floortime with other approaches. Many occupational therapists and speech-language pathologists integrate DIR principles into their sessions, creating a comprehensive developmental approach that addresses sensory, motor, communication, and emotional needs simultaneously.
A 2011 randomized controlled trial by Pajareya and Nopmaneejumruslers, published in the Journal of Developmental & Behavioral Pediatrics, found that children receiving home-based DIR/Floortime showed significant improvements in Functional Emotional Assessment Scale (FEAS) scores compared to the control group. A systematic review by Mercer (2017) in Research in Autism Spectrum Disorders classified the evidence as moderate, with consistent positive findings but a need for larger-scale trials.
The evidence base for DIR/Floortime continues to grow. While it has fewer large-scale RCTs than ABA-based approaches, the existing research consistently shows benefits in emotional functioning, social communication, and parent-child interaction quality. The 2015 Solomon et al. study in the Journal of Autism and Developmental Disorders found that a parent-mediated PLAY Project (based on DIR) produced significant gains in child interaction compared to community services.
Pajareya & Nopmaneejumruslers (2011)
A pilot randomized controlled trial of DIR/Floortime parent training intervention for pre-school children with autistic spectrum disorders. Journal of Developmental & Behavioral Pediatrics, 32(3), 264-270.
Solomon et al. (2014)
PLAY Project home consultation intervention program for young children with autism spectrum disorders: A randomized controlled trial. Journal of Developmental & Behavioral Pediatrics, 35(8), 475-485.
Written by Spencer Carroll
Founder & Autism Advocate
Evidence on this page
Key claims are paired with their source, evidence tier, and verification date so readers can inspect the public record directly.
Early Start Denver Model (ESDM) delivered to children aged 18–30 months produced significant gains in IQ, adaptive behaviour, and autism severity — some children no longer met diagnostic criteria at follow-up
Cochrane systematic review finds evidence that early intensive behavioural intervention (EIBI) may produce positive effects on adaptive behaviour and communication for young children with ASD (low certainty of evidence)
WHO recommends accessible, community-based early interventions for children with autism — timely evidence-based psychosocial interventions improve communication and social engagement
89,799
children are registered in the Ontario Autism Program
23%
Only 20,633 children have active funding agreements — less than one in four