DIR/Floortime and ABA are two distinct autism therapies: Floortime focuses on emotional connection through child-led play while ABA focuses on building practical skills through learning and behavior analysis.
If you have a young child with autism or other developmental delay, you may be exploring options like Floortime or early intervention ABA to support areas such as communication, social interaction, coping with changes, or handling everyday tasks. Floortime builds these skills by joining a child in play and using their interests to encourage interaction and emotional growth. ABA, on the other hand, identifies the specific skills a child needs to develop and teaches them through practice, positive reinforcement, and everyday activities.
Floortime and ABA can work together, with some children receiving both to address different needs.
What Is Floortime (DIR)?
Floortime is a play-based therapy that supports social, emotional, and communication development in children with autism and other developmental challenges. While Floortime therapy for autism is most commonly used in early childhood, it can be adapted for children of different ages and developmental levels — including nonverbal children and those with more significant support needs.
Based on the DIR framework developed by child psychiatrist Dr. Stanley Greenspan in 1989, Floortime aims to build the underlying emotional capabilities that children use to connect with others, communicate, solve problems, and navigate everyday interactions.
The three building blocks: developmental, individual differences, relationship-based
The DIR framework considers three parts of a child’s development:
- Developmental: Where the child is socially and emotionally, and which abilities they are ready to build next.
- Individual Differences: How the child processes and responds to things like sound, touch, movement, and communication.
- Relationship-Based: How relationships with parents, caregivers, and therapists can be used to encourage connection, communication, and growth.
Together, these three areas help shape how Floortime looks for each child. For example, if a child prefers playing alone with blocks, a therapist might join their play and gradually encourage back-and-forth interaction — helping the child build skills for engaging and communicating with others.
What Is ABA?
Deeply rooted in behavioral science, Applied Behavior Analysis (ABA) uses positive reinforcement to help children with autism learn new skills and reduce challenging behaviors. Therapy is individualized around each child’s needs and may focus on communication, social interaction, coping skills, and greater independence with daily activities.
In practice, ABA therapists break skills into smaller steps and reinforce the behaviors they want to encourage. For example, if a child tends to bite when they need help, a therapist might teach them to say or gesture “help” instead. When the child uses the new skill, the therapist responds with praise and the help they asked for, reinforcing a safer way to communicate their needs.
Core Differences Between Floortime and ABA
Floortime and ABA differ in their underlying philosophy, program structure, and intensity. While both are provided by trained therapists, Floortime sessions are often brief and woven into everyday life whereas ABA is a more structured treatment program.
Is Floortime Evidence-Based?
Floortime has a growing body of research supporting its use for children with autism and developmental delays, particularly for strengthening communication and relationship abilities.
What research shows for each approach
Research on Floortime has found encouraging results. A 2023 systematic review of 12 studies found improvements in social-emotional development, communication, daily living skills, and parent-child interaction. However, researchers noted that stronger studies are still needed.
ABA has been studied since the 1960s, with a large body of research examining its effects on learning and coping skills. For example, a 2023 analysis found significant improvements in intellectual functioning and adaptive behavior among children receiving comprehensive ABA-based interventions.
Can Floortime and ABA Work Together?
Yes, some children receive both Floortime and ABA because they can address different needs. For example, ABA might help a child learn safer ways to communicate instead of hitting or screaming, while Floortime might focus on initiating social interactions and maintaining back-and-forth engagement during play.
Floortime and ABA are usually offered by different providers and in different settings, with ABA typically involving more hours of therapy each week.
Importantly, both approaches can involve parents and caregivers. Floortime encourages parents to build interaction into everyday play, while ABA parent training helps caregivers practice ABA strategies during daily routines.
Does Insurance Cover Floortime?
Some insurance plans cover Floortime for children with autism or another diagnosis, but coverage varies by plan and provider. Call your insurer to ask about covered services, referrals, prior authorization, and in-network providers.
How to Choose the Right Approach for Your Child
There’s no single approach that works best for every child. However, you may want to consider ABA if your child needs help learning specific skills, becoming more independent, or replacing challenging or unsafe behaviors.
On the other hand, DIR/Floortime may be a good fit if your child struggles with back-and-forth interaction, learns well through play, or needs an approach that adapts to sensory differences involving sound, touch, or movement.
A psychologist, developmental pediatrician, or other qualified professional can help families determine which therapies may be appropriate. They can also help you find qualified Floortime providers in your area.
Conclusion: There’s No Single Right Answer for Every Child
Choosing the right therapy can feel overwhelming. You want an early start for your child with autism and to get it right the first time — so they can have the best chance to make progress.
It may give you some peace of mind to know that both ABA and Floortime have research supporting their benefits, and there are professionals and parent resources to help you decide what’s right for your child. As your child grows, you can always adjust the approach along the way.
If you’re considering ABA for your child, talk to our team to learn more about what support may look like.
FAQs
Is Floortime good for autism?
Yes, research suggests Floortime can build skills in engagement, communication, and emotional connection, particularly for younger children. Like any intervention, effectiveness varies by child.
Is Floortime better than ABA?
Neither approach is universally better. ABA has a larger evidence base and is more consistently covered by insurance. Floortime offers a child-led, relationship-focused alternative some families prefer. Many families find the best fit depends on their child’s specific needs.
Can Floortime and ABA be used together?
Yes, some families and providers combine both, using ABA for structured skill-building and Floortime-informed play to build connection and emotional engagement.
Does insurance cover Floortime?
Coverage is far less consistent than for ABA. Confirm current coverage details directly with your insurer, since policies vary by state and plan and change over time.
3 References
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Divya, K., Begum, F., John, S. E., & Francis, F. (2023). DIR/Floor Time in Engaging Autism: A Systematic Review. Iranian Journal of Nursing and Midwifery Research, 28(2), 132. https://doi.org/10.4103/ijnmr.ijnmr_272_21
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Eckes, T., Buhlmann, U., Holling, H.-D., & Möllmann, A. (2023). Comprehensive ABA-based interventions in the treatment of children with autism spectrum disorder – a meta-analysis. BMC Psychiatry, 23, 133. https://doi.org/10.1186/s12888-022-04412-1
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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
