S

Functional Emotional

Developmental

Capacities (FEDC)

S

Functional

Emotional

Developmental

Capacities

1. What is FEDC?

2. FEDC and ASD

DC: 0 -3 R Multiaxial System

Axis I Primary diagnosis

Axis II Relationship

Classification

Axis III Medical &

Developmental

Disorders or

Conditions

Axis IV Psychosocial

stressors

Axis V Functional

Emotional

Developmental

Level

DC: 0 -3 R

Axis V:

Functional

Emotional

Developmental

Level (FEDL)

0 - 3 m Attention and regulation

3 - 6 m Forming relationships/

mutual engagement

4 - 10 m Intentional two-way

communication

10 - 18 m Complex gestures and

problem solving

18 - 30 m Use symbols to express

thoughts and feelings

30 - 42 m Connecting symbols

logically/ abstract

thinking

The way in which the infant or

young child organizes

experience, reflected in his or

her functioning.

Bayley-III (2005)

Scale of Infant

and Toddler

Development

S Additions

Social-Emotional subtest

Authored by one of the

nation’s leading experts in

child development,

Stanley Greenspan, M.D.

DIR® /Floortime™ Framework A Developmental, Biopsychosocial model

Biologically Based

Individual Differences Family, Community,

Culture

ASD, Anxiety, OCD, Depression, Behavioral

problems, Attentional problem, etc.

Functional Emotional Dev Capacities 6. Analytic / logical thinking

5. Creative use of ideas and symbols

4. Complex social problem solving

3. Simple back-and-forth gesturing

2. Engaging and relating

1. Attention and regulation

Healthy Emotional and

Social Functioning

Child-caregiver

Interactions

The Team Leader: AFFECT

S Affect plays the central role to

integrate all areas of

functioning into one

milestone

S Orchestrates the entire mental

team

S Supports the child’s overall

development in language,

visual-spatial, sensory

processing & integration, and

motor planning & sequencing.

S

What is FEDC ?

About FUNCTIONAL EMOTIONAL

DEVELOPMENTAL CAPACITIES

SFunctional

SOverall emotional abilities rather than specific emotions

SUnite different processing abilities

SBuild on one another

1. REGULATION AND INTEREST

IN THE WORLD

S From birth on

S Uses senses to perceive the world and discriminate patterns

S Emotions from inner sensations to outer world

S Sensations provided have to be emotionally pleasant

1. REGULATION AND INTEREST

IN THE WORLD (CONT.)

S Different responses for individual babies:

- some babies are very sensitive and require gentle soothing; some babies are underreactive and require more energetic wooing

- some fast; some slow

depends on caregiver’s ability to adapt

S Emotions organize intellectual abilities sense of SELF

S comprehend meanings

2. ENGAGING AND RELATING

S 2 to 4 months

S Intimacy

S comprehend tone and facial expressions as patterns

3. INTENTIONALITY

S 4 to 8 months

S Emotions signals for communication

S Back-and-forth emotional signaling / opening and closing circles of communication

S Including facial expressions, vocalizations, and motor gestures…

S Beginning of “causal” interactions

S More defined SELF

4. PROBLEM SOLVING, MOOD

REGULATION, AND A SENSE OF SELF

S 9 to 18 months

S Continuous flow of emotional interactions to express wishes

and needs and solve problems

S Pattern recognition

S More integrated SELF

5. CREATING SYMBOLS AND

USING WORDS AND IDEAS

S 18 to 30 months

S Previous emotional experiences meanings in symbols

S Manipulate symbols in mind to solve problems in mind

S Allows sharing of meanings through symbols (social)

S Symbolic sense of SELF

S Feelings are conveyed as real rather than as signals (I am mad vs

I feel mad); feelings are global (I am awful / I am ok) and

polarized (tend to be all good or all bad)

6. EMOTIONAL THINKING, LOGIC,

AND A SENSE OF ‘REALITY’

S 30 to 40 months

S Connect symbols together logically logical thinking

S new skills including social skills

S Differentiated feelings: more subtle descriptions of feeling

states, e.g. loneliness, annoyance

7. MULTIPLE-CAUSE AND

TRIANGULAR THINKING

S 4 to 7 year old

S Multiple reasons for feelings and triadic interaction among

feeling states

S Requires emotional investment in > one possibility

S Multiple dimensions of SELF

8. GRAY-AREA, EMOTIONALLY

DIFFERENTIATED THINKING

S 6 to 10 year old

S Different degrees of feelings

S Compromise in social situation

S SELF as member of a social group

9. A GROWING SENSE OF SELF AND

AN INTERNAL STANDARD

S From 10 year old onwards

S Compare with internalized sense of self

S Make inferences (thinking in more than 1 frame of reference

at a time)

S Self-reflection

S

FEDC and ASD

How do we perceive ASD?

Diagnostic Labels

Core Problems in ASD

1. Establishing closeness?

2. Exchanging emotional gestures in a continuous

way?

3. Using emerging words or symbols with emotional

intent?

Secondary Symptoms of ASD

S Secondary symptoms are common in but not specific to Autism

S Behaviors that stem from the core deficits

• For examples: tendency to perseverate, self-stimulating, echolalia, narrow range of interests, over-reactivity…etc.

DIR Treatment Model

To help children mastering the six basic

developmental skills for relating, thinking

& communicating, through affect &

emotional interaction

DIR Treatment Model Foundations for Relating, Communicating & Thinking

Level 1: Shared attention & regulation

Level 2: Engaging & relating

Level 3: Purposeful emotional interactions

Level 4：Long chains of back-and-forth emotional

signaling & shared problem-solving

Level 5：Creating ideas

Level 6：Building bridges between ideas: logical thinking

(Functional Emotional Developmental Level)

DIR Treatment Model

Understand unique biological challenges

(individual difference) of children

Design treatment program to improve their

biological function

Work around the challenges to

help children learn, relate & grow

We can’t force closeness…

Let the child take initiatives

DIR Treatment Model

Understand child’s interaction patterns

Aware of family’s interactive styles,

changing the styles to work with child’s

unique nervous system

S Follow the child’s lead, join in the child’s world & build on

his/ her natural interests

S Support the child to be regulated so that he/ she could

engage with someone else, develop trust & love, expand

back-and-forth & meaningful interaction

S Communicate through affects, use of pacing in interaction,

consider all actions of child as meaningful

Comments & Discussion