DIR/Floortime in Singapore: What It Is and How to Check a Provider

Dictionary: EIPIC · EIPIC-P · ECDA · SG Enable

What DIR/Floortime is, in plain words

Two parts, one name. DIR is a way of understanding how a child develops. Floortime is what an adult does with that understanding, on the floor, in play.

DIR

The Developmental, Individual-differences, and Relationship-based model. D is where your child is in their development and where they are heading. I is the particular way your child takes in, handles and responds to the world, senses included. R is the belief that relationships drive growth.

DIR/Floortime

The DIR model put into practice. ICDL, the body that owns the name, calls it “the application of the DIR® model into practice”. It is a way of playing, not a separate therapy standing on its own. ICDL writes the name as DIRFloortime®, or Floortime™ for short, so you will meet all three forms on provider pages. They mean the same thing.

ICDL

The International Council on Development and Learning, a not-for-profit in the United States. It owns DIR, DIRFloortime and Floortime as trademarks and runs the official certificate courses. It was called the Interdisciplinary Council on Development and Learning until 2022, so you will see both names.

The model was built by Dr Stanley Greenspan, a child psychiatrist, and Dr Serena Wieder, a clinical psychologist, in the late 1990s. Greenspan, who died in 2010, was ICDL’s founding president.

ICDL says it is used by teachers, occupational therapists, speech therapists, mental health professionals and parents. So the person offering it to your child could come from any of those backgrounds. That matters later, because what you can check depends on which one they are.

What a session looks like

One adult and one child, usually on the floor at home or in a classroom.

The adult starts by watching. What is your child doing, what are they into, how are they feeling right now? Then the adult joins in, copying or adding a little to what your child is already doing, with warmth and interest.

The aim has a name: circles of communication. The adult does something, your child answers, and that is one circle closed. The Association for Science in Autism Treatment, a United States group that reviews autism approaches, gives this example.

Your child rolls a toy car towards the adult. The adult rolls it back, smiles and says something about it. Your child laughs and pushes the car again: another circle.

Over time the circles get longer. A child might start with simple back-and-forth play and build up to solving a small problem with the adult, or playing out a feeling.

Supporters of DIR/Floortime often recommend 15 or more hours a week of it. That is a lot of hours. In most of the studies one 2023 review looked at, trained parents ran the sessions themselves, at home.

If a centre offers it, ask to sit in on one session before you commit. Watch what the adult does when your child walks away from the game. That moment tells you more than a brochure can.

DIR/Floortime and ABA, side by side

If you are looking into it, you have probably heard of ABA too. ABA is short for Applied Behaviour Analysis, an approach built on the science of behaviour. Its form for young children is EIBI, early intensive behavioural intervention, which means ABA for many hours a week, started early.

The two grew out of different sciences. The table sets them side by side on five plain questions.

Neither column wins on that table, and that is the honest point. Both have studies that report gains. Both have reviewers saying the studies are too small or too weak to be sure.

Can a child do both? Some approaches are already built from both. They are called Naturalistic Developmental Behavioural Interventions, or NDBI for short.

An NDBI uses everyday settings and adults who respond to the child. Its teaching draws on developmental science and on ABA together. The Early Start Denver Model is one, designed for very young children and widely studied.

What one review does warn about is swapping rather than mixing. The 2023 review notes that “indirect harm can result from improper usage of floortime and rejection of other effective treatments”. If a provider asks you to stop everything else for it, ask why, and ask for the reason in writing.

Our guide to the five main autism therapies in Singapore sets DIR/Floortime beside speech therapy, occupational therapy, ABA and AAC, the communication aids such as picture boards and speech devices.

Is DIR/Floortime evidence-based? What the research shows, and what it does not

Not yet, by the standard the big evidence rankings use. In those rankings, evidence-based means enough strong studies back an approach for it to make their list. Small studies report gains, and a review published in 2026 still asks for the larger, careful trials that would settle it either way.

You will hear the opposite from some quarters, so start with who says what. ICDL, which owns the name and runs the official training, describes it as “recognized as a leading evidence-based approach”. The reviewers who rank autism approaches do not put it on their lists.

Two reviews of the studies. A 2023 systematic review kept 12 studies published between 2010 and 2021. A systematic review gathers every study that meets set rules and reads them together.

It reported improvements in emotional functioning, communication and daily living skills, the everyday tasks of looking after yourself. It also reported better parent-child interaction, as mothers described it. It found “no adverse events to children or parents during floortime”, which means no harm was reported.

The same review is plain about the limits. Only one of the 12 was a randomised controlled trial, or RCT. That is the kind of study where children are put into groups by chance, so the comparison is fair.

In most studies, parents ran the sessions at home and reported back, with no researcher watching. The authors say the number of children studied “was very minimal” and that “the findings cannot be generalized”. In other words, the results may not hold for children in general.

A second review, published in 2026, searched studies from 2007 to 2025 and kept 9 after screening. The children were 2 to 6 years old, and each study had between 11 and 68 of them.

It reported gains in social skills, self-regulation and parent-child interaction, and lower scores on measures of autism severity. Self-regulation means a child calming and managing their own body and feelings.

The review covered only one group of autistic children, chosen by a functioning label. That is a way of ranking autistic children by ability, and we do not use it. So the review does not speak for every child.

Then it graded the nine studies on quality.

An even split, in other words, with as many weak studies as strong ones. The common gaps included no blinding, which means the people measuring the children may have known which ones had the therapy. The authors close by asking for “further high-quality RCTs with larger samples and long-term follow-up”, meaning checks on the children long after the sessions end.

The evidence rankings. The Association for Science in Autism Treatment summarises the rankings like this. The National Standards Project is a review of autism approaches by the National Autism Center. Its 2015 report “concluded that DIRFloortime lacks the empirical support needed to meet criteria as an evidence-based practice”, that is, not enough strong study results.

A 2021 review of evidence-based autism practices by Hume and colleagues “excluded DIRFloortime from the list”. A 2020 analysis of over 150 early intervention studies, by Sandbank and colleagues, found that approaches built on developmental ideas alone, DIR/Floortime among them, showed small effects. That means the changes the studies measured were small.

The Association’s own view is that DIR/Floortime “is not currently supported by sufficient high-quality research to be recognized as an established treatment”, and that its use “should be carefully monitored”. That is one organisation’s reading. The rankings it summarises are the part that does not depend on whose reading you trust.

So read the evidence as it is: not proven and not disproven. A provider who calls it proven is using a word the reviews do not use. A provider who calls it worthless is going past them too.

What you can ask for is written goals for your child, and how the provider will tell you whether they are being met.

Where DIR/Floortime sits in Singapore

DIR/Floortime is not one of the professions Singapore registers. Someone offering it here is checked through whatever else they are, if anything.

The Ministry of Health set out the position in a written reply to Parliament on 9 January 2024. The Allied Health Professions Act is the law that registers allied health professions, the health jobs that work beside doctors and nurses. It covers five: diagnostic radiographers, occupational therapists, physiotherapists, radiation therapists and speech therapists.

In government-funded early intervention, “the funding agreements specify the minimum qualifications and training required”. So the funding contract sets the bar for staff. The Ministry added that it will “continue to perform risk assessments” of other professions, to decide whether they too need registering.

Here is why that matters to you. If the person offering DIR/Floortime is also an occupational therapist or a speech-language therapist, that part of them is regulated.

They must be registered with the Allied Health Professions Council (AHPC), the body that keeps the register. They must also hold a valid Practising Certificate, the licence that lets them practise. The AHPC’s registers page links to a public search, and anyone outside those professions will not be in it.

Public early intervention does not name it either. EIPIC, the Early Intervention Programme for Infants and Children, is Singapore’s government-funded early intervention scheme. The Early Childhood Development Agency (ECDA) runs the EIPIC page.

SG Enable handles referrals for EIPIC-P, the version of EIPIC run by private centres that ECDA appoints. It keeps two more pages, one on EIPIC-P and one on therapy and intervention. As of October 2026, the name Floortime, in any form, appears on none of these three pages.

A funded centre may still use play-based methods in its own programme. That is a fact about the centre, not the scheme, so ask the centre.

What it costs here

Those three public pages publish no DIR/Floortime fee, so the price comes from the provider. Ask for three things in writing before you pay: the rate for one session, the number of sessions a week, and how much of that time is spent coaching you to do it at home. The last one matters most, given the hours supporters recommend.

For comparison, the funded route does publish its fees. ECDA’s EIPIC page, last updated on 21 April 2026, puts the out-of-pocket fee at S$5 to S$430 for Singapore Citizen children, “depending on monthly household per capita income”. Out-of-pocket means what a family pays after the subsidy.

Per capita income here means the household’s monthly income divided by the number of people living in it. Our EIPIC guide covers who qualifies and how the referral works.

New EIPIC-P referrals have been paused since 1 June 2026, and SG Enable says referrals “will resume in Q4 2026 for enrolment from January 2027”. Q4 means the last three months of the year.

Children already enrolled keep their subsidised services. Our page on the EIPIC-P referral pause has the detail, and our guide to private early intervention costs helps you set a provider’s quote against the funded fees.

How to find and check a DIR/Floortime provider in Singapore

With no Singapore register for DIR/Floortime, the checking starts with ICDL, the body that owns the name. ICDL keeps a public online directory, the DIRectory, with professionals in over 50 countries. Anyone can search it by location, read a listing and contact the person.

Two things to know before you lean on it. Professionals create their own listings. And the DIRectory is open to anyone with a professional certificate from ICDL or from two other DIR training bodies, the Profectum Foundation and the PLAY Project.

So a listing is where you start, not proof on its own.

1. Search the DIRectory for Singapore, and note the name and the training it lists.
2. Ask the provider which DIR/Floortime certificate they hold, and which body issued it: ICDL, Profectum or the PLAY Project. Ask to see it.
3. Ask what their own profession is. If they are an occupational therapist or a speech-language therapist, look them up through the AHPC’s public search.
4. Ask for your child’s goals in writing, and how progress will be measured and reported to you.
5. Ask to sit in on a session, and ask how much of the plan is coaching you.
6. Ask for the session rate and the weekly hours in writing.

None of these is rude. A provider who is glad to answer them is easier to work with for the long stretch ahead.

Can parents learn DIR/Floortime and do it at home?

Yes. Parents sit at the centre of it. ICDL counts parents among the people who use it, and in most of the studies the 2023 review covered, trained parents ran it at home.

At its simplest it is the play you already do, with a different aim. You follow instead of lead. You join what your child is already doing.

Then you wait for the reply, and answer it, and see how many times the two of you can go back and forth.

Learning it properly takes coaching. ICDL offers parents online consultations, coaching, help setting up a home programme, and an introductory course, DIR 101, taught live online.

It also tells readers not to get misled by others, and says plainly: “Make sure your course is approved by ICDL”. Before you pay for a parent course from anyone else, ask whether ICDL, Profectum or the PLAY Project stands behind it.

What to do next

One step: before the first session, look the person up on ICDL’s DIRectory, then ask which DIR/Floortime certificate they hold and who issued it.

When you want the wider question list, for any therapist and not only for DIR/Floortime, our guide to choosing an autism therapist in Singapore has it.

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