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DIR Therapy at Easterseals DuPage & Fox Valley

Growing Family Relationships with DIRFloortime Therapy for Children with Autism Spectrum Disorder

Four-year-old Grace was diagnosed with Autism Spectrum Disorder (ASD) in March 2020, just as the world was shutting down. Grace began occupational therapy at Easterseals DuPage & Fox Valley through tele-therapy, as Grace’s mom, Lisa, shares was a tough time for their family.

“Occupational Therapist, Kelly, met me at my most vulnerable time as a mom and took me under her wing. I had suspected my daughter had Autism, but it was still very scary to hear those words. We now officially knew we had a journey ahead of us. It took some time, but I now see this diagnosis was the key to opening every door, Grace needed to grow and succeed."

When Occupational Therapist, Kelly Nesbitt, MOT, OTR/L, began sessions with Grace, she was also completing a rigorous DIRFloortime certification that help therapists learn a coaching model with skilled observations in play for children with ASD or other sensory needs. Sessions usually begin with observing what each child is gravitating to in play. Kelly shares that tele-therapy really allows therapists to get a real insight into day-to-day life for our clients. “I can be a fly on the wall and see their routines and behavior in a tele-therapy appointment.”

Easterseals DuPage & Fox Valley has six occupational therapists and speech-language pathologists certified in DIRFLoortime- the most in this area. This highly-skilled certification, focuses on following the child’s natural emotional interests and at the same time challenging the child towards greater mastery of social, emotional, and intellectual capacities. With young children these playful interactions may occur on the floor, but go on to include conversations and interactions in other places. DIRFloortime emphasizes the critical role of parents and other family members because of the importance of their emotional relationships with the child. Learn more about DIRFloortime here.

Kelly coached Lisa into joining in Grace’s play using certain gestures, voice and expressions to keep her daughter engaged and want to continue to play and do more. These sessions work to draw out play interactions so that the child is engaged and relating to the parent for longer and more "robust" interactions, no matter the game or toys the child wants to play with that day. The simplest play can have the most beautiful interactions and bonding experiences for a parent and child. 

Both Kelly and Lisa share tele-therapy can be hard at first for families, but everyone ends up understanding session goals quickly and become closer to one another. “Our first session with Kelly, I was very honest. I didn’t know if this was going to work. My oldest daughter, Ava, was now home doing school remotely, a pandemic had shut down some of the supports we needed, and it was at a point of my lowest confidence as a mom. I was trying to connect, always over analyzing and second guessing everything. Due to the pandemic and these familiar virtual sessions, I could bounce my ideas or fears with Kelly. If we were in person, I don’t think we would have bonded as quickly. It really didn’t take long to find our groove together.”

The family saw Kelly once a week for 45 minutes and by the third session, noticed real change. Since older sister, Ava was home, she had ideas to play, and Grace would follow along. By the end of their sessions together, Grace had her own ideas of play and it became full circle, quickly. “To reflect on this with a professional like Kelly, and her great perspective, has been so helpful. Grace was even able to play or walk away off screen and come back. She was able to hold attention in the session, which was not where we started. These tele-therapy sessions came and went so quickly and were truly the highlight of our week. The DIR model really worked for us. It met Grace where she was in development and helped her grow and helped our whole family blossom. It was unexpectedly wonderful.”

“A year ago, I was asked the question about Grace’s future, and I would find is so overwhelming and cry. Now, we spent the last year making sure she was ready for Kindergarten. Grace is so ready! Our short-term goal is trying all social opportunities available. Grace is even going to try t-ball this spring. Long-term goals for Grace is to walk into a room and feel confident chatting with peers and being her funny, silly, self. And to keep her happy- which is the ultimate goal for any parent,” said Lisa.

Child in Tele-Therapy with OT on left side Here we were "making ice cream" out of a sand sensory bin. Grace loved watching mom's reaction if she ate ice cream that was too cold or yucky. Mom's affect drew Grace to repeat this play over and over!


“The DIR Floortime coaching model involves a lot of skilled observation and joining in on the ideas and intentions of the child. With Grace, I start the session just observing what she is gravitating to in play (is she building blocks, picking up Barbies, etc?). I will then coach mom into joining in this play while using sensory strategies and different adaptations based upon that child's unique profile. I also help coach the mom about how to use her gestures, voice, expressions, and silly sounds (affect) to keep the child engaged and want to come back to play more. I try to emphasize to the family that the most important part is that the child wants to engage with you- it doesn't matter what toy they want to play with- the real "toy" is the parent. I will coach the parent through how to draw out play interactions so that the child is engaged and relating to the parent for longer and more "robust" interactions, no matter the game or toys the child wants to play with that day. The simplest play can have the most beautiful interactions and bonding experiences for the parent and child.” - Occupational Therapist, Kelly Nesbitt.


Easterseals DuPage & Fox Valley offers these services at our centers in Villa Park, Naperville, and Elgin. To get started or learn more, call us at 630.282.2022.

Are you interested in learning more about our virtual services options? Click here to learn more about Tele-Therapy.

Other Services for Children with Autism Spectrum Disorder

Support for the Whole Family: Parent-to-Parent and Sibling Support

Just like a GPS helps you navigate unfamiliar streets, our family services team helps parents and families navigate this new and unfamiliar path.  We offer educational resources, networking opportunities and social activities for children, families and caregivers.  

Our sibling services provide much needed support to both the typically developing sibling and the sibling with disabilities.

Learn More about Family Services

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