A review article: DIRFloortime® on improving social communication skills in Thai children with autism spectrum disorder
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Abstract
Background: Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and interaction, necessitating early, developmentally appropriate intervention. The Developmental, Individualdifferences, Relationship-based model (DIRFloortime®) is a relationship-centered, child-directed approach designed to strengthen foundational capacities such as engagement, reciprocal communication, and symbolic thinking. Although increasingly implemented in Thailand, its empirical evidence base remains limited.
Objectives: This review aimed to systematically synthesize existing Thai research examining the effects of DIRFloortime® on social communication outcomes in children with ASD and to explore its practical implications within the Thai context.
Materials and methods: A structured literature search was conducted across Scopus, Thai Journal Online (ThaiJO), Google Scholar, and reference lists of relevant publications. Empirical studies published in English or Thai that evaluated DIRFloortime® interventions in Thai children with ASD were included.
Results: Across studies, DIRFloortime® demonstrated consistent positive effects on functional emotional development, engagement, reciprocal interaction, and foundational social communication skills. Reductions in autism symptom severity and improvements in language-related outcomes were observed particularly in longer-duration interventions. Parental fidelity and caregiver involvement emerged as significant predictors of treatment outcomes.
Conclusion: Current evidence suggests that DIRFloortime® is a culturally congruent and developmentally meaningful intervention for Thai children with ASD. While methodological limitations remain, findings support its potential as a caregiver-mediated approach to enhancing social communication. Further large-scale, high-quality studies are warranted to strengthen the evidence base and inform national implementation strategies.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
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