DIR/Floortime Abroad

Recently, I was invited to speak at a conference in Moscow, Russia (or “forum” as it is translated there) entitled “Every Child Deserves A Family”.  This forum, hosted by Naked Heart Foundation, has been all about addressing the needs of special needs individuals in Russia.  Naked Heart Foundation was started almost ten years ago by the international model Natalia Vodianova.  Her mission at the time was to build playgrounds for children across Russia, as she had discovered that so many Russian children simply did not have adequate places to play.  One fantastic aspect of this trip is realizing that there are many Russians who value play as much as I do!  This forum brought together a large number of professionals from Russia and around the world (e.g., United States, Finland, Great Britain, and others) to talk about how to best meet the needs of individuals with disabilities.  In plenary sessions and workshops that covered early intervention through adult support, I heard about the state of the art in Russia, usually with a translator by my side whispering in my ear.

Not surprisingly, the vast majority of mainstream Russian practice is many years behind the United States and other parts of the world.  At the same time, this conference attracted some of the cutting edge practitioners, including my host organization, the Center for Curative Pedagogics (CCP), run by Anna Bitova.  CCP is one of several organizations supported significantly by Naked Heart Foundation.  CCP is a clinic serving about 300 individuals per year in a variety of ways.  Some individuals visit CCP for play therapy, speech therapy, or physical therapy, while some visit for play groups and life skills lessons.  Some individuals spend many hours a day there, while others come once or twice a week for an hour or two.  The program, housed in a cramped but homey three story building, feels like a beehive of constant activity.  Though I spoke only two sentences of Russian when I arrived (“Ya nyeh panamayu”, which means I don’t understand, and “Vee gavareetyah pah angleeskee?”, which means Do you speak English?), I immediately felt at home.  The warmth of my hosts, expressed in smiles, friendly touches, and the inviting bustle of the kitchen right in the middle of everything, put me at ease quickly.

The kitchen, by the way, is brilliant.  It is no bigger than a household kitchen, with several tables, a stove, and a sink with some counter space.  Always on the stove were four pots of different soups, a big pot of rice, and sometimes pasta or lentils.  On one of the tables was a salad—one day a green salad, one day cole slaw, one day a beet salad.  At the two dining tables were always plates of bread, as well as huge containers of sour cream (it seems to go on everything).  The first day I was there I got to partake of a kind of dessert cake, almost like a light cheese cake, but that treat was never repeated and I wonder if it was a special addition to the routine.  Coffee and tea were always available as well, and a water cooler stood in the corner.  During the day, staff eat lunch at different times; there are also some special needs adults who volunteer as workers in the kitchen, and they were almost always there as well.  Program participants seemed to wander in at times, and several times the siblings of people receiving treatment rolled through on a small scooter.  I sort of felt like I was in an Ingmar Bergman film, honestly.  I describe the kitchen in such detail, however, because it was clearly the beating heart of the place—and there really was a lot of life throughout the building.

Other active places included the woodworking shop, a place where program participants learn to make simple but beautiful ornaments and toys that are sold in a variety of places, helping the center to generate income; a clay room complete with kiln; a large physical movement room (where I watched group dance and massage activities); several play rooms; a staff meeting room with a permanently installed projector; plus offices, treatment rooms, and more.

At CCP, I led a training, an introduction to DIR/Floortime, of about 50 professionals and parents, most connected with CCP in one way or another, but some affiliated with other organizations.  Having a translator took some getting used to; having to stop every 15 seconds to allow the translator to speak was awkward at first, and forced me to simplify my narrative and plan my words more carefully.  Anna Bitrik would end up translating for me several times during my trip.  Anna is a psychologist at CCP.  A psychologist in Russia, by the way, is more like a masters level position, not usually a PhD.  The crowd was attentive and asked lots of questions.  It helped that their basic philosophy was so consistent with what I was teaching, so their questions tended to be more complex and elaborative than is often the case at an introductory training.

The training started at 10am and lasted until 4:45pm, with a break for lunch.  At 4:45pm, I had to race off to the Bolshoi Ballet with another companion, Elisa Rekhviashvili.  Elisa runs a small transition program in the Russian Georgia (near the city of Tblisi and near the Caucasus mountains, the site of the 2014 Winter Olympics at Sochi).  Elisa’s English was flawless and she was a charming partner to have.  Although she was never my translator, exactly, she helped me through several days of the forum.  But on this evening, we attended a two act comic ballet at the Bolshoi Theater, which is a stone’s throw from Red Square.

The theater is beautiful, exactly what you would imagine, with a magnificent interior and a live orchestra performing in the pit in front of the stage.  The show started at 6pm, and after two acts divided by an intermission, it was finished by 8:15pm.  Elisa told me that everyone in Russia goes to these kinds of cultural events regularly, and this audience had a wide range of tourists, fancily dressed people, children, and what looked like regular working stiffs.

After the show, I was again without a plan for dinner or transport back to the hotel, so with a little coaching from Elisa, I made my way home independently on the metro, including a change from the red line to the gray line.  It was a personal triumph and it felt good to navigate through a bit of the city on my own.  I might take a moment here to draw what may be an obvious parallel between my experience in Moscow and the experience of so many of the individuals we work with.  I arrived a stranger, unable to comprehend most the communication, not even recognizing the alphabet.  I had a tendency to withdraw from others, to seek out the familiar and repetitive, and to avoid risks.  For me, it took concentration and effort to keep putting myself into the fray, to keep trying to connect with people and to have new experiences.  Fortunately, many of my efforts were rewarded with success, but the times when I was unable to make myself understood—or to understand others—were challenging, and created a level of stress that never fully subsided during the trip.  All of these experiences seem quite similar to what happens on a daily basis to the individuals we work with.  What if every day felt like waking up in Russia?

The next two days were filled with attendance at the forum, Every Child Deserves a Family.  Day one started with keynote addresses from Natalia Vodianova, head of Naked Heart Foundation, Anna Bitova head of Center for Curative Pedagogics, and several other leaders in the Russian special education community.  In fact, each day started with a plenary session, two international presenters each on day two and three.  The rest of each day consisted of concurrent workshops addressing a range of issues from foster families and adoption issues to early intervention for special needs to vocational and residential support for adults with disabilities.

On the first day, I attended the workshop about young adult transition issues, trying to get a sense of the state of affairs of vocational and residential support.  There was one presenter from Finland, and the remainder were Russian.  The challenges that they are struggling with were common ones—lack of funding, and difficulty in finding the right level of support in the workplace and in independent living.  I did not hear much discussion about supporting individuals in improving their quality of life beyond the concrete aspects of work and residence.  I would have wished for more discussion about ways to strengthen and support the ability of individuals with disabilities to be a part of a social community, to find personal meaning and purpose in their daily lives, and to develop meaningful relationships.

On the second day, I participated in a workshop about innovative approaches to special needs intervention.  I devoted my presentation to providing an overview of DIR/Floortime, and managed to show three short videos to provide some clear images about what I was describing.  The remaining presenters, all from programs around Russia, discussed a range of intervention approaches.  Surprisingly, several of them seemed to be encouragingly focused on relationship-based approaches, though not fully appreciating what they were doing.

On the third day, I left the forum early to spend the afternoon at CCP, and this day was a highlight of the whole trip.  I was able to sit in on a play group (normally 6 children and 4 supporting adults, although on this day there were only 3 children in the group).  I watched them sing, play several group games, have tea together, watch a puppet show, work with clay, and engage in free exploration in the play room.  The adult leaders were wonderful, bringing high (but varied and sensitive) affect, a natural attunement to each child, and a sense of playfulness and creativity to their work.  They seemed to understand that “the action was in the interaction”.  In one really nice moment, one of the adults brought out a candle to light, which was part of a commonly repeated ritual in the group.  Everyone gathered around, and with great anticipation, the leader created a slow, chanting counting leading up to the striking of the match.  All of the kids hung with great expectation on his every word, filling in the Russian word for “Go!” at the end.

I was also able to watch a large group movement activity, which included a group dancing game and a massage activity.  During the latter, participants were paired with adults.  At first, the adults massaged the clients; later, the roles were reversed and the clients massaged the adults.  It was a nice moment of empowerment for the clients and a testimony to the authenticity of the relationships that everyone enjoyed this experience in a natural, relaxed way.

It has been a wonderful trip—not relaxing, but engaging and mind-expanding.  I’ve met some wonderful people and seen some exciting and positive work being done at CCP.  I am hopeful that the efforts of the Naked Heart Foundation will continue to spur significant change in Russia in the care and treatment of individuals with disabilities, including autism and related challenges.  I have been able to see that the work of The Community School, of other DIR programs, and of ICDL is truly cutting edge and essential to the strengthening of education and intervention for developmental disorders.  I am excited to be a part of the change in this field internationally.  I believe it is good for the children and families in Russia, but also important and good for children and families everywhere; the broader the acceptance of relationship-based approaches, the more people will benefit.

I feel privileged to have been able to go on this trip.

~Dave Nelson

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