DIRFloortime® with Emily Nguyen, OTR/L

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Have you heard of DIRFloortime®?

Until I started this series on OT specialties and certifications, I hadn’t heard of DIRFloortime® – not a single clue! But Emily, a pediatric OT practicing in Hong Kong reached out to share about her experience with this certification and how it has impacted her practice!

Before we dive into the interview, I’ll explain what DIRFloortime® is and provide you with some links so you can do some research on your own:

DIRFloortime® is an evidence-based intervention based off of the DIR® model, which stands for “Developmental, Individual Difference, Relationship-based,” and was developed by Dr. Stanley Greenspan and his colleagues.

The goal of this intervention is to “promote an individual’s development through a respectful, playful, joyful, and engaging process,” (Interdisciplinary Council on Development and Learning, n.d.).

Click here to read about the DIR® model and how it is comparable to DIRFloortime®.

Click here to listen to Dr. Greenspan talk about DIRFloortime®.

Click here for the ICDL home page (home of DIRFloortime®).

Click here for a list of DIR® courses.


Emily Nguyen, OTR/L is a pediatric occupational therapist who graduated from the University of Queensland, Australia in 2015 with her Bachelor of Occupational Therapy. She has been practicing for five years now, and is passionate about working with children.

You can find Emily on Instagram here.

She also just launched her new website here!

Why did you choose OT?

I found out about OT when I was in my last year of high school by chance. I had a friend who was in uni that was doing occupational health and safety and she mentioned she wished she chose occupational therapy. My immediate thought was, what is that? That night I remember going home, googling the profession and immediately thinking, “This is Me!” I chose it and got straight into OT from high school. It has been an amazing journey every since and I feel very lucky to have found something I loved so early on in life.

What setting(s) do you work in/have you worked in? Do you have a favorite and why?

I am a complete paediatric OT bias. I’ve always loved kids growing up and even when I was in uni it was my preferred field to work in from the get go! My first job was working for Queensland (QLD) Education. I was a school OT in rural Emerald QLD. I moved there by myself 9 hours away from where I lived in Brisbane. I was determined to get my first job working with children. I was based at a public state school with a Special Education Unit. I also would drive to schools nearby ranging from 30mins to 2 hrs to visit children. I then moved back to Brisbane to work for a not for profit, Autism Queensland. I provided outreach services visiting school and group programs.

In 2017 I moved overseas to Hong Kong. I worked at a Early Intervention Centre seeing kids below age of 6 with a wide range of diagnosis providing direct therapy. After 2 years there, I am currently working as a private OT at a private Children’s Therapy Centre in Hong Kong.

What does a typical day in the clinic/hospital/etc. look like for you?

If I am in clinic – I will read my notes, prepare / set up the room, provide direct therapy, discussion with parents afterwards, write case notes + plan next session, if parents didn’t attend I will give them a call to update or write a short email. If I am in school I will travel and take the kids out of class to provide direct therapy and liaise with their teachers any goals we have been working on.

Why (and when) did you decide to pursue the DIR Floortime certification?

I started being more interested in DIR when I was doing early intervention. The children were a lot younger and can be difficult to engage during direct therapy.

How often do you find yourself using the skills you learned from obtaining this certification? Do you believe the certification has impacted your practice (good or bad)?

I believe it has impacted my practice greatly. It shifts how you were traditionally trained and challenges you to adapt your practice without a plan, being present, going with the flow and following the child’s lead. The certification encourages a lot of reflection which is a good reminder for all of us OTs after many years of practice to ground ourselves again and be reminded of what’s important being present, appreciating what the child has to give us, taking it on and having fun with them.

Does your employer require you to have this certification? And do you get paid more because of it?

The private practice I currently work for values and practices the DIR model often, so it was recommended to me by my employer to do the online course. We get paid the same.

What are the steps to acquiring the credentials? (hours of experience, course(s), cost, exams, applications…etc.)

The course is honestly time consuming and requires your active participation to get the most benefits from it. The good thing is that the course is all online so you can be flexible and pick a time that works for you.

First you complete the DIR101 introduction 12 hour course (4 days). For this course you get a certificate of attendance, cost $179 USD.

To get a certificate of DIRfloortime Certified you need to do DIR201. My course went for 3 months January to April. Usually once a week sometimes twice a week for 2 hours a session. In total 28 contact hours. It is a mandatory requirement you attend every session. If you do however miss one, you must write a summary of the session you missed. This cost $799USD. My class was on zoom with 14 other students including 2 DIR mentors. Both were experienced Occupational Therapists, Maude Le Roux and Millicent Viljoen. I highly recommend attending their courses !

You are assessed on your active class discussion, 2 case presentation (includes recording of yourself applying DIRfloortime) and forum posting. You get a rubic scoring at the end with some helpful comments and feedback.

There is no renewal but lots of more course options if you want to be an expert DIR practitioner. All of which are quite expensive.  My employer paid for me.

Do you believe having the credentials is worth it?

If you are working with children diagnosed with Autism Spectrum Disorder and the younger population I think it is definitely worthwhile!

Do you have any other certifications or special training? Can you tell us a little about them and why you chose to pursue those?

I am trained in:

  • Ayres Sensory Integration and Praxis Test
  • Sequential Oral Sensory (SOS) Approach to Feeding
  • Therapressure© Brushing Protocol; having completed Sensory Defensiveness course presented by Patricia and Julia Wilbarger
  • Therapeutic Listening™ and Quickshift; Revolutionising the Use of Sound in Sensorimotor Integrative Treatment, presented by Sheila Frick
  • Picture Exchange Communication System (PECS)

All of them have helped me be a better children’s occupational therapist.

Do you have any other certifications in mind that you would like to pursue in the future?

I am thinking about Neuro-Developmental Treatment / Bobath Certified to help my kids with cerebral palsy and genetic conditions.

Do you have any words of advice for someone wanting to pursue this certification?

Go all in! Be vulnerable. Choose a child for your case study that you are finding difficult to engage with, film yourself, watch yourself back and reflect on it because everyone benefits and learns from these case presentations even though it can be difficult to share.

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