At CDI, we are committed to incorporating evidence-based practices into our programs and services. We believe education and research is meant to be applied. Our team is dedicated to remaining current with the most recent breakthroughs in early child development and discoveries in brain science. We believe this focus on innovation positively impacts the children and families we serve in the San Fernando Valley.

1) Relationship-Based Intervention Model

The field of relationship-based early intervention is gaining recognition through recent research and is now considered evidence-based.  For more information on the research supporting DIR/Floortime, click here.

DIR/Floortime is derived from over 50 years of study and research about child development from the fields of psychology, medicine, and education, and includes the areas of language, attention, mental health, attachment, infant development, sensory processing, and motor development. DIR research 2020_Cullinane

In 2014, the PLAY Project published a three‐year, multisite, randomized, controlled trial that showed improvements in both parent‐child interaction and autism symptomatology. This large scale study focused on parent-mediated play and relationship-focused intervention for young children with autism. Significant improvements were found in the caregiver/parent and child interaction, the social interaction of children with autism, the social-emotional development of children with autism and autism symptomatology. Using a relationship-based intervention, the PLAY project also found that parent stress and depression had improved. Read the journal article here.

In 2011, two new randomized-controlled studies showed statistically significant improvement in children with autism who used a relationship-based approach (DIR/Floortime) versus a mix of behavioral approaches. In 2007, a pilot study looking at pre/post changes with Floortime showed significant gains in children with autism. DIR/Floortime has the strongest research of any intervention to support its effectiveness in improving core deficits such as relating, interacting, and communicating in children with autism. (Greenspan)

The York University study showed groundbreaking brain imaging research on the results of developmental treatment for autism. Children in the York University treatment outcome study who received weekly DIR/Floortime showed a significant increase in brain efficiency. The children who did not receive DIR/Floortime relationship-based treatment showed a significant decrease in brain efficiency. Previous research has demonstrated how children with autism have too many neural networks at birth and then too few neural networks by adolescence. This creates a brain that cannot efficiently process and adapt to incoming information (Courchesne). Relationship-based intervention targets brain efficiency and makes managing incoming information and adapting to the daily challenges of life much more possible for children with autism and other developmental delays.

CDI integrates the latest brain research into an individualized, collaborative intervention approach that is meaningful and effective for children and their families.

Watch the video below to view a powerful video showing the York University study results on Floortime.

More research articles on DIR/Floortime (or developmental interventions based on Floortime)


1) A pilot randomized controlled trial of DIR/Floortime parent training intervention for preschool children with autistic spectrum disorders.  Kingkaew Pajareya and Kaewta Nopmaneejumruslers Autism published online 13 June 2011.

2) Learning Through Interaction in Children With Autism: Preliminary Data From a Social-Communication-Based Intervention.  Devin M. Casenhiser, Stuart G. Shanker and Jim Stieben Autism published online 26 September 2011.

3) J. Salt, J. Shemilt, et al., The Scottish Centre for Autism Preschool Treatment Programme II: The Results of a Controlled Treatment Outcome Study Autism, March 2002, Vol 6 (1) 33-46.

4) Solomon, R., J. Necheles, C. Ferch, and D. Bruckman. “Pilot study of a parent training program for young children with autism: The P.L.A.Y. Project Home Consultation program.” Autism, 2007, Vol 11 ( 3) 205-224.

2) Parent Coaching Model

Parent coaching is an evidence-based model which aims to build parents’ confidence and competence in supporting the growth and development of their child.  Parent coaching is a strategy where the therapist helps the parent reflect on the impact of their own interactions with their child. The parent and therapist use these reflections to evaluate the effectiveness of treatment strategies and collaborate to come up with solutions. Coaching can be used during natural family routines as a way to help families have opportunities to practice strategies during home visits, problem solve challenges and receive supportive feedback. Coaching is therapy and is a direct intervention with a child and family.



3) Natural Environments and Routines-Based Intervention

Natural environments are settings where you would typically find families with infants and toddlers, such as a families’ home, parks, stores, early care and education programs, and other community settings.  Part C of the Individuals with Disabilities Education Act (IDEA) requires that early intervention services for infants and toddlers be provided in natural environments. Services in natural environments allow professionals to help families obtain more functionality in their daily lives and allows their child’s intervention services to follow along with their everyday routines. Routines that occur within natural environments for young children provide the most effective framework to support and sustain early intervention activities.  When developmental interventions are embedded in children’s regular routines and activities, skills learned are functional and meaningful for children and their caregivers (Kashinath, Woods, & Goldstein, 2006).


4) Trauma Informed Care

Trauma signs and symptoms in young children can take many forms and are often misinterpreted. Understanding the signs and symptoms of early trauma requires understanding of the neurological, biological, psychological and social effects of trauma. Trauma-Informed Care and Practice is a strengths-based framework that is responsive to the impact of trauma, emphasizing physical, psychological, and emotional safety for both service providers and survivors; and creates opportunities for survivors to rebuild a sense of control and empowerment.


The National Child Traumatic Stress Network

5) Reflective Practice

“Reflective practice is the process of examining, with someone else, the thoughts, feelings, actions, and reactions evoked in the course of working closely with young children and their families.” (Zero to Three). In the context of early childhood development, reflective practice is used both as an approach for working with families and supervising early childhood providers. Reflective practice is a continuous process that involves professionals taking the time to think about an issue, event, or practice, from different perspectives as a strategy to improve the quality of service and intervention delivered to children and families.


6) Strengthening Families: Five Protective Factors

Strengthening Families™ is a research-informed approach to increase family strengths, enhance child development and reduce the likelihood of child abuse and neglect. It is based on engaging families, programs and communities in building five protective factors:

  • Parental resilience
  • Social connections
  • Knowledge of parenting and child development
  • Concrete support in times of need
  • Social and emotional competence of children

These key resources outline the Strengthening Families Approach. The topics below provide additional information, tools and resources for understanding more about Strengthening Families and the Protective Factors Framework.


7) Pyramid Model

The Pyramid Model for Supporting Social Emotional Competence in Infants and Young Children is a conceptual framework of evidence-based practices developed by two national, federally-funded research and training centers: The Center for the Social and Emotional Foundations for Early Learning (CSEFEL) and TACSEI. Based on evaluation data over the last eight years, the Pyramid Model has shown to be a sound framework for early care and education systems. Extensive training materials, videos, and print resources to help states, communities and programs implement the model have been developed.


8) Brain and Child Development Science

CDI team members are well versed in the science of early child development. This science provides many ideas that can be used to create policies and services to improve the early years of life.


9) The Importance of Play

Play is the work of infants and children. It is through play that children at a very early age engage and interact with the world around them. Play is one of the most important ways to nurture development and is vital to healthy brain development.

10) Multidisciplinary Research

Development does not occur in isolated disciplines. Infants and children are learning to socialize, move, and communicate simultaneously. If one area of development is delayed, it affects other areas of development as well. Often in early intervention, several different therapists are providing specialized intervention specific to one discipline. Research shows the effectiveness of the disciplines working together to support “whole child” development.