Here is a fine example of how people with Ph.D's spouting professorial language
can be truly evil and stupid and incredibly stubborn when there are self-serving
issues involved:

http://www.blisstree.com/autismvox/engaging-floortime-2-greenspan-on-how-autism-\
develops/
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I will begin my review of Dr. Stanley Greenspan's new book, Engaging Autism:
Using the Floortime Approach to Help Children Relate, Communicate and Think not
by reviewing the techniques of his Floortime approach, but by considering his
views on "how autism develops." Appendix B of Engaging Autism is entitled "How
Autism Develops: The DIR Theory" and opens with a reference to Greenspan's
earlier work on "the development of symbol formation, language, and
intelligence," and especially to his 2004 book The first idea: how symbols,
language, and intelligence evolved from our primate ancestors to modern humans,
whose co-author is Stuart G. Shanker.

According to the observations we have made of a range of infants, young
children, and their families (Greenspan, 1979, 1992, 2001; Greenspan and
Shanker, 2004, 2006) the development of symbol formation, language, and
intelligence is based on a series of critical, emotional interactions early in
life. When these interactions are not mastered, these abilities do not develop.
Biological factors present in autism can make it difficult for a child to
participate in these interactions. We have observed that children with ASD have
not fully mastered these critical early interactions (Greenspan et al., 1987;
Greenspan, 1992; Greenspan and Wieder, 1998, 1999). (p. 395)

Though this is only one paragraph from Engaging Autism, these four sentences are
emblematic of Greenspan's thinking throughout the book and, indeed, behind the
uses of Floortime in treating "children at risk for ASD" (p. 399). The first
sentence is a general statement about the development of "symbol formation,
language, and intelligence" in children—about child development—-about children
in general. A certain "series [my emphasis] of critical, emotional [my emphasis]
interactions early in life" are necessary for a child to "master," and it is
precisely this "mastery" of these "formative emotional interactions" that does
not occur in children with ASD. Greenspan's Floortime is an intervention
designed to create "special opportunities for the necessary [my emphasis]
formative emotional experiences [my emphasis]."

In other words, due to "biological factors," an autistic child (according to
Greenspan) has difficulty in acquiring these "formative" experiences, so that
his development is impeded. Floortime, with its emphasis on looking at the "core
psychological deficit in autism" —identified by Greenspan as an infant's
capacity to "connect emotions or intent to motor planning and sequencing and to
sensations and, later to emergent symbols" (p. 397)—focuses on recreating, via
those "special opportunities" (i.e., the specific techniques of Floortime), that
connection between emotion and motor planning, etc., that some children do not
develop "because of their unique biologies" (p. 395). Greenspan notes that these
"biological factors" include a child's genetic make-up that "may presdispose a
child to autism, or create vulnerabilities to cumulative pre- and postnatal
challenges such as infectious illnesses, toxic substances, and factors that can
precipitate autoimmunity" (p. 396)—-Greenspan seems here to be referring to
theories about the MMR vaccine, thimerasol, mercury, environmental toxins, air
pollution, etc., as causes of autism.

In the next sentence in this paragraph (in a section entitled "A Multifactor,
Cumulative Risk Model"), Greenspan writes:

Postnatal factors such as experiential or physical stress may also contribute to
the behavioral patterns symptomatic of autism and ASD. (p. 396)

A few pages later, he writes:

When biological factors (or severe deprivation or abuse) interfere with the
formation of a primary connection among the sensory system, affect, and the
motor system, behavior is not strongly linked to affective qualities of
sensation. Therefore, infants with this deficit evidence more aimless
behavior…..(p. 399)

In addition to "biological factors," Greenspan suggests that something in an
infant's experience may be causing "stress" on his system. The second passage
quoted above provides a more specific sense of what he means by "experiential
stress," namely "severe deprivation or abuse." It is suggested here that a child
is "at risk for ASD" (p. 399) because something is lacking in those taking care
of the child—the child's parents; indeed, Greenspan suggests that the child's
caregivers may be "severely depriving" and even "abusing" a child.

Is it possible that Greenspan is suggesting that a child can be "at risk for
ASD" due to improper care from the child's parents?

If so, enfolded in Greenspan's discussion in Appendix B of "How Autism Develops"
and in his "developmental, individual-difference, relationship-based" DIR model,
is more than a hint of a theory of autism that most parents have long thought
outmoded and discredited, namely, the refrigerator mother theory of autism first
stated by Leo Kanner and promulgated by Bruno Bettelheim.

I will continue my analysis of Engaging Autism and more of the specifics of the
Floortime approach as Greenspan presents them in this book in a future post.