DIR® and DRBI

A Shared Commitment, But Different Concepts

At ICDL, we support efforts to improve developmental services for autistic individuals and others with neurodevelopmental differences. We also recognize the value of creating meaningful categories that help families, professionals, researchers, educators, and policymakers better understand different approaches.

However, ICDL does not support the current definition of Developmental Relationship-Based Interventions (DRBI) proposed by Cullinane and colleagues. While well-intentioned, we believe the current definition lacks sufficient conceptual clarity and is being applied in ways that may create confusion rather than understanding.

Our concern is not with the idea of creating a category. Our concern is with creating a category that is so broad that it no longer clearly defines what belongs within it or what distinguishes one approach from another.

DIR Is More Than an Intervention

One of the most important differences concerns how development itself is understood.

DIR is fundamentally a developmental framework. It is a comprehensive way of understanding how human development occurs through the continuous interaction of biology, relationships, experience, and culture.

DIRFloortime® is the primary practice approach that emerges from that framework.

While DIRFloortime includes specific clinical strategies, those strategies are always intended to support the child's developmental process rather than simply produce particular behaviors or skills.

Grwoth and development is the goal. While using the term "intervention" is not horrible, we are cautious about this because we recognize that many autistic adults have reported feeling like interventions were designed to intervene on who there were as a person with a goal to make them "normal" instead of helping them grow and develop in the context of their own authentic way of being.   

For this reason, ICDL believes it is more accurate to describe DIR as a developmental framework with evidence-informed practices than simply as an "intervention."

The Rationale Behind This Distinction

Families are increasingly looking for developmental approaches that are evidence-informed, respectful, and neurodiversity-affirming. When broad categories are poorly defined, it becomes difficult for families to understand important differences between approaches. Programs with very different theoretical foundations, training standards, clinical practices, and evidence may all begin describing themselves as "DRBI," even though they may share little beyond using relationships in some way. A category should bring clarity. It should help families understand what they are receiving, help researchers study similar approaches together, and help professionals communicate using consistent language. If the category becomes so broad that almost any relationship-focused service fits within it, those goals become much harder to achieve.

Our Concern About The Current Use of DRBI

ICDL has observed organizations describe themselves as providing "Developmental Relationship-Based Intervention" while offering programs that differ substantially in philosophy, developmental theory, professional preparation, and clinical practice.

In some cases, the DRBI label is being used as if it represents a clearly established evidence-based approach in its own right. Yet, it does not. We believe this risks creating confusion for families, professionals, researchers, funders, and policymakers. Evidence belongs to specific models and practices that have been defined, studied, replicated, and implemented with appropriate fidelity.

A broad category should not be used in ways that imply that every program within it has the same evidence base or requires the same level of professional preparation.

ICDL's Position

While the creation of a category to organize and identify the similarities between developmental approaches has merit, the current proposed definition of DRBI is flawed and confusing.  The way it has been defined it inherently too broad and too narrow at the same time.  This vague and confusing definition has opened the door to for-profit organizations to take advantage by offering DRBI services that are not DIR and do not have clear evidence-based support.  We caution parents to look closely at when they are presented with DRBI instead of DIR, because these are not the same.