Tips on Actually Doing the “Home Program” Your Therapist Recommends

“Home Program” is a therapy phrase that your OT, PT, and SLP use when we talk about the ideas and assignments we recommend to families to do each week at home to try to reinforce the skills we are teaching in the skilled therapy session.

I think everyone would agree that the follow-through at home is critical to children learning new skills, yet both sides (therapist and parents) tend to ignore this critical step.  Why?  It is really hard.  It is hard for therapists to know what parents are capable of and willing to do.  It is hard for parents to find the time and energy to do one more thing each day, much less something that challenges our child.  I’ve been on both sides of this problem and found some useful tips for therapists and parents.

This is what I hear from parents…

I didn’t understand it.

  1. Keep it simple.  What is obvious to a therapist is not to parents.  Simpler is almost always better.
  2. Practice it together.   A good rule for both parents and therapists is to have the parent try the assignment before leaving a therapy session to make sure it is clear enough and simple enough to do at home.

I didn’t remember it.

  1. binder to organize special need child informationWrite it down.  Have your therapist write it down for you or bring along a notebook/binder and write it down for yourself.  It is hard to remember every recommendation given by a therapy team.  Writing it down helps to make sure everyone knows the key skill(s) to work on each week.  However you choose to write it down, make sure you can see it daily at home- such as posting it on the fridge.  I have also seen families taking a photo or video during sessions- this is an awesome idea as well.
  2. Track it visually.  This benefits both parents and children in remembering to get home programs done.  It can be a simple as a calendar with a star each day the assignment was done to a more complex weekly chart of assignments from OT, PT, and SLP that need to be done daily.  Children can earn a reward if they get enough completed, and I often encourage parents to reward themselves if they get it done as well.

I didn’t have the right materials/ supplies.

  1. Home Program BinMake a home program box or binder (or both).  It is one thing to work on skills in a well-stocked therapy room, it is another thing to try to do it at home.  I found a good solution in making a home program box that holds all the pieces I need to do activities at home.  Each week I add to the box, and now I have an easy collection of activities to grab at a moment’s notice.  My bins are filled with oral motor games and toys, but other bins might be filled with fine motor art activities, or cards with yoga poses for gross motor work.
  2. Invest in the materials.  If you know your child will have ongoing needs, it is worth investing in the materials for a good home program.  Don’t be afraid to ask where your therapist got their equipment or toys.  It is amazing how much is now available online through therapy websites and Amazon.  Start browsing and you may find tons of great ideas for home.  This may mean making sensory bins, creating an art space, or even a sensory gym.  It may not always be easy or cheap, but it is worth it if your child needs it.

I didn’t have the time.

  1. IMG_1270-XLMake it fit into a daily routine.   Life is busy, but a good home program shouldn’t take huge amount of time or energy.  The best assignments will just fit right into current routines.  Therapists can recommend ideas for this, but parents really are the ones who need to find the right way to build the assignment into home life.  For example, we do oral motor exercises while brushing teeth twice a day.  If you need to work on fine motor skills, maybe it can be done during snack time by picking up small sprinkles.  The best therapy happens during play and daily routines!
  2. Involve all the caregivers (and siblings if appropriate).  Parents have a lot to do and often it is a challenge just to keep the children clean, dressed, and fed.  Sometimes other caregivers can be a great resource for helping with therapy home programs.  Grandparents, babysitters, older siblings, and other teachers/therapists/caregivers.  If the home ideas are written down, it is easy to share!

No one asked if I did it.rewardchart

  1. Follow-up.  Parents need to know that they will be held accountable to have tried, but that it is ok if it didn’t work.  If therapists don’t ask if parents tried the home ideas, it gives the message that it wasn’t really that important. There should be a conversation each session about how the home assignment worked and what the therapist can do to support the parent more each week.

Final Note- Parents should feel proud of themselves when they successfully learn a new skill that will help their child.  Being a parent is a challenge, even more so when a child has special needs.  The goal of any therapy should be to empower parents to be able to meet their children’s unique needs.  It is the responsibility of both the therapist and parent to find a way to make this happen.

 

Paige Hays is an occupational therapist who provides in-home, pediatric occupational therapy services in the south metro area of the Twin Cities, MN. She is a mother of 2 girls, avid DIYer, and a highly skilled and experienced OT. She specializes in working in pediatrics, with diverse expertise ranging from cognition and sensory issues to working with children with neuromuscular disabilities or complex medical needs.  www.paigehays.net