I recently started doing speech therapy through the Early Intervention program in my state as a side-gig (that will hopefully turn into my full time gig). It's only been 6 months since I started doing therapy following this in-home model and I have already learned SO much.
But the best lesson I've learned so far was to embrace bagless therapy! I know that bagless therapy is nothing new. There are tons of blog posts about it already. I know this because I read through a ton of them myself. But bagless therapy was still a little scary for me. I think I equated bagless therapy to therapy without a plan. My type A personality was not okay with that. But I learned that "bag" does not equal "plan." I can have a plan without my bag! So how do I do this?
Session 1
- I look at parent goals/child needs. I review their IFSP with them, but I also talk with the parents every session to see what needs they would like addressed. We also talk about some of the things I am seeing, developmental norms, etc.
- We make a list of a few target words, vocabulary groups, and skills we'd like to work on.
- I spend a little time explaining what therapy will look like, why play based therapy is important and effective, and how the parents can be an active part of their child's therapy.
- We use the remaining time to go through the child's preferred toys and talk about ways that we can use them to target the goals we set.
Session 2
- Check in on how things went throughout the last week and troubleshoot any problems with the family.
- I often provide the family with parent handouts for targeting specific vocabulary/words they mentioned in the previous session. I use these two resources a lot: Word of the Week and Vocabulary of the Month Parent Handouts.
- I do more in-depth modeling and coaching with the child's preferred toys. If we can, I will try to move the skills into some non-preferred toys to help with generalization of skills. But this sometimes takes a few sessions.
- We also discuss where we can incorporate these skills into their daily routines. I take some time to reiterate how important it will be for the parent to be a part of their child's therapy.
Session 3
- Check in on how things went throughout the last week and troubleshoot any problems with the family.
- I might provide them with a specific routines based handout, if I have one. Otherwise, I will review how to target these skills in their routines.
- Continue will play based therapy - modeling and coaching with the parent. Continue working towards targeting skills in familiar and new activities to help with generalization.
Further sessions will be a mix of 1, 2, and 3 based on how quickly the child is learning new skills and how the family's needs change. When a child has started mastering a skill, I'll often start over with a lot of the session 1 activities I talked about - just with new skills!
I have seen my kids (and parents!) really blossom with this strategy. Parents feel empowered and kids are learning the skills they need to function in their environments. Changing my mindset from providing therapy to coaching the parent has helped tremendously. I'll be honest, I still have some families that have no desire to participate in their child's therapy, no matter how much I try to encourage them. But I still ask the questions, go through the routines, and hope that they might try the skills. Even in these situations, I still try to use what is available within the home so that the child still has access to the toys once I leave.
Occasionally, I'll have a parent ask for some ideas for Christmas or a birthday. In that case, I might bring a toy in to show them how it could be used with their child. Then they can see if their child showed any interest in it. It gives them a chance to see how it might work for their child before investing in it.
And, despite my best efforts, I do sometimes still bring something into the house. But I limit myself to ONE activity. Some things that I just haven't been able to completely leave behind include:
- a few animals (I can use these with other things the kids have. Can we build a barn for them with our blocks? Can they ride on a toy car? Can they hide in a shape sorter?)
- bubbles (I keep one of those tiny little bottles in the pocket of my scrubs, just for emergencies!)
- my spinning laser light (once again - fits in my scrub pocket for emergencies)
- a few cars (once again, can usually be incorporated with toys the child already has)
- playdoh (I keep a few cans in my car so I can run out and get them if needed. It seems like it has been a huge motivator).
- a book (I rotate the book based on the season or skill I am trying to target. I use a book almost every session so that I can model to parents how to meet their child where they are at with book reading. Families can usually access any book I have through their local library if they feel so inclined).
- Don't forget that you can always use movement and songs/fingerplays! No equipment needed!
I hope this gives you some hope for bagless therapy! Try it and see what you think! I hope you are as pleasantly surprised as I was!
Thanks for stopping by!
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