Supporting Home Practice

Successful and effective Speech Pathology always relies on consistent carryover at home, right...? But so many of us have had clients who don't do their home practice, and it can sometimes have a very obvious impact on progress (or lack thereof).

What I do when this happens (or preferably, BEFORE it happens) is sit down with my clients and/or their caregivers to work out when, where and what they can practice within their daily routines. This last part is crucial to building up any habit or practice, whether it's speech therapy or drinking more water during the day.

I use a simple grid like the one below. We look at the client's therapy goals (preferably a maximum of two) and plot them out on the lefthand side. Then we fill out two boxes across the grid for times/activities during their existing daily routine in which they can practice that goal/therapy support. Repeat this process for the second goal.

In the example below, I'm illustrating with some language boosting strategies for a young child such as a preschooler who is presenting with emerging language skills and requires models to extend their language further.

Example of the Home Practice Grid

And voila! The client/caregiver now has 4 different opportunities across their day in which to practice the target skill. Even if they only do 1 or 2 of these in a day, that's amazing!

Of course, you might need to come back and 'tweak' the grid in the next session -- that's perfectly reasonable! Breakfast might have seemed like the ideal time to practice 'Special Talking' for a stuttering client doing the RESTART-DCM approach, but actually it's way too chaotic and the 'Demands' are too high for the child's 'Capacities' in that part of their daily routine.

And naturally, you do a new grid when the client's goals change!

I found this approach so practical, functional and kind. Especially for families who are attending multiple therapy appointments a week, or have multiple children. The last thing we want to do is create caregiver guilt around "not doing enough" for their child! This is a great way to collaborate with carers to identify times of day they can practise their therapy goals... without it becoming overwhelming. For older clients, this is a great way to give them ownership over their own therapy goals and progress. It also stops us from creating a sense of guilt within the individual.

I learnt this wonderful method from a keynote address given by a physiotherapist many, MANY years ago at a Disability SPOT (then known as SPOT on DD) conference I attended -- one of the first conferences I ever attended as a practising Speech Pathologist!