Addressing the Issues: "Bag-Free" Therapy
Over the last week, I have written two posts addressing some recent changes and challenges I have been facing in my speech therapy position. As a result, many readers have shared their thoughts, comments and own work experiences in early intervention. This immediate and supportive feedback from the readers has been both encouraging and inspiring, sparking new topics of interest!
One reader brought up the practice of "bag free" therapy. This is a hot topic in our area right now as well and it goes hand-in-hand with "routine-based" therapy. The philosophy is that if we bring bags of toys into the therapy session then we are creating the activity and not really seeing the child in their natural environment.
The way I have been addressing this is by attempting to find the BALANCE between both models. With the "bag free" model there is often less pre-therapy planning involved. It also tends to naturally encourage the input of the parent. They know you are walking into their home and will treat the communication issues on an "as is" basis regardless of what activities the child may be engaged in. For these reasons, I believe "bag free" therapy is often an appropriate and necessary option.
I feel that if this is ALWAYS the therapy model I am using; however then there may be times I am not addressing all the needs of the child. For example, there are times when I want to incorporate a new oral motor tool, so I will bring it along with me. Or, maybe the family does not have many toys for the child to play with for whatever reason and language and play skills are a significant need for this child.
Regarding articulation, I also have my "bag of tricks" that I use complete with a mirror, microphone, tape recorder and picture/sound cards that I use to help practice isolated sounds. With many of my "speech only" kiddos with significant articulation issues, I use a speech book, which is always left with the family. They are instructed to add pictures and practice the activities daily. In addition; however I often bring paper and glue activities for the child to complete to add to the book. These activities help them gain the confidence and practice they need to improve their ability to make sounds and be understood by their family members. I feel it is unrealistic to ask every family to have all the different tools that I know can help stimulate speech and language.
If I know I have an activity or toy that will help a child learn and develop a specific skill, I include it in my session. The big picture idea behind this is that the parent will see what the child is capable of and will then attempt to replicate this during their own time with the child. I've given them a reference point. For some parents, they are unsure of how to play with their child and may not know what type of toys to use/buy for speech and language stimulation. By demonstrating what works, I feel I am able to be more effective as a therapist.
I see the advantages and disadvantages of both models and as I stated earlier, I try to use both as I deem appropriate. "Bag free" therapy is a newer concept for me so I would love to hear how other therapists use it and see the benefits in their early intervention speech therapy.