Therapists and teachers often hear this common phrase from caregivers: “If only my child were like this at home!” It’s no secret our clients often behave differently in the home compared to the therapy environment. Much of this has to do with differences in expectations, the influence of peers, structure, and routine. But this therapeutic environment doesn’t just come together like magic; it takes a lot of work from everyone on that client’s team. But, don’t worry! There are many strategies that therapists use in the clinic that caregivers can implement at home to reflect a more structured therapeutic environment.

Schedules: Setting the Scene for Success 

Children thrive when they understand expectations and are given an environment and structure to succeed. Start by keeping common routines, like getting ready and going to bed, at the same or closely similar times each day. Keep these routines very structured, with the same kinds of things occurring each time. For example, bedtime will always be at 8. So, at 7 we take a bath, then pjs, then brush teeth, then story time, then snuggles with mom and dad, then lights out. Written and visual schedules will further help this process, as children can cross things off and see their progress through the schedule as they go along. This predictability and routine will help things move along smoothly! 

First/Thens and Timers: Knowing What to Expect 

Sometimes a simple shift in the way we say and present things can make all the difference. Transition warnings, timers, and first/thens are excellent and easy tools for home. For example, maybe hair brushing is a non-preferred activity. So, when it’s time for hair brushing, we can say, “First brush hair, then read a book.” Putting a more preferred activity after a non-preferred activity often helps with the motivation to complete that activity. Timers also can be useful. “We will brush hair for 5 minutes, then all done.” The child can watch this timer and understand that this non-preferred activity has an endpoint, which makes them much more likely to complete the activity without protest. Meeting a child where they are and telling them what to expect helps them to trust us; this helps them listen to us when it matters most! 

Star Charts and Token Boards: Motivation Helpers 

Sometimes certain expectations and routines may be especially challenging, and our children may need a little more incentive. Token boards and reward charts can help with this. For example, a token board may look like this: 

The child would choose a reward that they don’t often have access to, like a treat or an iPad video, and “earn” that reward by completing tasks or keeping safe hands/feet/body while completing tasks. Children can also use sticker charts throughout the week and earn rewards at the end for completing certain routines, tasks, and keeping good behavior or good listening. 

Bring It Home: You Can Do This! 

The strategies above can help your child achieve success in the home environment, and it’s important to customize these based on your unique family routines and goals. Our team of multi-disciplinary therapists are here to help, and if you’d like more specific advice based on your child’s individual goals and strengths, please reach out to your child’s therapy team! 

Therapists and teachers often hear this common phrase from parents/caregivers: “If only my child were like this at home!!!” It’s no secret our clients often behave differently in the home vs. therapy environment. Much of this has to do with differences in expectations, the influence of peers, structure, and routine. But this therapeutic environment doesn’t just come together like magic; it takes a lot of work from everyone on that client’s team. But, don’t worry! There are many strategies that therapists implement in the clinic that parents/caregivers can also implement at home to reflect a more structured therapeutic environment (and they are fairly easy to start, too!!).  This blog gives some strategies that can be implemented at home to give your child a more structured environment.

Schedules: setting the scene for success

Children thrive when they understand expectations and are given an environment and structure to succeed. Start by keeping common routines (like getting ready and going to bed) at the same or closely similar times each day. Keep these routines very structured, with the same kinds of things occurring each time. For example, bedtime will always be at 8. So, at 7 we take a bath. Then Pjs, then brush teeth, then storytime, then snuggles with mom and dad, then lights out and our sleepy time alarm clock on (set for the same time each morning). Often, written and visual schedules will help further with this process, as children can cross things off/take things off their schedule as they go along. This predictability and routine will help things move along smoothly!

First/Thens and Timers: knowing what to expect

Sometimes a simple shift in the WAY we say and present things can make all the difference. Transition warnings, timers, and first/thens are excellent and easy tools for home. For example, maybe hair brushing is a non-preferred activity. So, when it’s time for hair brushing we can say, “First brush hair, then read a book.” Putting a more preferred activity after a non-preferred activity often helps with the motivation to complete that activity. Timers also can be useful. “We will brush hair for 5 minutes, then all done.” The child can watch this timer and understand that this non-preferred activity has an endpoint, which makes them much more likely to complete the activity without protest. Meeting a child where they are and telling them what to expect helps them to trust us; this helps them listen to us when it matters most!

Star charts and token boards: motivation helpers

Sometimes certain expectations and routines may be especially challenging, and our children may need a little more incentive. Token boards and reward charts can help with this. For example, a token board may look like this:

The child would choose a reward that they don’t often have access to (like a treat or iPAD video) and “earn” that reward by completing tasks and/or keeping safe hands/feet/body while completing tasks. Children can also use sticker charts throughout the week and earn rewards at the end for completing certain routines, tasks, and/or keeping good behavior/good listening.

Bring it home: You can do this!

Any or all of the above strategies can help your child achieve success in the home environment, just as they help in the therapy environment! Together we can all help your children thrive, no matter with whom or where they are.

Why is a visual schedule important?  

A visual schedule is used to teach new skills and promote independence. Using a visual schedule helps to provide a routine in many situations. Teaching a child to follow a visual schedule is a skill that will benefit him/her in school, at home, and while out in the community. 

Tip #1  

• Use pictures that are simple with no distractors in the background.  

For example, use a simple clip art picture or remove other items in view and take a picture of an item on the table or in a room.

Tip #2  

• Start with a basic “First/Then” schedule. One of the first skills we work on is “first/then”.  

Have the child engage in a less preferred activity in order to gain access a more preferred activity or item. For example, first math, then iPad time. Using a “first/then” visual provides a small visual schedule for the child to know what to expect. 

Tip #3  

• Make it doable and not overwhelming.

Depending on your child’s level of tolerance, it is best to focus on one activity at a time. You can slowly extend the visual schedule to more than one activity over time. However, it’s important to remember not to make the schedule too overwhelming. For some children, seeing their entire day on a visual schedule can be too much to process. In other cases, it’s better to chunk the day into smaller time periods. For example, a visual schedule for morning activities, midday activities, and afternoon activities. 

Tip #4  

• Break up preferred activities with less preferred ones.

 It’s a good idea to scatter more preferred tasks with less preferred tasks. If you know that your child has a few work tasks in a row, put a more preferred activity into the schedule to break it up. For example, first math, Simon says, spelling, then iPad.  

Tip #5 

• Reinforce independence.

Always reinforce independence (“Great job! Awesome work!”) whenever a schedule is completed independently. For example, when completing chores, independent work activities, or activity schedules. If a child needs support or prompting, you should start out with a model, gestural prompt, partial physical, or partial verbal before providing full verbal or full physical prompting.

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