Occupational therapy, due to its very nature, is a flexible discipline that can work in just about any setting. Examples include outpatient clinics, skilled nursing facilities, inpatient hospital units, transitional care units, school districts, community clinics, and home health companies to name a few. Treatment is tailored to fit the needs for anyone across the age span, from neonatal care to hospice. Out of all of the possible clinical combinations, pediatric home health OT has a unique format filled with a variety of approaches for children:

1. Therapy occurs at home: The OT physically shows up to conduct treatment in the child’s own home. This allows for the child to comfortably participate in an environment that is familiar, which eliminates the stressors that come with working in a sterile and intimidating clinic. The OT has an advantage because he or she can create treatment based off of the child’s interests, which is incredibly easy to observe in a safe, home environment.
2. The child is the focal point of treatment: Although adults including parents, caregivers, or additional family members will be heavily communicating with the therapist, it is the child who steals the stage for therapy. Working with a young client is rewarding, but it can be tricky for children to communicate their needs and goals to a stranger. Therapy looks a lot more like a play group rather than treatment. Additionally, children may not see the barriers (physical, cognitive, behavioral) keeping them from succeeding in meaningful tasks.
3. Scheduled appointments are different: There are some settings in which an OT will see a patient 7 times a week, and for other settings maybe just twice a week. In the case of home health care for children, there are some organizations (i.e., early intervention) that will only allow for two or three appointments per month. This means that OT has time to cram in tons of clients per month, but at the expense of not getting to know the child very well.
4. Caregiver input is essential for success: In order for children to meet their goals in therapy, parents, guardians, foster parents, or other relevant caregivers need to take the reins. Being proactively involved in your child’s therapy sessions is essential, especially if home health therapists only show up a couple of times a month.

The following are some tips that parents/caregivers should consider if they need assistance in participating in their child’s OT treatment (or really any other rehabilitation treatment for that matter):

1. Be present: Be awake and at the house at the time of each appointment. Make sure your child is ready for treatment. This doesn’t necessary mean that your kiddo needs to be spit-shined and properly dressed; however, it does mean that the child is away from other distractions in order to focus on therapy (i.e., meal-time, naps, bath-time, etc.).Remember that the therapist is not hired to be a babysitter. In fact, most therapists will expect parents to stay in the room where the child’s sessions will take place. Put your phone away so that you can actively engage in the sessions as well.
2. Create a productive working environment: Being a parent of young children usually equates to a messy household, so please don’t think that therapists expect to arrive at the home while it is in pristine condition. Instead, concentrate on eliminating distractions that you know your child will try to go after during therapy. Examples include electronics, toys (other than ones used in therapy), blaring music or televisions, snacks, etc.
3. Involve siblings if necessary: Consult with the therapist about whether or not it is a good idea to have siblings present during sessions because you may be surprised by their answer. Depending on the goals, therapists might want siblings around as playmates for the child in order to carry out treatment (i.e., sharing toys in order to get the child to crawl, stand, or walk).
4. Communicate treatment ideas to others: Realize that although treatment occurs at home, what the child learns from therapy will translate to other environments including school, community centers, friends’ houses, etc. If the child’s treatment creates changes that could impact other settings (i.e., coping skills, transition techniques, schedule changes, etc.), it is important for parents to communicate those changes with teachers, aides, and other parents or adults in which the child has frequent contact with.
5. Actively carry out treatment outside of therapy sessions: When you sign on for home health, be ready to take on some changes to your own day-to-day schedule. If the child only completes therapy requirements during the few days per month in which he or she is seen by the OT, no long-lasting changes will occur. Parents or caregivers will be expected to carry out intervention as instructed by therapy in order for the child to positively benefit from services.