How does a therapist incorporate activity-based intervention into their practice?
Toby: Actually, the therapist needs to think of it in the opposite way: How can they incorporate their practice into this approach?
This requires creativity. We want to promote trunk and postural control. Where does the child need it? Where does the family want the child to demonstrate this? How can I provide ideas or strategies that promote trunk control when and where trunk control is needed?
This requires that early intervention therapists have in-depth conversations with the family about what they do, when they do it, why they do it, and how important it is, in order to prioritize. The therapist’s role is coaching, teaching, supporting the family, and in this way providing loads of opportunities for practice.
This approach is very different from the traditional development approach and it demands more of a therapist. It requires a team approach and thoughtful conversations.
Sometimes therapists say ”Well, if I’m not doing something, putting my hands on the child, I’m not doing therapy.” There actually isn’t much evidence to show that bringing your child with a significant disability to the therapist once or twice a week for half an hour is going to do very much. But we do know that kids learn when given practice. And you need that practice in a variety of opportunities in order to generalize skills.
Certainly there are children who will learn the developmental motor milestones in the traditional sequence—maybe children born prematurely or those with mild developmental delays—children who are not going to have a significant disability. Providing them with opportunities where they are taught to do the various milestones may be appropriate. However, many times early intervention therapists see children with a known disability such as cerebral palsy, and this child will not follow a traditional developmental sequence or program. Using that as your basis to formulate goals or objectives is probably going to make accomplishing the goals very difficult for the child and may be very frustrating for you as the therapist.
But with a collaborative, activity-focused early intervention approach, you’re using all the knowledge of a professional in order to solve the problem. We want to see children participate in whatever activity they want to, or are expected to. Our role is to help them get there.
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