Home Programs with Lots of Choices Do NOT Increase Compliance!

OT Home programs with lots of choices do not increase compliance

A big mistake I see many pediatric occupational therapists who work with children make is taking a lot of time developing a home program with a lot of activities.

And I get it.  Everyone tells you that people love choices! It’s easy to fall into that trap.

Does every OT who provides their families home programs with lots of choices get full compliance?  No!

I remember providing a whole page of sensory activities for families or teachers to pick from. Or even worse we would run packets of activities to use at home over the summer in the schools.

It would make sense that people want choices, but I feel that is contraindicated. With so many choices, many times, the families will not complete ANY of the activities! This is called choice overload or over-choice.

So how do you get families to follow through and actually DO the home programs? You actually give them LESS.

What is an Occupational Therapy Home Program?

Some therapists call these Home Activities, or a Home Exercise Plan or HEP (I really do not like that one as to me leave the ‘”exercise” plans to the physical therapists!). These are activities that occupational therapists give their clients to complete on their own after a session


Many of these programs consist of lists of activities. With photos and detailed directions. I think of the exercise programs my son would leave PT with when he had a sports injury. Or the pages of information on how to facilitate speech when he was in early intervention.

Why Do Occupational Therapists Give Home Programs?

Let's seriously consider the GOAL of our home programs.

We are looking for:

  • Carry-over
  • Family Empowerment
  • Incorporating activities into daily routines

But what happens when a family is already overwhelmed?

Why Do Families Not Complete the Activities?

#1 reason is they do not have the time. They are overwhelmed. And in many cases, they have so much on their plates already having a special needs child who requires more of their time. More help with daily activities, more doctor's appointments, and therapy sessions.

How do you Get Families to Follow Through and Actually DO the Home Programs?  

You give them LESS!  Give families ONE activity to try after each session.  Something you have TRIED during the session, so you know it works!  Something that is EASY to fit into their daily routine.

Home Programs should have:

✅ ONE activity
✅ An Activity you have tried 
✅ An Activity the child LIKES.
✅ A EASY activity.
✅ An Activity that takes NO special materials!
✅ Suggestions on WHEN to complete the activity.  First thing in the morning?  While brushing teeth? At bedtime?

How I Developed this One Activity Home Program Method

I got into this habit when I worked in early intervention. We were required to write a home activity in our notes for the family. I saw so much better compliance.

But even before that. One of the very first children I worked with was a child with Down Syndrome named VJ. VJ was really hard to engage. One day I had a really good session with VJ. We did a flashlight activity where we “chased” each others' flashlights around a dark room, then he found certain pictures on the wall, then he found letters on the wall. He loved it. I suggested this very simple activity to his mother. and I remember her face lighting up at the simplicity of the activity. And I also remember her reporting back that they started practicing his letter recognition at night this way before bed.

Home Activities in Early Intervention

This one-activity home program also works great in early intervention when you are working activities into daily routines. I like to have my families do joint compressions for proprioceptive input and calming at bedtime. Or to provide oral input before toothbrushing. I also like to have families work on pincer grasp by putting small pieces of food in ice cube trays at snack time. 

Thinking this way you will not overwhelm families with even more to put on their already very full plates. 

So let me ask you: Do you really want to keep spending so much time developing home programs that overwhelm families and that they do not complete?  

Or do you want to provide home programs your families enjoy, complete, and see more progress in your clients?

What is your favorite pediatric occupational therapy home program activity?

Related Articles

OT Daily Notes Do NOT Need to be Long to be COMPLETE

7 Strategies to Combat Therapist Burnout

How to Write Functional Pediatric Occupational Therapy Goals

Advice for New Occupational Therapists

Do you need help writing SOAP notes?

Not sure what you should be in your daily SOAP notes?  Want an easy, reproducible format to use for your notes?  Check out the template!
Designed for students, fieldwork students, and new therapists. 

Fast, easy complete pediatric OT daily soap note template

Similar Posts