Developing a Functional Home Program for Adult Speech Therapy: 3 Simple Steps

For a home program to be worth you and your patient’s time, it should be interesting, motivating, and practiced regularly. The principles of neuroplasticity tell us that while practicing a challenging action is important, it’s even more important that the practiced action be relevant and meaningful. Further, language and cognition research tells us that people perform better when their assigned practice features personally relevant vocabulary or fits within the context of their real lives.^{1, 2}

Speech therapy home programs often incorporate photocopies, word scrambles, deduction puzzles, and other tasks that aren’t usually a part of someone’s everyday life. How can we break away from our traditional habit of handing our patients a stack of worksheets, puzzles, or card games each week and make the switch to a functional home program instead?

These three simple steps can help get you started.

1. Know the Purpose

Our goal in speech therapy is to improve our patients’ real-life functioning, so the home program is the perfect opportunity to see if your efforts in therapy make a difference. Are you trying to improve a skill, teach a strategy—or something else entirely?

Assign tasks that can be practiced within a real-life context. For example, if you spend your time in therapy creating a memory aid that features family names and pictures, use the home program to see how the memory aid is working in different contexts.

2. Measure How It’s Going

Just telling your patient to practice isn’t enough. You need information that lets you know if the home program (and the time spent in speech therapy) is successful in your patient’s real life.

A functional home program includes a way to track the purpose. Continuing the example above of the memory aid featuring family members, you can personalize what you track, such as:

• • How often your patient is using the memory aid without cues
  • How quickly they can access a grandchild’s name with the memory aid
  • How many reminders are needed to use the aid in conversation both at home and out in the community

3. Review the Home Program and Let It Inform Your Therapy Session

At the start of each session, review the home program with your patient and then use your findings to determine the most effective use of your therapy time. Are the strategies working or should you practice a different strategy? Maybe the strategy has been working well in one environment and you can now progress to a more complex environment. Could the strategy be used to meet a different functional need?

Remember: The most important part of a functional home program is the person for whom it’s intended. Your patient has the best input and insight into what is important to them and what might help them get back to what matters. I often find myself asking my patients questions like, “Do you have any ideas for how you could practice your strategy this week?”

Want more tips on how to personalize your therapy sessions? Watch the recording of my MedBridge webinar, “Close the Game Closet: Evidence and Tools for a Person-Centered Approach for Treatment of Adult Neurogenic Disorders.”

Breaking away from traditional worksheet-style home programs and incorporating a more person-centered approach allows us to meet real needs efficiently, improves patient satisfaction, and keeps patients better motivated—all of which lead to better outcomes.³