Preparing for Home Practice
How do I know what to do for home therapy?
Your therapy team will provide suggestions for movements to work on. You can write notes to share with your therapy team. Note any questions, challenges, or successes you experienced while practicing at home.
Where should we do therapy?
A space that is quiet and calm is best. Remove anything that distracts you or your child. Turn off the TV or radio and keep your phone on silent. You and your child need to able to really focus on moving his/her assisting hand and arm.
When should I do therapy?
Your therapy team will help you identify times in your routine that may be easier to practice. Pick times when your child is alert (not sleepy). Practice can happen during play time, mealtime, and/or bath time. Before you start, make sure you have at least 10 minutes of time where you can fully focus on your child.
What activities will we do?
The activities you do will depend on your child’s interests, age, and skill level. Your therapy team can provide activity suggestions specific to your child. Activities are meant to be easy to do, so you don’t need a lot (or any) set-up or clean-up time. Activities will be simple things that you may already know how to do. This will make it easier to teach your child.
Activities may engage your child’s senses. Often the focus is on senses of touch, sight, and sound. These senses inform movement. For example, if an object looks squishy, you pick it up more gently. Using information from the senses, or “sensory processing”, can be more challenging for children with cerebral palsy. Children need practice using their senses to learn how adjust movements for a variety of objects. Sensory play may include things like water play, handling textured balls, or poking play doh.
Child & Caregiver Positioning
How do I position my child for therapy?
It is important to place your child in a stable position. You want your child to feel secure when moving his/her assisting hand and arm. This means being in a position where your child does not have to work head control or sitting/standing balance. Suggested positions are listed below, but you can also discuss options specific to your child with your therapy team.
- Children with limited head or trunk control:
- Lying on the floor
- Side lying with the assisting arm on top
- Rolled towels, customized pool noodles, or small pillows can used if needed to create an ideal position
- Children developing head and trunk control:
- Car seat
- Bouncer seat, positioned so that it doesn’t bounce
- Children with good head control and/or good or developing trunk control:
- Floor seater with tray
- Children with good head and trunk control:
- Sitting on the floor
- In a chair that provides an upright and stable seating position
- Rolled towels, customized pool noodles, or small pillows can used if needed to create an ideal position. Ask your therapy team for suggestions.
- Highchair with tray
How do I position myself for therapy?
You want to be in a position where you can make eye contact with your child. This will help you observe your child’s reactions. You also want to be in a comfortable position to present different toys to your child.
Toys and Objects
What toys or objects do I need?
You don’t need any special toys or objects. You do not need to buy anything. Items in your house are often great objects for therapy, like wooden spoons. Any object or toy that your child is interested in is a great object.
Your therapy team will help you identify things that are appropriate for your child. You may want to collect a bin of these things to keep handy for practice times. Reserving selected toys for therapy sessions (and not free play) is one way to maintain engagement as toys remain novel. As your child grows and learns new movements, toy preferences will change. Always select safe toys that are not choking hazards for your child.
Your therapy team will suggest toys based on your child’s current skills. Below is a list of some toys, objects, and food to give you an idea of things that might be used:
Toys
- Blocks
- Bubbles
- Duplo pieces
- Toy people, animals, food
- Balloons, balls
- Stickers
- Pompoms
- Sensory balls (noise, textures)
- Shakers, rattle
- Push and go toys
- Chunky/knob puzzles
- Drum/ drum sticks
- Light wands/finger lights
- Paper and highlighters, markers, and/or crayons
- Toy xylophone or piano
- Play dough
- Story board/bath books
Finger food
- Shredded cheese or cheese strings
- Small cereal (e.g., puffs, O cereal)
- Fruit (e.g., banana, blueberries)
- Vegetables (cut to shape and size to elicit desired movement)
- Peas, corn, cooked pasta
- Teething biscuits/ crackers
- Fruit puree or yogurt pouch
Household objects
- Foil paper
- Tissues in tissue box
- Bin of dry rice
- Foam soap
- Ice cube tray/egg carton
- Squirt bottle
- Cardboard tubes (e.g. from toilet paper)
- Empty food containers
- Plastic cups
- Straws
- Bag clips
- Toothbrush
- Spoon/scoop/spatula/chopsticks
- Brush/comb
- Body lotion
- Tape
- Pots and pans
- Necklaces, hats, scarves
- Laundry basket
- Sponges
- Wash cloth/ cleaning rag
- Paint brush
- Coasters
- Photo album
- Piping bag (can make own with a plastic bag and bag clip)
What type of constraint should I use?
During constraint-induced movement therapy (CIMT) practice, a neoprene mitt is often the first option to 'hide away' your child's hand. If your child’s skin becomes irritated by the mitt, your therapy team can suggest other methods of constraining their hand. Ideas include:
- Large mitt or sock
- Clipping the end of a sleeve, using a bag clip
- Wrapping the arm against the torso with a scarf
- Caregiver gently holds down preferred hand (for young children)
Your therapist will provide instructions for how long to wear the constraint each day. Time wearing a constraint on the preferred arm and purposefully practicing movements counts as CIMT practice. The constraint should not be worn outside of the prescribed CIMT time.
