Laura Deer, M.S. CCC/SLP, CAS
To bring toys or not to bring toys….that is the question! Speech language pathologists and other professionals who work in the natural environments with the birth to three populations are often faced with this debate. Many states require that early intervention services are provided in the natural environment and some states require that the therapists go bagless. Meaning – the therapist only uses materials within the natural environment.
So you might be asking yourself, “Why is this a REQUIREMENT for some states?” I’ve worked in two states with different requirements. I went to grad-school in Florida where treatment was required to be in the natural environment. At that time we were not required to be bagless, however, I don’t remember bringing materials into the home. Most of our therapy was routine-based. Now I am working in California where we do not have any restrictions on therapies with the early intervention population. I worked with the early intervention population in a clinic setting and in the home environment with toys. From my experience and education, I can see why some states require a bagless approach in the natural environments.
Here is a list of the positive things I’ve observed by using a natural environment/bagless approach (this list is not specifically driven by research – information is based upon my education, experience and observations):
Little children are more apt to communicate when they know the routine – I learned this when I was in graduate school at FSU and it is totally true! When a routine is new to a little one they are so absorbed by the new stimulus. They are learning what to expect next and can’t process anything extra. At this point, their nervous systems are in a higher state of arousal as they anticipate something new. For example: When a baby is experiencing their first few baths they are just living in the moment. When you say “splash” they aren’t thinking about the word connected to the action. They are experiencing the water on their face. Once bath-time becomes a routine, the little one knows what to expect. They already know what the water feels like on their face and know what will happen next. When the routine sets in the nervous system calms and the brain is more receptive to learning language.
I have also seen this to be true when little ones go into a new environment. I worked with 0-3 kiddos in individual and group sessions in a clinic environment. Parents frequently reported their child would say and do more things at home but they didn’t see the same in the clinic setting. When the children were in the clinic they were still so absorbed by the new toys and were distracted by other children.
Parents learn how to use therapy strategies during naturally occurring routines and with the toys they already have – I always say that the parents are the child’s primary teacher. My goal is for parents to feel comfortable using communication strategies with their children on a daily basis without thinking about it. It is easiest to do this with activities and materials they already have. Parents can learn how to adjust routines they are already doing in a slight way to help facilitate communication development. And when therapy is over, all of the materials are still in the home to use! When a clinician brings in toys, it is easy to see how to use the strategies with those toys but generalizing those skills to different activities can be hard in the beginning.
Cost effective– When a family sees a child obtaining success with an activity they often want to do what they can to carry that over. Many families often feel pressure to buy the toys and materials that the clinician has because they don’t know how to use the same strategies with their own toys or they see their child likes something and they want to go out and buy it. It doesn’t matter if the family is from a high or low income family – having pressure to buy more toys is never a good thing. It can also be extremely expensive when the toys are older and are not made anymore. People on Ebay increase the prices since they are not available anymore. I saw one family purchase a toy for $50 that should have only been $15!
More focus on environmental arrangements – When a therapist uses their own materials they aren’t going through what you have. It can be very beneficial for a therapist to help you go through your toys and provide suggestions. I have helped families organize their toys to increase communication opportunities and accessibility. It is also a good language learning activity to sort out toys together. If the child seems bored with toys, then the therapist and family can decide together which toys to rotate out to make things more exciting. A good therapist can really help you get the most out of what you already have.
Families more inclined to join in – Sometimes when a therapist comes in with their “bag of tricks” the family doesn’t feel comfortable joining in. They want their child to get the most out of therapy and don’t want to disrupt the therapist in any way. When the families use their own activities and materials then it encourages the family to be involved to bring out toys or materials to join in using together.
The child is more focused – When I worked with one company doing in-home visits where it was expected that I bring toys into the homes. The families were already used to this approach so when I tried to go bagless, they were reluctant to change. I noticed when I brought toys into the home that the child’s attention span was reduced. The children knew I had a bag full of toys and they wanted to go through all of the toys so they don’t miss out. They often wanted to rush through activities and didn’t really enjoy what they were doing. We were often left with time at the end of the session where the child wanted more toys and I wasn’t able to provide. At this point, it was harder to find something for them to focus on.
Less tears! – Children were upset if I didn’t bring the toy they wanted or they were upset when I had to take my toy home. I hated to see children cry because I had to take away a toy they were having fun with.
So you might be asking yourself, If bagless is so great, why doesn’t everyone do it? Some therapists are very structured and have a harder time just “going with the flow.” It can be harder for the therapist to go bagless because they don’t always know what they are walking into. They really need a good solid understanding of your child’s goals to be able to implement them during any activity. They also don’t have as much control over the session, which can be hard for a therapist. It is also reinforcing for the therapist when a child is more engaged and motivated with a new toy.
I use a mostly bagless approach with the early intervention population. I occasionally bring in toys or books from time to time. I usually only do this when the family expresses they were thinking of buying new toys/books and wanted to know some suggestions of what to get. Then they could try out some different toy ideas. They could also see the type of books I like to select for my clients.
I always take feedback from the family and like to work together as a team. I am open to talking about different therapy approaches with all of my clients. If bagless isn’t the best thing for you and your child then I’m open to exploring other options. It seems most families prefer bagless once they understand all of the benefits!
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