Using Toys in the Home vs. Bringing My Own

     When I first started doing home based speech therapy for children birth-age 5,  I always brought my  own bag of toys and "therapy materials" into the homes with me.  My large L.L.Bean Tote made a great bag to hold books, puzzles, farm sets, preschool toys and games. I brought things that I could use to encourage speech and language production.  The children loved seeing my bag and they couldn't wait to see what was in it each week.  They often had favorites and I made sure to bring those each time.  I was sure to search for toys that could be used to teach concepts and vocabulary. I found toys and books with current TV characters and  things that looked fun to even the parents. For the longest time, I thought this was the best way to run my therapy sessions.  What could be better?  I had the knowledge, the techniques to model and the best toys to do it with.
     The first time a child cried because I had to take the toy away with me I started to question this method.  I started to let kids borrow toys until the next time I came, in order to prevent meltdowns.  Parents started to go out and buy the same toys that were in my bag so their child didn't have to be sad when I would leave.  I also started thinking about how I was demonstrating great techniques with the toys I brought, but I could not be sure that the parents could take what they saw and generalize that to the toys and things they had available in their home already.  A new theory started spreading among therapists that connected with the natural language environment concept.  Since we would be providing therapy in the child's natural environment, we should also use only what is in that environment to do our sessions.  There is no better way to be sure the parents are able to carry over what I do in the sessions to their child's everyday life.
     It was around this time that I attended a workshop that asked the question "How comfortable would you be if you had to leave your bag behind?"  The workshop talked about using things in the child's home, even if they had no toys.  The idea of a child having no toys is not surprising to me.  I have been in many homes that had only a few infant toys for toddlers.  We were given grocery bags full of random household items and asked if we could plan a session around these items.  We were all more creative than we thought and we were able to work on just as many concepts with these everyday items as we were with our bag of the best toys. I was in complete agreement with this theory.
     Now the questions started popping into my head.  How could I now do this with families that were already used to me bringing my bag?  What will a parent think of a therapist who brings nothing to work with?  How open will a parent be with having me use their things?   I didn't think I could quit bringing my bag "cold turkey."  I would probably have to wean myself and my families slowly.  I wondered if I would be able to do this with 100% commitment.
     I was able to start this method with one family I started seeing the very next week.  This was easy to do because during the first session I explained the theory to the mom and she thought it was very logical.  The second benefit in this particular case was that I was not bringing in any toys that other children had played with and may contain germs.  This particular child had a compromised immune system due to chemotherapy.  So, I was on my way to trying this method in a very willing family.  This family also had more toys than any family I had ever worked with, so I was not being tested on my creativity too much yet.  This was going very well.
     My next challenge was to sell this idea to families and children that were used to my bag full of toys.  I started slowly with families that I knew would be willing.  I surprised them with the method one day by telling them that I had left my bag of toys home accidentally. I took the opportunity to explain the theory and they generally said that it was not a problem and we used toys and books that were in the home.  This also had a bonus benefit of the fact that I was no longer tied down to providing therapy in one little spot in the house.  We went to the child's room, a play room, outside etc. This made it easy to talk more about actions and different vocabulary.
     The hardest situations were in the families that had few toys and lived in homes that did not provide much in the way of space or opportunity to do a variety of activities. I used the shopping bag method I learned at the workshop.  A asked that each time I arrived, they would have chosen at least 10 items from around the house and placed them in a bag for us to use during the therapy session.  I was surprised at how this also encouraged the parents to think about finding things that could teach concepts. In these homes, we sat at the table and used all of the things in the bag. Some of these sessions turned out to be the most educational for parents.  They used creativity and realized that even if they could not afford the newest and best toys, they could still help their child with what they did have and with what they could do. 
     Today, I admit that I do use a combination of these methods.  In some situations, when I am confident that the parents understand the techniques I use, I will occasionally bring items that may introduce concepts that I could not do with their items.  I also bring things as examples for parents when they have asked what things they should try to get for their child.  I sometimes bring things to assess how a child is doing in an area and to see where we should focus next.  I think the best method is to use what is in the home, but there is still a place for us to bring in things that make therapy most beneficial to the child.