Going bag-free

20 Mar

I’ve sensed something. I can feel it coming. On the horizon it looms.

Going bag-free.

I was speaking with another SLP at the PALSS conference this week who said being “bagless” in early intervention has been “a thing” for “a long time.” You hear this sort of thing often – core vocabulary was identified in the 80s and 90s, NSOMEs were noted as an issue in the 80s, etc etc – but no one listened until 2008 or whenever. “Oh that’s nothing new! We’ve known about that forever!” What is with that? Is it that with social media we’re connected now and we can make sure everyone is on the same page? Or were we too bull-headed in 1986 to listen the first time?

I’ve seen talk about going into the home for early intervention and bringing nothing with you but the shirt on your back on Facebook for about a year now. But APPARENTLY it’s been best practice for awhile. WHY DIDN’T I KNOW HOW COME YOU DIDN’T TELL ME UNTIL NOW? We have really got to work on being accountable to ourselves and each other for best practice. Don’t hand me an article from 2003 about natural environments and routines and the negative effect of bringing toys into the home and say “tsk tsk” and slap my wrists in 2015. Tell me about it in 2003. I’ve only had my bag for 2 years! This whole thing could have been avoided if I didn’t have my damn bag in the first place.

OKAY. Now that I’ve got that out of my system. Going bag-free. Nothing has been written in stone for my clinic yet about getting rid of the toy bag, but I’ve been preparing. As I said, I’ve seen a lot of talk on social media, and I know in southern DE the therapists haven’t been bringing their toy bag for maybe 9 months now. So I know it is headed my way. I’ve been transitioning my bag out of the houses I usually go to by only bringing a few toys, or only bringing books or puzzles, and letting families now that we’ll be playing with their toys soon. Any new houses I’m going into I’m not bringing my bag in the first place. I’ve taken most of the toys out of my car (so now I look like a real freak with an apartment full of toys and no children.)

And honestly, it isn’t a big deal most of the time. A majority of the children I see are lucky and privileged enough to have toys and books in their homes. So it isn’t changing anything except for the clamoring to get into my bag. Really it is kind of nice – I feel a lot less like Santa.

But what about those homes that there isn’t much by way of toys? I’ve thought a lot about this too. And again I don’t see the problem – we’ll use routines, we’ll use the great outdoors, we can make toys, we can make fun. I can say to a family “What would you normally be doing right now – and how can I be a part of it?” As my CF supervisor always told me, “Be the toy” and as Lindsey Cargill at the PALSS conference said, “Be the fun.” I can do that. We can sing. We can listen to the radio. We can dance. We can meet at the library. I can give away my toys to less fortunate families. I can give away my books.

And the research makes sense. How crappy am I making families feel by bringing a bag of toys? Am I not saying, “Your stuff. that your child has access to the 167 hours a week that I’m not here, isn’t good enough?” Am I not saying, “Therapy only happens when I’m here with my bag-o-fun?

HOWEVER, I do have one question for you SLPs who have gone bag-free (sounds a bit like going green, no?):

How are you addressing really specific goals that you’ve gleaned off the PLS that require pictures? Such as “identifies actions in images,” “identifies line drawings,” “identifies photos,” “identifies object function.”

Are you still bringing a book or puzzle now and then? Are you digging through the mail or the newspapers that families have to use their natural environment? Are you drawing pictures with crayons and markers? Using apps on Mom’s phone? Talking about what we see on TV? Talking about family photos on the walls? Drawing with chalk on the sidewalk? Yes to all of the above? Are you even writing these goals anymore, or are you writing goals based on the routines of the family?

I’m ready for a new challenge and I see this as a chance to improve my coaching skills and become more comfortable with getting involved with routines-based therapy. I’m interested to hear your point of view and get some fresh ideas!

NP: Conor Maynard

PS: If you want to look at the routines based research it is Robin McWilliams starting circa 2003 and he has a ton of great stuff out there on the world wide web

PPS: Does anyone have a link to a good video of typical 2 year old language? One where Mom or therapist isn’t asking 60 bajillion questions? Just a 2 year old talking.

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