Are you tired of using generic worksheets for homework in speech therapy with adults? Today I am sharing the ONE THING you need to know to easily create a personalized, functional home program for the adults you work with.

Around 5 or 6 years of working as an SLP, I grew tired and bored with a version of worksheet therapy that I had fallen into. It’s not that I didn’t mean well, but I realized that I was hearing complaints about speech therapy being unenjoyable, being too much like “school”, or having nothing to do with a person’s normal life. How could I argue when games like Colorku, Rush Hour, and Taboo were some of our prominent therapy materials? That’s not exactly real life, unless all you do is play games!

So, for the last 6 years I have been reading about and changing my practice to be person-centered. This means that therapy goals, activities, home programs and strategies were all collaboratively decided with the Person based on their unique goals and situations. (The Person= patient/resident/client/receiver of therapy/center of person-centered care). Now I spend more time in therapy listening and understanding what exact skills/situation someone wants to improve. Since brains improve when stimuli is salient, relevant, and meaningful, having a functional home program is actually more fun AND better for the brain!

Here is the ONE THING you need to know to create a personalized, functional home program for adults:

Create home assignments WITH the Person you are working with! 

The Person sitting across from you is the most important part of creating a functional, meaningful goal and therapy assignment. If you collaborate with the Person, the creativity and meaningfulness of assignments will exponentially increase (I speak from experience!). I happily use a portion of my session to review the skills needed for a certain task, and together we decide the “next steps” for practice of a skill or strategy at home. Start with “Do you have any ideas for how you could continue to practice ______ this week?”

Since the goal of speech therapy is to improve real life, a home program is the perfect opportunity to put new skills or strategies into practice in their actual real life. (Toss the Workbooks and Close the Game Closets, because doing well on worksheets or games is not the real goal of therapy!)

Here are some of the fabulous ideas my clients have thought of:

• Make a loaf of bread (Goal for alternating attention)
• Learn to use voice command to send a text message (Goal was for thought organization for multi-step process)
• Pull items out of the cupboard for meals (We were working on sustained attention)
• Create a training manual specific to job (Goal for high-level written expression and organization)
• Write a computer program that made a report from data (Goal for high level problem-solving and memory for returning to work)
• Use a Diabetes picture chart to document blood sugars (Goal was short-term memory)
• Use a TV remote with labels (Goal was thought organization and memory)
• Check email (Goal was procedural memory and following written directions)
• Memorize a new CD song accompaniment (Goal was new learning/memory and strategies)
• Write thank you notes (Goal was using a to-do list to help memory)
• Preach a sermon (Goal was using motor speech strategies)
• Teach self to sort and sum information in Excel (Goal for divided attention and new learning for returning to work)
• Create outline to teach a kid bible study (Goal for verbal expression in discourse)
• Use Picasa to create a photo/video project (Goal for thought organization)
• Set up an automatic bill-pay online (Goal was for improved function with memory strategies)

If you are in a setting with a more medically complex patient, the above tasks may be too advanced. However, don’t give up on using patient-centered activities as a way to encourage cognitive-communication skills! We know from studies that communication is an often overlooked but highly valued skill in hospitalized patients. Functional homework assignments could include:

• Have family write 3 names/phone numbers for the Person to use
• Call 2 family members
• Order a meal by pointing, writing, or calling
• Ask the doctor/nurse a question (this is a great article about the PACT method for how SLPs can assist with a Person communicating with providers)
• Write a card to someone
• Choose what TV station to watch
• “Teach back” medications or PT/OT recommendations

If you need more treatment ideas using person-centered home topics, check out my Home Sweet Home Series  or Back To Work Series.(UPDATE 2020: These have now been replaced by the comprehensive Activity Studio!)

The bottom line is: You are guaranteed to have person-centered, functional therapy ideas if you use the input of the Person you are treating. The ideas can be as unique as the Persons we see! What are some of the great functional and person-centered tasks you have used for home programs in speech therapy?