Monday, November 28, 2011

Toy Bags Again

Banishing toy bags from home visits is both symbolic and meaningful. I have written about this issue before: Here's a summary:

Working from a toy bag implies that the home visitor’s interaction with the child for 1 hour a week is intervention.
The hour is better spent working with the parents, because adults can benefit from 1-hour, weekly sessions.
The toy bag implies that what the family has is inadequate.
The home visit should be, in part, about reassuring families’ of their competence.
If the toys are so important, why are they removed at the end of the visit?
The home visit should prepare the family to intervene during all the many hours between home visits.
Toy bag ladies (and gentlemen) spend 80% of the home visit on something that consumes 5-15% of a child’s time: adult-child-toy play.
Home visits should provide consultation to families on interventions that can happen in all naturally occurring routines.
Toy bag play tends to be adult-directed.
Intervention is most effective when it follows a child’ interest.


Abby Brayton said...

Thank you for sharing this! This is a great reminder for why we shouldn't be bringing toys into the home with us when working in early intervention. Do you encounter families that expect you to bring toys and are upset if you don't? How do you handle this?

Maureen said...

I am interested in Abby's question! As a family member I opposed toybags for all of the reasons outlined in Robin's post. I often found myself trying to engage my child's therapists to answer my questions about tibial torsion, or how I could get my child to use his pediatric walker when it was too cumbersome in the house. Now as a parent involved in policy discussions I often hear that family's expect the toy bag and are mad/upset when therapists don't bring them. I am surprised, and wonder why families expect that therapy sessions will only be about playing with toys.

Mary said...

Amen to this! @ Maureen- I have often had to "wean" families off of the toy bag expectation. I use this as an opportunity to talk about meaningful learning opportunities (their daily routines) and help them to support their child with those- teasing out what may be missing in the parent/child interaction, asking questions about "What they notice when..." and, among many other things, adapting an interaction, (or how a toy or other household material may be utilized) to make growth toward outcomes. I have never had a family (after two or three "weaning sessions") ask for the toy bag- they usually are too delighted in the increased competence, engagement and/or participation on the part of the child and an increase in their confidence in supporting their child.

Abby said...

Mary, thanks for describing how you "wean" families off of the toy bag. That was very helpful. Maureen, I feel that the toy bag issue is something that needs to be addressed at a policy level. In the area where I work, families often have multiple therapists coming into their home, and often the therapists are from different companies. I think individual therapists can make a difference by showing families that the toy bag is not necessary, but many therapists and companies are still relying on the toy bag. I think it would be more effective to do company-wide or regional trainings on how to do therapy without a toy bag and what that therapy would look like. Would love to hear other ideas about the topic of toy bags.

Robin McWilliam said...

Where do parents get the idea that a toy bag is useful or to be expected? From professionals somewhere. Most people don't know what to expect from early intervention home visits, so, if they're expecting anything at all, they must have learned it somewhere. Be careful of professionals who start off using toy bags and then say families expect them!

The policy issue is an important one. It would be a simple policy, involving no expenditures (actually, a decrease in expenses for the toys). In my experience, the no-toy bag mandate is made, when at all, at the program level. Even then, some administrators are afraid--"What if a toy bag is really needed for a family?" Patiently, we explain, no toys-in-toys-out are even necessary. We can lend toys, but that's different. I can't see a downside to a no-toy-bag policy. I have one with my program.