While working in an outpatient rehab center, many of the parents expressed one concern. It was something along of the lines of, “My child does great with you here, but I can’t get him to do the same at home.” As an occupational therapist (OT), I understand very well the difference the environment makes in someone’s functional ability. 

Now, let’s compare the home environment and the clinic environment. 

• Scenario 1: The child walks into the therapy room where there’s a table with 2 chairs, a trampoline, a swing, and a ball pit. He immediately goes for the swing and the OT follows the child’s lead and does gross motor activities (in combination with sensory integration) for the first half of the session. The second half of the session, the OT has the child sitting at the table working on handwriting and other fine motor activities. At the end of the session, the mom walks in and is very surprised to see the child sitting so...