Regardless of how many hours a week your children receive therapeutic services, most of their time is spent outside of the clinic. This is why you, the Home Team, are so important.

According to psychologist Dr. Anders Ericsson and colleagues(1), it takes about 10,000 hours of quality, meaningful, and motivated practice at an appropriate challenge-level to master a skill. Your child’s time spent in therapy is a small fraction of those hours.

Home Team, this is where you shine: following their therapist’s recommendations for home, or home exercise program (HEP), to make the most of their episodes of care.

Let’s take a deeper look at why this is so great:

The 10 Principles of Neuroplasticity (2) (brain’s ability to change/learn) and How They Apply to Following a HEP:

    1. Repetition: not just “one and done,” to make and keep lasting change, practice needs to happen multiple times. This is seen as “reps” in a HEP.
    1. Intensity: reps should be performed in the recommended time frame to promote effectiveness. For example, 10 reps in a week is a lower intensity than 10 reps in a day. This is seen as “per day” or “per week” … in a HEP.
    1. Use it or lose it: lack of practice could lead to loss of ability to perform or proficiency at a skill. Following the HEP can facilitate maintaining progress made in therapy.
    1. Use it and improve it: this can be loosely interpreted as, “practice makes perfect.” Following the HEP can promote improvement of skills worked on in therapy.
    1. Salience: importance, meaningfulness, and/or benefit of a skill to a person. This can be encouraged in following HEP recommendations to incorporate activities into daily routine.
    1. Specificity: can be described as “context.” This can be both internal (the way the child practices) and external (the environment/conditions). Following the HEP can promote practice in the context needed to perform a skill.
    1. Time: change/learning takes time. Following a HEP consistently between appointments can facilitate allowing the time needed to learn.
    1. Age: people can potentially change/learn more when they are younger. Following the HEP can support making the most of this potential in therapy.
    1. Transference: practicing/acquiring a skill in one area can facilitate change in another. Following the HEP promotes practice of a skill, which can promote progress that could be built upon to work toward other goals.
    1. Interference: When practicing, there is the possibility of “overdoing it.” Address any questions or concerns about this and the HEP with your child’s therapist.

There you have it. We rely on you, Home Team, to follow the HEP and encourage change, learning, and progress. Together, we can best promote your kiddos to reach their potential!

So talk to your child’s therapist about their HEP to brainstorm, make it fun, and ask questions! We are happy to work with you and discuss how to best apply a HEP to you and your family as individuals, because we all root root root for the Home Team!

Written by: Jenna Heinrich, PT, DPT

  1. Ericsson KA, Krampe RT, Tesch-Römer C. The role of deliberate practice in the acquisition of expert performance. Psychological Review. 199;100(3):363–406. doi:10.1037//0033-295x. 100.3.363.

  2. Kleim JA, Jones TA. Principles of Experience-Dependent Neural Plasticity: Implications for Rehabilitation After Brain Damage.Journal of Speech Language and Hearing Research. 2008;51(1):S225-S239. doi:10.1044/1092-4388(2008/018).