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Since a therapy program needs to be done as intensively as possible, parents who choose to do so are in the best position to spend the time that is required with their child. It would be uneconomical for a therapist to spend all her time with one patient, and virtually impossible for a child to receive such individual care in an institutional setting. This does not mean that all parents of brain injured children should be forced to administer the treatment program to their child. For some, this would be impossible or impractical. However, there are parents who are in a position to become completely involved, and it is for these parents that an intensive, home-based treatment program is offered.
Although some people may think it unfair to expect parents to carry out their own therapy program, it is interesting to note that this opportunity for complete involvement is one of the main aspects that attracts parents to this type of treatment. Many have been desperately looking for something 'to get their teeth into', for they usually realize very quickly that there are not going to be any easy answers. They know that if their child is going to improve, it will require lots of hard work on their behalf. Even if the child doesn't respond as much as they would have liked, at least they will know that they have done all they can to help him.
Another important aspect of a parent-run treatment program is that it is carried out in the home environment. The familiar surroundings of home are reassuring to most brain injured children. In an unfamiliar environment, the child may feel threatened and afraid. Taking him to a therapy centre, no matter how pleasant the place may be, can make the child tense and upset, and in such a state he is unlikely to perform at his best for the therapist. And, no matter how nice the therapist is, he or she is not mummy or daddy. A severely brain injured child is completely dependent on his mother, and to take him away from his lifeline and place him in a strange environment with many unfamiliar people may be an extremely traumatic experience.
It seems to be human nature that most people work better if everything is well structured and highly organized. It is a rare person who can work to maximum output without some sort of external control. This applies as much to parents of brain injured children as it does to anyone else. Many parents complain that when they take their child to a therapy centre, they are often not told exactly what should be done with their child each day at home. They may be shown treatment techniques that they can do with their child, but the instructions regarding the required repition of the exercise are sometimes vague. They may be told to do the exercises when both they and their child are in the mood, or to fit them in between all the other things that need to be done around the house. They are often not told exactly when they should be done, or how many times they should be repeated.
Thus, without a specific timetable, it is difficult to carry out a well organised therapy program. There are always other things that need their attention. Since no one stresses to them the importance of constant repetition, the therapy is usually performed in a rather spasmodic way. Although the parents often feel that this is not right, they find it difficult to correct their ways since they have no clear guidelines to follow.
If a home-based therapy program is to be successful, the parents need to know exactly what they are required to do on a day-to-day basis. Thus, everything should be clearly set out and organized in such a way that the parents have a specific daily timetable to follow. Of course, there will be days when, for whatever reason, it will not be possible to carry out the full quota of what is required, but at least it will be clear what should be attempted each day.
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