As a new OT, it’s easy to feel like your impact happens inside the session.
You plan engaging activities, build rapport, and introduce new skills – and that all matters. But one of the most important lessons you need to understand early in your career is this:
Your sessions alone are not enough to create lasting change.
The Reality Check: How Much Do Children Actually Retain?
Let’s talk about the Forgetting Curve.
This concept explains how quickly we lose newly learned information if it’s not revisited.
Here’s what that looks like in practice:
- After 20 minutes → a child recalls ~60%
- After 1 hour → ~50%
- After 1 week → only 5–10%
- After 30 days → just 2–3% remains
This isn’t a reflection of the child (in fact, this data is the same for adults). It’s how the brain works.
While the concept of The Curve of Forgetting has been around since the 1880s, it is still incredibly accurate and important for all professions, but I find it especially crucial for OTs.
The Good News: Practice Changes Everything
Now look at what happens when practice is introduced.
Each time we revisit a skill:
- Retention increases
- The rate of forgetting slows
- Skills become more automatic
Repetition isn’t just helpful—it’s essential.
This is the difference between a child exposed to a skill and a child who can actually use it in daily life.
The 0.6% Problem (And Why It Matters)
Let’s put your therapy time into perspective.
If you see a child for 50 minutes per week, you are working with them for roughly: 0.6% of their week.
That means:
- 99.4% of learning opportunities happen outside your session
- Progress depends on what happens at home, school, and in the community
This is why even the “perfect session” won’t lead to meaningful outcomes on its own.
Reframing Your Role as an OT
A helpful way to think about this – and explain it to families- is to compare OT to physiotherapy.
If someone sees a physio for back pain:
- They’re given exercises to complete at home
- Progress depends on whether those exercises actually happen (and I don’t know about you, but I’m pretty slack with doing these at home when I’m prescribed…)
OT is exactly the same. You are not just delivering therapy. You are designing carryover.
Your job is to:
- Teach skills
- Translate them into real-life contexts
- Support families to implement them consistently outside of sessions
- And follow up (to make sure they’re actually doing them, and that they’re working)
What Home Practice Should Actually Look Like
Here’s where many new grads go wrong:
They prescribe “home programs” that feel like extra therapy sessions.
But families don’t need more to do – they need smarter ways to do what they’re already doing.
Effective home practice is:
- Embedded into routines
- Quick and achievable
- Relevant to the child’s goals
For example:
- Spraying plants or helping clean → hand strength
- Playing board games → turn-taking and regulation
- Using visual schedules → smoother transitions
My advice: Think integration, not addition.
A quick side note
Although I’m focusing on your role in supporting your clients, the curve for forgetting is an extremely important tool for you to know for your own learning. As new grads or returning OTs, you’ll be learning new content and skills every day. You also have to ensure you’re practicing those skills to retain them too. Make time to practice: sometimes a diary helps or schedule time in your weekly calendar for personal development.
I’m a big believer in ‘practice what your preach’ and that definitely extends to this concept.
So get cracking! Make time for your development and review your current at-home strategies or plans to make sure they’re working for your clients and their retention.
