How to Hand Your Child's Home Program to a Nanny

First, let's name the reality

If you are a parent in the UAE or any city, there is a good chance your child spends significant time with a nanny. This is the reality of how many expat families here are structured: dual-income households, long working hours, limited maternity leave, and no extended family nearby.

Research conducted in the Gulf found that 58% of children under three spend between 30 and 70 hours a week with domestic workers (Roumani, 2005, cited in Sanderson & Preedy, 2016). For many UAE families, that figure has not changed.

Sanderson and Preedy's study with families across Dubai and Ras Al Khaimah found that while UAE parents were aware play mattered, the nanny was frequently the person present during the hours when play, learning and attachment naturally happen. The researchers noted this could have real developmental consequences if the carer did not understand the importance of attachment and guided play.

This is not a criticism of nannies. It is a systems gap. And it is exactly the gap this post addresses.

Your child's OT handed the prescription to you. But you cannot always be the one to deliver it. So the question is: how do you hand it over in a way that works, and how do you hold on to what cannot be handed over at all?

You've come home from the OT session. You know what needs to happen this week. And you also know that you can't be the one to do it every single day. So you tell your nanny.

You explain the activity. You show her the sheet. You say it needs to happen for 10 minutes, ideally after breakfast. She nods. She says she understands.

And then Thursday comes and you realise it happened once.

This isn't about your nanny. It isn't about effort or intention. It's about how the handover was done. Most handovers fail not because the person doing them is unreliable but because the system they're handed is full of gaps. When something is unclear, human beings default to not doing it. That's not laziness. That's self-preservation.

The good news is that a handover that actually works is a skill. And like every skill in this space, it can be learned.

The five principles below are adapted from the business frameworks of Alex Hormozi, applied here to something far more personal: getting your child's play prescription to actually happen at home, every day, even when you're not the one running it.

1. Document the outcome, not the task

Most handovers sound like this: do this activity, for this long, on these days. That's a task description. It tells someone what to do but not what success looks like. And when people don't know what success looks like, they don't know when they've done enough.

The first shift is to describe the outcome instead.

Not: do the playdough activity for 10 minutes.

But: by the end of the week, he should be able to pinch and roll a small ball without help. That's what we're working toward.

When your nanny understands the goal, she can make small decisions in the moment that move toward it. She's no longer following a script. She's working toward something she understands. That's the difference between someone who is covering a task and someone who is contributing to progress.

Your OT's prescription pad already names the goal. Use it. Read it out loud together. Make sure she can say it back to you in her own words.

2. Don't stop until she can do it right

We tend to think a handover is complete when we've finished explaining. It isn't. It's complete when the other person can do it correctly without you in the room.

Those are very different things.

Before you hand over the play session to your nanny, do it together at least twice. Not so she can watch you do it. So you can watch her do it and correct in the moment, before the habit sets. The goal is not for her to have heard the instructions. It's for her to have done it right.

If the activity involves a specific support level (minimal, moderate, or maximum), show her what each one actually looks like in practice. Minimal support looks different for every child. She needs to see your child specifically, not a general description.

Once she can run a session and you'd be comfortable leaving the room, the handover is done. Not before.

3. Remove every decision from the handover

Every question your nanny has to answer in the moment is a gap in your handover. And gaps get filled with guesswork, avoidance, or the path of least resistance.

A good handover answers every question before it gets asked.

Which activity? Written on the sheet. How long? Written on the sheet. What level? Circled on the sheet. How much help to give? Described on the sheet. What if he refuses? Tell her in advance. What if he gets it right on the first try? Tell her that too.

This is exactly what a well-designed play prescription pad does. It's not just a reminder. It's a decision-removal tool. When every variable is already answered, your nanny doesn't need to interpret or improvise. She just needs to show up and follow the system.

The fewer decisions she has to make, the more consistently it happens.

4. Build a feedback loop that doesn't require you

You're not going to be there every day. But you need to know what's happening. The mistake most parents make is building a feedback system that requires them to remember to ask. They forget. The nanny doesn't volunteer. The week passes.

Make the feedback structural instead.

One sentence at handover. That's it. Not a full report, not a detailed review. Just: how did it go today? You're not checking up. You're creating a moment where the session gets acknowledged and you stay informed without micromanaging.

If you want something more consistent, ask your nanny to leave the prescription sheet on the kitchen counter after each session. Its presence tells you it happened. Its absence tells you something to follow up on. No conversation required.

Simple systems get used. Complex ones don't.

5. Accountability without micromanagement

There's a version of oversight that makes people feel watched and a version that makes them feel supported. The difference is usually whether the system does the checking or you do.

When you personally follow up every day, it feels like surveillance. When a system naturally surfaces whether something happened, it feels like structure. Your nanny is far more likely to run the session consistently when missing it shows up in the system than when missing it means waiting for you to notice and say something.

This is why the prescription sheet on the counter works better than a check-in text. The sheet is neutral. It carries no frustration, no disappointment, no implication. It simply records that the session happened or it didn't.

Build the structure. Let the structure do the accountability. Save the conversation for when something actually needs to be addressed.

What stays with you — and why the research is clear on this

All of this is about making the doing transferable. But some things aren't. And this isn't a sentimental point. The research is specific about what a nanny can deliver and what only a parent can.

Studies in family-centred paediatric occupational therapy consistently find that parent involvement is not interchangeable with caregiver involvement when it comes to child outcomes. Children whose primary caregivers are actively engaged in therapy, not just present but attuned, show greater generalisation of skills across settings and stronger long-term progress than those whose therapy is delivered primarily by a third party (Hanna & Rodger, 2002; Lage et al., 2024). The reason is not logistical. It is neurological. Children learn differently in the presence of their primary attachment figure. Stress responses regulate differently. Motivation responds differently. The same activity lands differently depending on who is in the room.

This does not mean a nanny cannot do meaningful work. She can. The physical practice of a skill: the repetition, the setup, the time, can absolutely be carried by someone else. That is precisely what these five principles are designed to help you hand over well.

What cannot be handed over is the emotional attunement. When your child looks up after getting something right for the first time, the person they look for matters. A warm nanny can encourage and celebrate. But the weight of your noticing is different. It is the noticing of the person whose approval shapes a child's sense of their own competence. Research on parent coaching in paediatric OT is consistent here: when parents are present for the moments of success — not just the practice — children build not only the skill but the belief that they have the skill (Medbridge, 2024).

The decisions stay with you too. Whether to move up a level. Whether your child is having a hard week and needs to repeat the same activity. Whether something is not working and needs to change. These calls are made in conversation with your OT, not delegated to whoever ran the session on Tuesday.

And the relationship stays with you. Your nanny is a critical part of the system. She is not the system. You are. The play prescription was handed to you because you are your child's most important person. The goal of a good handover is to give you breathing room, not to remove you from the picture.

A system that makes all of this easier

A good handover needs three things: a clear outcome, a trained person, and a written reference they can follow without you.

The play prescription pad your OT gave you covers the third part. It names the goal, the activity, the level, the support approach, and the time. It removes the guesswork for whoever is running the session, whether that's you or your nanny.

At The Toy Pharmacy, our Play Hub goes a step further. Each week's Play Plan is laid out in daily doses, with the activities, the level, and the support approach already built in. It's designed to be followed by anyone who is part of your child's care, not just the parent who went to the OT session.

If you want a system your whole household can follow, not just you, that's exactly what we built.

References

UAE context and nanny research

Sanderson, K., & Preedy, P. (2016). Supporting parents of preschool children to develop strategies for schema-based play activities to enhance attachment and well-being: A preliminary study in the United Arab Emirates. FIRE: Forum for International Research in Education, 3(2), 25–40. http://preserve.lehigh.edu/fire/vol3/iss2/4

Roumani, H. B. (2005). A study of the use of housemaids as nannies, as opposed to qualified child care givers, in households in the Arabian Gulf. Journal of Early Childhood Research, 3(2), 149–167.

Parent involvement and child outcomes in paediatric OT

Hanna, K., & Rodger, S. (2002). Towards family-centred practice in paediatric occupational therapy: A review of the literature on parent–therapist collaboration. Australian Occupational Therapy Journal, 49(1), 14–24. https://doi.org/10.1046/j.0045-0766.2001.00273.x

Lage, C. R., Wright, S., Monteiro, R. G. D. S., Aragão, L., & Boshoff, K. (2024). Collaborative practices between parents and primary caregivers in paediatric occupational therapy: A scoping review. Australian Occupational Therapy Journal, 71(5), 833–850. https://doi.org/10.1111/1440-1630.12954

Novak, I. (2011). Home programme intervention effectiveness evidence. Physical and Occupational Therapy in Pediatrics, 31(2), 190–213. https://doi.org/10.3109/01942638.2010.533746

Parent coaching and skill generalisation

Medbridge Education. (2024). How parent coaching enhances paediatric occupational therapy. https://www.medbridge.com/blog/how-parent-coaching-enhances-pediatric-occupational-therapy

Wingrat, J., Price, C., & Wright, T. (2024). Facilitators of and barriers to caregiver adherence to home therapy recommendations for infants and children with neuromotor and neuromuscular diagnoses: A scoping review. American Journal of Occupational Therapy, 78(2). https://doi.org/10.5014/ajot.2024.050567

Handover and accountability frameworks

Hormozi, A. (2021). $100M Offers: How to Make Offers So Good People Feel Stupid Saying No. Acquisition.com.