We think this is one of those questions that sits quietly in a lot of allied health teams.

The AHA is wondering, how much am I actually allowed to change here?

And the AHP might be thinking, of course you can adapt it if it's not working.

The problem is that nobody has necessarily said that out loud.

There is a big difference between adapting and changing the goal

This is probably where we would start.

Changing the way you get to a goal is not automatically the same thing as changing the clinical goal itself.

If someone is working on a particular movement, communication skill, functional task or participation goal, there may be lots of ways to practise that skill. The exact activity might change while the reason you're doing it stays the same.

But that only works when the AHA actually understands the reason behind the activity.

If all you have been told is, "Do this activity for ten minutes," then of course changing it feels risky.

The why matters more than we sometimes realise

If you're an AHP delegating work, one of the most useful things you can give an AHA is not another page of instructions. It's the why.

Why are we doing this activity? What are you actually watching for? Which part matters most? What can be made easier? What can be made harder? What would make you want the AHA to stop?

That little bit of context changes everything.

Because now the AHA is not trying to perfectly recreate a set of instructions. They're working within a clearer boundary.

A simple example

Imagine the plan says to complete a fine motor activity at the table.

The client arrives and absolutely cannot settle at the table. They're moving around the room, avoiding the chair, and every attempt to bring them back is making things harder.

If the actual goal is practising a particular hand skill, could that activity happen on the floor? Could it happen standing at a vertical surface? Could the same movement be built into something the person is already interested in?

Maybe yes. Maybe no.

And that is exactly why the conversation between the AHA and AHP matters so much. The answer depends on the person, the goal, the risk, the plan and the boundaries that have been set.

There should be some things that are very clear

We don't think an AHA should have to guess which parts of a session are flexible.

It can be really helpful for the AHP to make it clear what falls into the "yes, adapt this" category, what falls into the "check with me first" category, and what falls into the "stop and contact me" category.

That sounds simple, but it takes away a lot of uncertainty.

And it also protects the relationship between the AHA and AHP because you're not relying on assumptions.

Confidence is not the same as working beyond your role

This is another bit we think gets muddled sometimes.

We want AHAs to grow in confidence. We want them to notice things, problem solve, communicate and become more comfortable in sessions.

But confidence should not mean feeling like you have to make every decision yourself.

Sometimes the most confident thing you can do is say, I'm not sure about this one. I need to check.

That is not failure. That's good teamwork.

And AHPs need to make it safe to ask

If every question gets met with a rushed answer, a sigh, or a feeling that the AHA should already know, eventually they might stop asking.

That's not what we want.

We would much rather have an AHA ask one extra question than sit in a session feeling completely unsure about whether they're still working within the plan.

And sometimes those questions tell the AHP that the delegation itself needs to be clearer.

Good delegation should give an AHA enough room to think without leaving them alone to guess.

We'd love to know how your team handles this. When an AHA needs to adapt something in a session, is it really clear what they can change and when they should come back to the AHP? Tell us in the comments.