"Identifying a problem was the easy part. Self-reflection was the real work."


Matt, Rahoo Baby Co-Founder & CEO, discusses what he means.


Part I -

What I realized while working at Boston Children’s Hospital (BCH) as a pediatric occupational therapist (OT


For the purpose of this blog entry allow me to address a few of the reasons why working at Boston Children’s Hospital has had a continuing and profound impact on who I am, and the creation of Rahoo Baby. When assessing my career so far, I often look back and think about the following three things:


  • The important relationships I was able to build with the families I worked with
  • The intelligence and compassion of my co-workers and mentors
  • Learning that working in a large, bureaucratic company is not best-suited to my goals


Numbers one and two, though personally valuable, are not the purpose of this writing. Working at a place like BCH allowed me the opportunity to work for and alongside some truly inspiring individuals…It’s why the long hours didn’t often feel like long hours. Number three however, is what inspired me to sit down and write this.


When I started working at BCH I was fresh out of graduate school. For the first few years, just being part of the hospital’s daily action was enough for me; interacting with my mentors, learning the nuance and complexity of early childhood development. And of course, helping infants and children in that development is its own personal reward that I will never forget. It was truly an excellent job – a job I had hoped would turn into an entire career. I took great pride in my success and valued the security and comfort that it allowed for. 


In my fourth year at Children’s, something changed. I was no longer confident that I would be happy spending the rest of my career on the same path, in the same role. I began to question whether my personality gelled with the day in and day out of working for a large and complex institution. Excellent co-workers, salary and daily gained experience seemed like it should be enough, but I still found myself professionally unsatisfied. I was uncertain of my next move.


When I first began to feel this way, it caused stress to the point where I was having trouble sleeping. I never had trouble sleeping in my life before that point…I even felt a sense of guilt at my career questioning. This was the exact job I had been working toward since I was 16 years old. I remember clearly thinking to myself “Matt, this is the job you worked so hard for. You did it. Stick with it and keep making the most of the opportunity.”


What was it about my literal Dream Job that left me feeling this way?


I stuck with it, yet with each passing month the answer to my question was becoming clearer to me. I realized that I was someone who took satisfaction in and was motivated by process. Does that sound over-simple? Maybe, but let me explain…


The process that I’m referring to is that of generating a new idea or initiative, followed by intense working realization of that goal. That process to me, is both fascinating and a highly motivating pursuit. I realized that in a word, it’s building. Silly as it may sound coming from an occupational therapist, I realized that in some ways I am by nature, an architect and builder.


Occupational therapy is a science. Turning simple play into therapy that has lasting neurological impact on an infant or young child requires a great deal of education and knowledge. But make no mistake - the bulk of my day was spent playing with infants and children, then typing up a report on each individual session. So while rewarding, it’s not like my job included all that many opportunities to generate and build new initiatives. But working in a major hospital, in a department of about fifteen people (forty if you include the physical therapy department), did come with the occasional opportunity to develop a new department initiative.


The team of OTs would often come together for a two hour meeting to discuss projects we would like to work on to help advance the department. I admired my managers commitment to keeping up with the latest trends in the field of therapy. Potential projects would include learning a new assessment tool, doing a deep dive on a relevant area of research, or mastering the use of a new therapy device on the market. The sequence of meetings over the course of a couple months would often go something like this:


We would first meet and identify an area of focus that would help to strengthen our team of therapists. The meeting would conclude. We would feel excited about the idea and motivated by the prospect of team-work and managerial support.


Two weeks later we would meet and the excitement around the decided-upon area of focus would have diminished. Everyone’s particular responsibility was murky, and that lack of clarity led to a lack of satisfying results.


Another two weeks after that we would meet again. Often at the end of that two-hour meeting our team all left with a slightly vague understanding of a new assessment or treatment. BCH therapists are a group of people I consider to be true scholars, but at the conclusion of these projects our team would often still lack the confidence needed to use these new tools to better the lives of our patients. “Is this process producing effective results?” I remember thinking.


It wasn’t. It left me perplexed because I had faith in, and great respect for my superiors and the other therapists around me. But in some ways the process was failing me and my co-workers. It wasn’t actually, but in a way I even felt like it was letting down our patients... It legitimately upset me. I was just perplexed. I mean, what happened? We’re a group of smart, motivated therapists who all get along well with each other. So how is it these projects weren’t achieving the end result that any of us had set out to achieve?


The lack of success came down to a number of factors, but I realized that the chief issue was a lack of follow through. As one of the youngest and least senior members of the staff it simply wasn’t my place to express my frustration, help identify the possible flaws and recommend a list of possible solutions. But that’s what I wanted to do. I wanted to dig in and analyze how these projects could be realized for optimal results. Frankly, I felt like it would have been worthwhile for me to do so, but that wasn’t my job. I, like the other hard-working therapists, had a long list of patients that needed to be seen, and like everyone else, I was chronically behind on session notes. I was doing my best, but I knew I was capable of more. Looking back, the stress, anxiety, and guilt that I was experiencing was the friction between opposing internal forces:


 Dream job VS Lack of professional fulfillment

“I know and appreciate my place” VS “I know have the drive to build something”


I knew I had the ambition and drive to create something. I knew that finally, I had to fully embrace and adapt to my own personal strengths. I had realized that I actually enjoyed solving the bigger picture problems.


By the time my time ended at Children’s Hospital I left with a tremendous amount of personal insight on top of the unparalleled clinical experience. I now knew that I enjoyed looking at projects from a 50,000-foot view just as much as I loved being in the weeds intensely focusing on the smaller tasks needed for its success. I was ready to apply myself to a new problem worth solving, and six years working as pediatric OT allowed me to identify that problem.





Evaluation and treatment. That is what we do as therapists. To truly evaluate and treat, it is important of course, that we have the chance to evaluate a baby or child in person and speak with their family.


We evaluate each baby or child as a whole individual, and we evaluate each category of development individually.  Each category has subcategories. Motor development includes subcategories like gross motor and fine motor; cognitive development includes subcategories like attention span, memory, and problem solving. There are more categories, and many more subcategories. Any child a therapist sees has the potential to be struggling with challenges that stem from any one or several of these categories. After identifying those challenges during the evaluation process, we establish a treatment plan.


A treatment plan includes specific exercises and activities designed to bolster skills in the area of development identified as weak during the evaluation. Being able to show the effectiveness of treatment using both qualitative and quantitative measures is why therapy gets covered by most insurance.


Believe it or not over 90% of infants never receive an evaluation or treatment from a licensed therapist. It’s a formal, lengthy process. The healthcare system simply wouldn’t be able to accommodate every infant having access to their own therapist. Naturally it’s reserved for the infants and children who need it most.


But here is my question – here is what I started to wonder: can we reach more families with our expertise through products we design and all of the different mediums that exist today? Does it have to be all or nothing? The truth is that pediatric specialists can have a massively positive impact without meeting the family in person.


Does every child need access to fancy assessment tools and a tailored treatment plan for quality care? In some cases, yes, absolutely. But what about the moms and dads just want to know they are taking counsel from the right professionals about what skills, products, what activities are generally best for infant development? Should that require a referral from a doctor? Third party payment? Scheduling an appointment? Traveling to that appointment? Our team at Rahoo Baby does not believe so.


In todays world things like MyGym classes and subscription services for Montessori toys are as easy as going online and ordering. I believe that accessing clinically validated information and products that spark infant development should be just as easy to access for all families. This was the initiative I was ready to apply myself to; this is what I was ready to build.


So is the purpose of Rahoo Baby to give parents the personalized experience that they would get by jumping through hoops to see a specialist in person at a clinic? Nope. But that’s the point. Because not every baby actually needs the highly nuanced, personalized care that therapists are capable of offering. We do believe however that every parent should at least have access to the basics of what we have to offer – the type of developmental insight they can learn and incorporate into their baby’s lives. Rahoo Baby is about giving parents as many keys as possible to unlock their baby's development in a way that toy-sets, or classes led by an instructor with a not-so-relevant degree, never could.


The healthcare system has built a wall around the information we hold onto as pediatric therapists. It keeps more than 90% of parents on the outside. All parents deserve access to the information on the other side of the wall. Rahoo Baby is knocking down that wall.


January 19, 2021 — Matthew Breen