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Many of the people who stand to benefit most from routines are the same people who do not develop positive routines for themselves and need help with doing so.
For starters, consider these five suggestions for helping establish routines, especially with children who present challenges such as those mentioned above:
1. Identify the desired outcome. If it’s broad (such as to be ready for school), you may need to consider mini-routines, based on either where (i.e. the bedroom) or when (i.e. before breakfast) the activities to be linked are going to take place, or the type of activities (i.e. dressing). Mini-routines ultimately will be linked.
2. Recognize that developing a new routine may necessitate breaking a less-than-desirable habit or routine (i.e. screaming when he wakes up); in these cases, you’ve got two tasks to work on, breaking the habit and replacing that behavior with a step to the routine. You may be able to work on both, or you may have to tackle what’s less than desirable by creating a new situation or context the child will come to experience as one that will regularly comfort him and relate to the desired outcome (i.e. being present in the bedroom before he starts screaming, playing music, turning a light on, cuddling, etc; Dad’s going to come in and go into the bathroom with me). It will probably be easier for you to begin working on establishing a routine in an aspect of daily living that is not already negatively impacted by a problematic habit or routine.
3. Start small and think achievable & motivating. What can your child already do or come closest to doing? What can you link on either side of that do-able step? Work on linking the two activities. And if your child needs help with controlling his/her movement or understanding what to do & when to do it, make sure your assistance is delivered in a regular, repeatable way, allowing time for him to initiate the desired step.
4. Remember that linking even small steps takes time, at least a few weeks and likely longer to become automatic.
5. Know that trying new things and new ways is also valuable, but when you’re working to establish a certain routine, try “new” things outside of the routine you’re trying to develop. Once a routine’s firmly established there’ll be opportunity to foster flexibility, balancing structure and variations.
I believe that routine is essential for the children and families of the children we work with at Pediatric Therapeutics. For more suggestions, or to discuss these ideas, please speak with your therapist or feel free to contact me at sheila.allen@pediatrictherapeutics.org.
–Sheila Allen, MA, OT