Why is my child having trouble with following daily routines?
When looking at our child’s skills, we will commonly be puzzled to why they are having so much trouble completing a task that we take for granted. The role of an occupational therapist is to break down the smaller steps that are required for your child to be successful in completing a skill such as following daily routines.
Following daily routines is actually quite complicated and requires a large number of smaller skills to be developed first. These skills include (but are not limited to):
- Planning, sequencing and memory: to be able to follow and recall a sequence of steps in order to follow the daily routine.
- Receptive and expressive language: to be able to express concerns with changes to routines, the ability to express the aspects of the daily routine, and to understand instructions when setting up the routine.
- Following instructions: to be able to listen and follow instructions in order to complete a task that is part of a routine.
- Fine motor skills: in order to complete parts of the routine such as self-care tasks including getting dressed (completing buttons, zips, etc), to complete fine motor skills at school that are part of their routine (handwriting, craft activities, scissor skills etc).
- Gross motor skills: in order to balance when getting dressed, to complete parts of a school routine such as physical education.
- Understanding of their own sensory system: to determine the best environment to complete a part of the daily be (some children have difficulties completing tasks when in a loud or bright environment).
- Emotional regulation skills: to help your child cope when unexpected change occurs.
Is there anything I can do at home to support?
For children with Autism Spectrum Disorder (ASD), setting up daily routines plays an important role in helping to create a stable and familiar environment. Routines provide predictability and help to ease anxiety and worries that may be present in the everyday lives of children. It also helps children have greater control over their environments.
Setting up a daily schedule can be completing by using a visual schedule. The visual cue helps children see what is coming next so they can prepare themselves. A visual schedule is a sequence of pictures, words, videos, or other visual cues that show the child what they are expected to do. A visual schedule can include a series of tasks that are part of a routine (such as going to the toilet), or a series of tasks that are going to be completed throughout the day (from waking up to going to bed at night).
Visual schedules can be used in a variety of settings and in a variety of different ways. It has been said that visual schedules can help with the following:
- Improving activities of daily living including showering and toileting
- Increasing positive behaviours
- Increasing independence in children
- Decreasing meltdowns
- Assisting with transitions.
Another tool that may be useful in setting up daily routines is using a timer (such as an egg timer, sand timer, or alarm clock). This can be helpful in transitioning to the next activity/part of the daily routine as they hear the verbal cue and know it is time to transition. A visual representation of the clock, which shows different times for different parts of the routine, can also be a beneficial visual cue in setting up a daily routine.
Tips and tricks in setting up a visual schedule:
- Break down the routine into simple steps (see picture above)
- Have the schedule in a place where the whole family can see it
- Select the appropriate schedule for your child (e.g. visual, using timers etc.)
- Provide positive reinforcement when your child is following the routines
- At school, a daily routine could look like a timetable of the day’s lessons. Your child may find calendars, diaries and lists helpful as they get older to help keep track of upcoming events.
How can an occupational therapist support these skills?
It is common that families and teachers will identify concerns with specific skills such as following daily routines. Occupational therapists are trained to analyse your child’s current skills and difficulties to identify smaller goals your child will need to achieve as stepping stones towards achieving a larger goal, such as following daily routines. As every child is different, the skills that one child needs support in, is likely to be different to another child. Hence a thorough assessment is always the best place to start. Supports for working towards following daily routines may include, but are not limited to:
- Assessing current skill sets and environmental factors.
- Building the skills required in order to follow a daily routine.
- Assisting parents to set up an appropriate visual schedule for their child.
- Providing education and ideas to parents to continue working on the goal at home.
- Working with your child’s school teacher in order to set up a daily routine for your child at school.
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