Therapy Blog: Establishing routines



Why do routines matter?

Routines dominate most of our day from the moment we wake up to the time we go to bed.  These routines consist of tasks we know we need to complete to help our day to run smoothly and to take care of ourselves and others. Anything from brushing our teeth after breakfast, getting to (and from) work, taking a lunch break at 12 or cooking dinner in the evening.

These tasks are what Occupational Therapists (OTs) call Activities of Daily Living (ADLs) or daily living tasks. As adults we have practised the same ADLs for years and as a result, we get very good at knowing what activities we need to complete and approximately how much time each task will take.

Children also have routines that they are required to complete every day and depending on their age and ability there may be an expectation from parents, carers and educators that they complete these independently or with support.  However, children haven’t had the years of practise that adults have at completing ADLs. We all know that practise makes perfect! Occupational Therapists use their knowledge of neuroplasticity to inform how they teach children to independently complete these routine daily tasks.

What is neuroplasticity?

Our brains are shaped by experience and most grown adults will have very different thoughts and behaviours today compared to 10 or 20 years ago. This is neuroplasticity in action. As we experience, learn and adapt our behaviour, changes in brain structure and organisation occur. In simple terms, neuroplasticity is the 'muscle building' part of the brain. Just as your body will get physically stronger when specific muscle groups are worked, our brains have the ability to get stronger and to help us become experts at performing certain tasks. We get better at the things we do often and with the tasks that we don’t do on a regular basis, our ability to do them well declines over time.

Activities of Daily Living

Your OT will take the time to understand what tasks and routines are important for your child to learn to complete independently or with support, these are your child's ADLs. Your OT will decide how best to help your child to learn and to improve their ability in everyday routines.  

Some routines that children can need assistance with include:

  • Morning routines – completing tasks such as waking up on time, washing, toileting, eating breakfast, brushing teeth and getting dressed in order to leave the house for the day
  • Transitions – some children can struggle with transitions from task to task and from place and place such as getting into the car
  • Bedtime routines – finding ways to help your child become calm and ready for sleep

If your child needs more support to complete any of these tasks then your OT can work with you to establish routines that are suited to your situation.

Establishing routines

Depending on your child’s ability, your OT will work with you and your child to provide tools that will help them to complete daily living tasks independently or work towards completing tasks with less help. There are a number of ways that your OT might work with your child and your family to establish routines and this will be tailored to your needs. Here are some of the ways that your OT may work with your child and your family.

Visual supports

Visual supports can help children to learn a routine. Visual supports present information using symbols, photographs, written words and objects. One of the more commonly used visual supports is a visual schedule or routine board. This is a series of images that show activities or steps in specific activities. A visual schedule can show all the activities involved in a single day, or all the steps involved in a specific activity like eating a meal or taking a shower. Visual schedules can be used in different ways depending on your child’s needs. They can help a child to understand and anticipate what is going to happen next, to signal a change in routine, or to help a child to complete tasks without being told what to do by an adult.

Structure and consistency

Having structure and consistency in the way that we perform  daily living tasks, helps with neuroplasticity. Doing the same thing over and over, in the same way, helps children to build neurological pathways and over time to get better at completing given tasks. Here are some quick examples of what this might look like:

  • Having a consistent wake-up and bed time each day
  • Completing morning tasks in the same order each day
  • Having time allocated each day for homework or screen time
  • Following conventions (that suit your family) around mealtimes

Preparation and planning

Preparing and planning for daily living activities can really help to take way some of the stress. For example, with the morning routine, any tasks that can be completed the night before will help you to feel less time pressure in the morning. This might include making lunches or packing bags. Identifying any tasks that cause stress, such as picking out your child’s clothes, is helpful too so that these become a priority to complete ahead of time.

If you would like more information about establishing routines to support your child and your family, our experienced team of Occupational Therapists are here to help. Simply follow this link and fill in the simple form or call us on 1800 XAVIER.