ADHD: Establishing Routines

Step 1: Deciding on tasks

Step 1: Decide What Tasks Must be Done
To establish a routine you first have to agree on what tasks are truly important--not your idealized vision of what your child ought to do. What absolutely must be included as a part of the daily routine? The school will allow any child to attend whether or not he has made his bed, but a teacher will frown on children arriving buck-naked. Decide what tasks are necessary and in what sequence you want them to be done. If your child is over four, try to include him in the decision making process. What does he think is important? Ask how much time he thinks he needs to get ready in the morning. Seek your child's input but keep in mind that very young children have no concept of time, and many challenging children have no inner clock; therefore they have no accurate sense of time passing. Furthermore, they may never develop one. Now is the time to teach them to rely on watches and timers.

Steps Toward Establishing a Routine

1. Decide what tasks must be done.
   • Separate the desirable from the truly essential. Ignore the unessential--you can expand the routine once your child has fully mastered the essential tasks.
   • Prioritize the important tasks.
2. Develop a written checklist and post it where your child will see it every time he needs to use it.
3. Reinforce routines with incentives for performance.

Ask how many reminders your child thinks he needs to get out of bed. An adolescent will often say "none" and accede to one. Agree on a sequence, prioritize what's really important, develop a checklist, and post it.

The checklist becomes the standard, so that both you and your child use it as a reference point. Place the checklist where your child will see it every time he needs to use it or give him a new copy to use every day.

Quick Tip
For any new routine, develop a written checklist and post it where your child will see it every time he needs to use it.

Some children benefit from a short checklist attached with Velcro to their backpack. The list includes things like homework, assignment book, forms, and lunch money, which the child checks off as he fills the backpack. To help a child learn to use the list, the parent's responsibility is to reward the child for using it.

Parents need to establish a rule that "if it's not in the backpack and down by the door, it doesn't go to school." For the child to make the connection and take responsibility, he may have to bear the consequences a few times of having forgotten to put his homework in the backpack.

Parents must make sure that their expectations are realistic and reasonable. "Realistic" means that the child actually has the skills to perform those behaviors on his own. "Reasonable" means that parents are not asking too much. Can they reasonably expect their child to complete all that's being asked? Even with parental or external prompts, however, they cannot count on perfection. They can expect, given a limited number of tasks, that with practice, the child will be able to get through the list, Therefore, an effective checklist should not be more than three to eight items long, depending on age and abilitiy to follow through on things.

Get Ready the Night Before

1. Have your child pack his backpack (according to a list) the night before.
2. Place it by the front door. (very important)
3. All homework, schoolbooks, paper, pencils, permission slips must be in backpack the night before.
4. Reward the child for completing all aspects of the routine with minimum of support.

   Rule: If the item is not in there the night before, it doesn't go to school.
   Rule: If it's not in there, Mom or Dad won't bring it to school.