ADHD: Establishing Routines

Step 2: Written checklist

Step 2: Develop a Written Checklist and Post It

Checklists
Sharon: A short written list of two to six items not only establishes the steps of a routine, but conveys expectations and criteria for performance as well. The list's length depends on the child's age, as well as his level of distractibility. Limit lists for younger children to one to three items; three to six items for adolescents. Often parents send children to their rooms with the direction "Clean up your room." A challenging child can't break down this complex task into its component parts. To him it is overwhelming and he either "can't do it" or says, "I need your help." Remember too that for any child--not just challenging ones--the concept of cleaning differs substantially from yours. Yours is akin to House Beautiful and his is that he moves his socks. There's a big gap there.

A list clarifies expectations in clear, observable terms so that both parent and child know when the task is completed.

1. Trash in the trash can
2. Toys (books and papers) on the shelf and/or in toy box or milk crates
3. Dirty clothes in the hamper
4. Clean clothes in drawers and/or hung up

Write the list on an erasable white board, post it on a bulletin board in the bedroom, or put it on a Post-it Note that you stick on your child's door. Whatever you do, put the list where your child can't miss it. Remind him to check off each task as it is completed. Use picture cues for very young children. When your child says he's finished, you both survey the results as compared to the list. Acknowledge successful completion of each step. Call your child's attention to items still incomplete before he moves on to another activity. This way, the list defines "finished," not you.

Sharon: A list can also lay out a schedule. An afternoon checklist might be:

1. Snack
2. Homework
3. TV/free time
4. Dinner

If your child asks to watch TV, refer him to the schedule. That way, the list--not you--reminds him that the policy is homework before TV. Similarly, allow adolescents to decide which three of six chores they'll do by noon on Saturday and which three they'll complete before they go out Saturday night or Sunday afternoon. Implicit in this is that they must do all six before the weekend is over. In fact, they have to do them all before they earn the privilege of socializing on Saturday night or Sunday afternoon.

Picture Checklists for Younger Children
A younger child can work from a picture list or schedule. Have the child use a camera to take pictures that show "out of bed," "wash," "dress," "eat breakfast," etc. (Take an extra set. Your child may have photographed his toes.) Arrange the pictures in sequence on a Velcro strip. After he completes each step, he pulls a picture off and places it in an envelope. When he finishes the sequence, he brings you the envelope.

Checklists + Schedules = Predictability = Fewer Meltdowns
Schedules visually demonstrate sequence to a child, thus making his world more predictable. A child enters a situation with a preconceived notion about what the outcome will be. Often, some of the worst meltdowns occur when a child's concept of outcome does not match reality. Some children have particular difficulty making transitions. Knowing what will happen, as well as what will not happen, helps prevent those meltdowns.

Adults generally know what's on the agenda. They know the stops they intend to make (or don't intend to make) when they're running errands. It's not a state secret. But we generally don't share our agenda until the child demands to stop for fast food. ("We can't, we don't have time. It's not on our schedule." "What schedule?" the kid wails.) Or when your teen thinks a trip to the mall was to buy her Nikes. Try not to take this personally, but your children are not interested in going to the linen store. It isn't on their schedule. A list of intended errands that the child can check off or the teen can review to see that the shoe store is only one of the stops reduces fallout. Errand lists are especially successful if you include child-friendly stops, contingent on their behavior at other stops.