ADHD: Establishing Routines

Building Structure and Predictability through Routines
All children need structure in their lives. Some can develop it for themselves, but most--especially challenging ones--need adults to provide that structure for them. Similarly, most kids prefer predictability. They like to know roughly how the day will go, what will happen if they misbehave, and that there will be no school on holidays. For some children, however, predictability isn't merely desirable or preferable--it's essential.

Theodore: I like to know what's going to happen because then I can prepare myself. I need to know ahead of time exactly what's going to happen and for how long. Otherwise, I get upset if things don't go the way I expect them to. For example, when we're down at the beach, we used to have a lot of arguments because I got fidgety not knowing how we were going to spend the day. I'd think to myself that I'd be able to play Game Boy for much of the day, but I'd get mad when my parents would make me go for a walk on the beach. I'd get upset because I hadn't expected to do that. I had too much free time down there. Sometimes, partway through the week, I'd want to go home. Once we began drawing up a daily schedule for me, I did much better because I knew what to expect. If I knew I was going to take a walk on the beach because it was on my schedule, that was OK.

Sharon: Kids like Theodore, and that includes almost all challenging children, whether they have ADHD or not, need to know what to expect ahead of time. This information helps make their life predictable, giving them a sense that they can navigate their world successfully. Otherwise, they feel out of control or overwhelmed by the moment. When they feel out of control, they may act that way. They need structure and predictability. Without this, it is difficult for them to make lasting changes in their behavior.

Providing structure and establishing routines is easier than you think. Although children have difficulty doing so on their own, you can help them if you remember to ask the following:

• What do I want him to do instead of what he's doing?
• What are the behaviors and/or steps that are most necessary to the situation?
• How can I put that in a visual format so he doesn't have to rely on me telling him what to do?
• What would make it worth his while?