Routines and Why They Can Help

By: Laura Van Zandt, MS, OTR/L

Routines are very important for all children, but they can be particularly important for children with developmental delays. Routines help provide a sense of certainty and security for children by offering them a predictable pattern that allows them to know what to expect, which will result in less frustration as well as fewer tantrums or meltdowns.

Certain routines are almost universal, such as morning and bedtime routines, but others may exist for specific circumstances or stages of life, such as your family’s weekend morning or school or summer routine.

A great place to start a routine is having a set bedtime. The American Academy of Pediatrics recommends that children ages 3-5 should get 10-13 hours of sleep a day (including naps) and children ages 6-12 should get 9-12 hours of sleep each night. The benefits of getting enough sleep are numerous and include mental/physical health, attention, memory, learning, behavior, and more. The AAP also recommends no screen time 30 minutes prior to bed, no electronics in children’s bedrooms, and having a set bedtime routine.

Setting up a bedtime routine:

Photo from Take Three Photography

Bedtime routines can be anything you want them to be, as long as they are familiar and predictable. For my infant son, he takes a bath every other day. After his bath (or mom and dad quiet playtime on non-bath days), he gets a nice massage and we read a couple goodnight books. When he shows us signs of being tired, we turn off the bedside lamp, swaddle, and turn on the white noise machine.

This routine is something I hope to keep as he gets older. For an older child, you can do a similar routine but you will need to add in time for personal hygiene and perhaps next day activities such as pick out your clothes, pack your backpack, etc. You can use a similar routine for naps, except they would just be shorter.

Aside from bedtime, morning routines, can also be beneficial. Some families have different weekday and weekend morning routines, but other children may need to have one routine that stays the same regardless of the day.

Mealtime can also present an important routine. An easy place to start is to try to have meals around the same time each day. I know this isn’t always possible- but getting as close to a specific time each day can be beneficial and having everyone sit together to eat.

Additionally, having chores to do in family routines helps children develop a sense of responsibility and some basic skills, like the ability to manage time. These are skills children can use for later in life that you can begin at a young age. One great example is singing the “clean up” song when it’s time to finish an activity and move onto something different.

“Clean up clean up
everybody everywhere.
Clean up clean up
everybody do your share.

Clean up clean up
everybody everywhere.
Clean up clean up
everybody do your share.”

Routines can also be great for teaching personal hygiene. Ever heard a parent sing the ABC song while their child washes their hands? This is just one great example.

Here are some tips if you are looking to introduce routines into your daily life:

1. Only change one part of the day at a time.

2. Come up with your basic non-negotiables and then give your children some                    choices (bedtime stories together or separate?).

3. Make a poster with the routine, including photos in the right order, to allow for              self-monitoring. In a good routine, everyone understands their roles, knows what              they need to do and sees their roles as reasonable and fair.

4. Follow the same routine every single day for at least one month, after which it will         become habit and your older kids should be able to keep themselves on schedule for         the easy routines.

Establishing routines has lots of great benefits that can help both you and your child develop scheduling abilities, and increase the likelihood that your family will have a smooth day.

For more information on Easterseals DuPage & Fox Valley, visit eastersealsdfvr.org. 

Down Syndrome Enters a New Era

By: Dr. Peter Smith, Associate Professor of Pediatrics, University of Chicago

Editor’s Note: Through a partnership with the University of Chicago, developmental- behavioral pediatrician, Dr. Smith leads a new Neurodevelopmental Disability Clinic at Easter Seals DuPage & Fox Valley which provides support for children with Down Syndrome, ADHD or Autism, disabilities that may include complex medical and emotional issues.

Dr. Smith also leads Easter Seals DuPage & Fox Valley’s multi-disciplinary team including an occupational therapist, speech-language pathologist, developmental therapist, audiologist and parent liaison in the Medical Diagnostic Clinic. This clinic specializes in early diagnosis of young children.

Current Processes Are Not Working

Individuals with Down syndrome (DS) are living longer and healthier lives than ever.  There is consensus that complete information needs to be offered to all parents of children with Down syndrome (both pre- and postnatal) regarding the current experiences, health outcomes, lifespans, and quality of life for individuals with DS.  DS represents a dramatic “success story” and the lives of individuals with Down syndrome are improving in every way measurable.  Unfortunately, this good news is too often not being shared with new and expectant families.  Doctors are not prepared for this task and parents report frustration with the process.

On the Cusp of Potentially “Game Changing” Therapies

In addition to the dramatic changes that have already occurred, DS as a clinical and research arena is on the cusp of developing even newer therapies that have the potential to improve cognitive outcomes.  Multiple research teams have protocols already enrolling study subjects.  For example, the team at the Jerome Lejeune Institute in Paris has an active study underway  that employs a combination of folic acid and thyroid hormone, targeting infants and primarily measuring cognitive performance during and after therapy.  Their preliminary work has shown significant promise and preliminary results might be released later this year.  Because of their early successes, there are ongoing efforts to mount a similar study here in the United States.  The NIH has recognized this new era and has launched an international registry (see https://dsconnect.nih.gov ).  However, this “breaking news” has not been widely disseminated.  Many worry that recruitment to these studies could be diminished due to the lack of awareness by primary care providers and the general public, which would slow the progress of the studies.

A Growing Number of States Have Addressed the Issue: Including Illinois

Because of the lack of general knowledge of both the dramatic improvements in the lives of individuals with DS and the emerging clinical trials in DS, a coalition lead (of course) by family support organizations has emerged.  They have initiated a new “information rights” movement that includes clinicians, policymakers, legislators, and researchers that has worked to enact new state laws addressing the problem of misinformation.  The first to successfully pass legislation was Massachusetts: in 2012, a coalition helped to pass a state law, mandating that clinicians provide accurate information and Referral to parent support organizations.  Most recently, Illinois, passed unanimous legislation in 2015, which proves that this is truly a bipartisan issue.

To learn more about our specialty clinics including the Medical Diagnostic Clinic, visit eastersealsdfvr.org.