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Form for Establishing a Routine

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Topic Overview

Use this form to problem-solve and establish a routine.


What is the problem?







What time of day or activity can be used to help you remember?







What are the steps in the routine that you need to make a habit?

1.

2.

3.


What will you use to remind you to follow the routine?







We will keep track of the number of times you follow the routine by:






Plan ways to reward your child for each success. Create bonus rewards for a day in which your child remembers and completes approximately 90% to 100% of a routine.

Credits

Current as of: December 16, 2019

Author: Healthwise Staff
Medical Review: Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Louis Pellegrino, MD - Developmental Pediatrics

Is it an emergency?

If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
If you are concerned about a possible poisoning or exposure to a toxic substance, call Poison Control now at 1-800-567-8911.

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