Routines support Children with impairments in executive functioning by Angela Pruess

For a moment, put yourself in the shoes of your child. Imagine you weren’t able to plan your day based on preference or convenience, and were forced to move from place to place without knowing what will come next. Someone else almost always chooses where you go and when you go there. In addition to this seemingly relentless variability, your body and emotions seem to be changing a lot all the time as well.

When we consider living our child’s reality for a moment, it is easy to see why children need and thrive with predictable routines and consistency in their environments. When we break it down it looks something like this.

Routine = Predictability = Stability = Security = Safety (basic need)

To put it simply, routines reassure children that their basic needs will be met. For children who struggle with Attention Deficit Disorder, Sensory Processing Disorder or Anxiety, having the security of routines is exponentially more important for a variety of reasons.

Routines support impairments in executive functioning. Children with ADHD, anxiety, and sensory issues typically struggle with a variety of challenges related to executive functioning (which can be likened to the CEO of the brain) such as memory, time management, planning and organization.

Children challenged in these areas may struggle with a variety of seemingly mundane daily tasks with just a few examples being, planning and beginning to get dressed, having any sense of time management in the am before school, following through with packing up their backpack, remembering parent’s directions, making decisions regarding which shoes to wear to school or transitioning outside to get on the bus.

These are vital skills woven into our day that for most of us, are carried out without our awareness. However, these basic tasks can be extremely overwhelming for a child with a challenged nervous system. Routine and structure give important cues in both space and time that will help a child to move more easily through their day.

Routines allow your child the resources to learn. Having a structured environment with predictable routines gives kids external controls to offset their own lack of internal controls. Feeling like they have a grasp on what to expect affords the child reliance on what’s happening in their environments, therefore allowing them to allocate their resources towards learning and growth as opposed to anxiety and stress management.

Routines help to decrease defiance and increase cooperation. Due to decreased processing ability, kids with ADHD and anxiety become easily overwhelmed with commands and directives leading to defiance and power struggles (not to mention many of these kids are strong willed in temperament as well). This often creates stress for parents, and places unneeded stress on the parent-child relationship.

When children know what is expected of them throughout their day, they are likely to integrate it into their automatic thoughts, increasing the odds of following through with expected tasks and reducing the amount of re-direction (i.e nagging) needed from adults.

Routines help develop independence. When daily tasks are predictable and consistent, it increases the odds that children will develop increased self-reliance. Kids love the independence of initiating their own tasks as they are made to feel competent and powerful in doing so. It is often easy for parents of children with ADHD or anxiety to jump in and assist with everyday task completion, and sometimes this support is necessary. However, it is important to promote and support independent task completion as well, giving lots of praise and attention to when attempts are made to initiate or follow through with a task on their own.


Routines help promote development of an internal clock. Grasping the abstract concept of time can often be difficult for kids with processing delays. When tasks and events occur repeatedly at the same time each day, children learn to internalize this structure. Not only will this help them to develop an overall sense of time, but it will serve to assist their bodies in regulating physiological processes such as sleep cycles.

Parents of children with neurological challenges often wish there was more they could do to support their child in the challenges they face in the world around them each day. Being thoughtful about the routines and structure put into place at home each day is an enormously helpful way to do just that.

Using the Kidibank™ app allows parents engage positively with their children in order to promote self-competence, healthy habits and responsibilities. Find out more at


Angela Pruess, LMFT, is a Child and Family Therapist and special needs parent on a mission to support and empower parents of behaviorally challenging kids.  Over at, she wants to make life easier for you by decoding your child’s maddening behaviors, as well as their developmental and emotional needs. When she’s not supporting parents, or seeing kids in her private practice, she is at home being challenged (a lot) by her own three kids (and sometimes husband). Follow her on facebook.