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Form for Establishing a Routine

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: June 16, 2021

Author: Healthwise Staff

Medical Review:

Adam Husney MD - Family Medicine

Kathleen Romito MD - Family Medicine

Louis Pellegrino MD - Developmental Pediatrics

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