The Power of Routines

Have you ever been frustrated when your favorite, regularly scheduled TV show was replaced by a news or sports event? Had your morning ruined when you discovered you were out of coffee? Your routine was thrown off!

All people depend on routines. Routines provide a predictable framework to our days and reduce stress. Changes or unexpected events can cause stress.

For children—and especially for children with deaf-blindness—routines provide consistent, repeated experiences that allow them to anticipate what is about to happen, communicate in a structured and familiar setting, and actively participate to the greatest extent they can.

In a routine, the steps happen in the same order, in the same way, at an expected time, and at a good pace for the child. Through their regularity and familiarity, routines provide additional information that may not be available to children as a result of their hearing loss and visual impairment. As children learn routines, they also learn about the world (concept development). The stability of the routine creates an environment in which children are available for learning. Without routines, children may react negatively out of fear because they don’t know what might happen or be done to them next.

Formalizing an activity into a routine may be referred to as “routine-based intervention” or “activity-based learning.”

Why use routines?

  • Routines provide “a systematic approach that is individualized to meet the child’s skills and preferences” (FACETS, 1999).
  • Routines provide opportunities for consistency, predictability, anticipation, and repeated practice (Smith, 2002).
  • Using routines creates stability (Aitken et al., 2000).
  • Through a routine, the student has the best chance of recognizing an event, feeling secure, learning, and responding (Aitken et al., 2000).

What does it mean to identify an activity as a routine?

To be identified as a routine, the steps in an activity must be formalized. In the beginning, the structure and sequence must be identical each time the steps are performed. For an activity to be considered a routine, it should initially meet the following criteria (Smith, 2002, p. 1):

  • There is a clear signal to the student that the activity is starting. The steps of the activity occur in the same sequence.
  • Each step is done the same way each time (same materials, same person, same place).
  • Assistance is given in the same way each time until the student is ready for a lower level of prompting.
  • The pacing of instruction is precisely maintained until the activity is finished (no side conversations, no going to get something you forgot, or spontaneously adding new or different steps that won’t happen the next time the activity is done).
  • There is a clear signal to the student that the activity is finished.

Once a child is familiar with a routine, it may be possible to vary the materials, the person helping the child, or where the routine takes place. As a child is able to accept small changes, he becomes capable of generalizing concepts and activities. Parents and teachers must assess each child’s readiness for changes to a particular routine.


Aitken, S., Buultjens, M., Clark, C., & Eyre, J. T. (2000). Teaching children who are deafblind: Contact communication and learning. London: David Fulton Publishers.

FACETS (1999). Tip sheet: Considerations for planning routines based intervention. Retrieved on July 10, 2009 from:

Smith, M. (2002). Routines. Retrieved on July 10, 2009, from:



Ready to Change

  • Begin by selecting a motivating activity (see Likes and Dislikes for more information about identifying a child’s preferences).
  • Develop formalized routines with activities that occur on a regular basis (such as bath time, diapering, feeding, starting the school day, going to recess, etc.).
  • Make sure the routine is meaningful to the child so his participation makes sense and is easier.
  • Establish (as a team) a consistent set of steps that all team members will follow when carrying out the routine with the child. Consulting with other team members may allow a variety of goal areas to be addressed within a single routine.
  • Carry out the routine as designed. Evaluate what works and what needs adapting. Revise. Repeat.
If others have to “read” the child’s behavior as communication, he may not yet be readyfor tangible symbols that represent communication/language. If the child uses consistent ways of communicating that are purposeful, however, it may be time to introduce some tangible symbols into the routine. These could be pictures, photos, tactile objects or parts of objects. Remember to start with what the child “likes”!
  • The amount of time will vary depending on the student. If you think he’s taking too long, it’s possible that he has not had enough time to understand the act of “reaching” for the symbol. More hand under hand modeling of reaching to each section of the calendar box may help the student get the feel of the movement.
  • Also, ask yourself how many activities on the student’s schedule or calendar are ones that he likes. Often the symbols represent activities in the school day, but are not “likes” of the student. Always start with the “likes” of the student. When a calendar or schedule box is used consistently and in the same way, the student will understand it.
  • How often do you reinforce the tangible symbol that represents the activity during that activity? The symbol should be used frequently, just as you would use new vocabulary words frequently when teaching a student.
  • Remember that your purpose for using hand under hand is to show something to the student in a respectful way, without startling or controlling her. Modeling a movement using hand under hand encourages empowerment and control by the student. Observe carefully how much and how quickly she wants to take charge. Move your hand back farther and make the touch under her hand lighter and lighter until she reaches herself. Knowing when to back off is critical — not too soon and not too late. Learned helplessness occurs when we don’t give students the opportunity to take over when they are ready.
  • First, gestures, touch, or symbols that represent steps in a routine help the student make the connection between objects and activities linked to the routine. This promotes concept development.
  • Using a consistent routine also gives the student some control over the pace of an activity. For example, if he knows that the card with beans glued to it means it’s time to put his hands into the tub of beans, it allows him to get ready for touching, both mentally and sensorily. He may delay touching the beans while preparing for this next step.
  • Another example: A student might let you know she wants more water after tooth brushing by giving you the card that represents water. The student is able to communicate what she wants, rather than just following your routine, like it or not. Creating predictable routines gives students more “say” in the matter, thereby empowering them-whether or not they are able to physically complete the entire routine themselves.
  • The idea of “partial participation” means that every student can actively participate in the classroom and community to the greatest extent possible. The student completes parts of steps in the routine while others assist where he can’t.
  • For example, Bob is able to participate in making specialty drinks to be sold to his peers, in this way: He presses a switch that is connected to a blender. If he is not able to pick up the ingredients and put them in the blender, another person does that part, or, Bob might be able to touch the symbol that tells another student to put the fruit into the blender. Then Bob might point to the symbol that represents putting the top on the blender, and hit the blender switch himself.
  • Finally, he might touch the symbol that tells a student to pour the drink into the glass. Bob completes parts of the routine even though he is not able to do all the steps himself. The routine has value to the school community, and Bob’s participation is meaningful to the routine.

FACETS: Considerations for Planning Routines Based Intervention

From a joint project of Kansas University Affiliated Program and Florida State University. Discusses important considerations when planning routines, including targeting goals, identifying opportunities for teaching and learning, the role of facilitators, inclusion of a variety of intervention strategies, considerations for choosing cues, natural consequences or contingencies, and identifying environments.

Incorporating Active Learning Theory into Activity Routines

By Kate Moss & Stacy Shafer – Education Specialists, TSBVI Outreach

Focuses on Phase IV and V of Lilli Nielsen’s five educational phases of educational treatment outlined in her book, Are You Blind?, and addresses how active learning principles can be incorporated into routines.

Make It Routine

By Robbie Blaha & Kate Moss – Texas Deafblind Project

Discusses the benefits routines provide for a child, including opportunities for communication, emotional support for learning, a framework for learning, method for building procedural memory, and a way to highlight new information. Offers suggestions on choosing activities, developing the routine and setting up a family-friendly schedule. Includes sample schedules and a sample routine.


By Millie Smith – TSBVI

Addresses the criteria necessary to call an activity a routine. Includes a sample activity.

The Deafblind Disabled Baby:
Program of Care for Parents of the Deafblind Baby with Multiple Disabilities

By Peggy Freeman

A chapter on routines from a longer work by Peggy Freeman. Takes an in-depth look at the various stages of learning that take place in a variety of areas, including feeding, sleeping, bathing, dressing and undressing, as well as toileting. Offers examples outlining ways to adapt and change routines as a baby grows and develops. Select Routines (from the offered list on this web page)

Social interactions in routines: The framework for communication.

By Kathleen Stremel (2009)

Addresses routines within the context of communication and social interactions with others giving examples and forms that can be used (from the offered list on this web page).

Routines to Consider (adapted from a list in Stremel, 2009):

  • Social routines
    • Play with objects/constructive
    • Pretend play
    • Physical play/recreation/leisure
    • Social games/activities (e.g., selling chocolate bars for club, attending school dances, eating with peers)
  • Caregiver routines
    • Personal routines
    • Comfort related
    • Dressing related
    • Hygiene related
    • Food related
  • Work and Volunteer routines
    • Greeting co-workers
    • Getting ready for work (coat off, lunch in refrigerator, workstation readied)
    • Work tasks to be done
    • Lunch routine
  • Community activities
    • Library, park, playground
    • Visiting grandparents
    • Fishing with Granddad
    • Restaurants, post office, coffee shop
    • Grocery store, hair salon, bookstores
  • Pre-Academic/Academic routines
    • Reading books, shared reading
    • Songs and rhymes
    • Computer, TV, video
    • Art play
    • Early number sense/math
    • Classes: band, art, computer