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Form for Establishing a Routine

Table of Contents


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 for Form for Establishing a Routine

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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