Form for Establishing a Routine

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: October 24, 2023

Author: Healthwise Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.