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Make the Morning Run Smooth Strategies for Developing a Morning Routine

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As a pediatrician, I work with all children including those with disabilities. I hear how difficult it can be to get out the door in the morning. In this blog, I share tips for creating a morning routine to get out the door on time and with less stress. Most children do better when there are routines that are predictable and consistent, including children with Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorders.

Learning a morning routine can be especially challenging for children with disabilities. They often need more directions, practice, and patience to learn these skills.   Each family will need to change these tips to work in their home.

Plan Ahead:backpack

  • Have your child pack his/her backpack and place it by the door at night. Make sure homework and projects are in the backpack. Creating a homework folder makes this easier.
  • When possible, pack lunches the night before.
  • Help your child pick out clothes the night before. This helps stop disagreements about what to wear.

Wake Up

  1. Start backwards. Figure out what time you need to leave.  Decide how long the morning routine will take. Give 10 to 15 minutes of extra time. That amount of time determines when to wake your child up.
  2. Pleasant wake up. Have the alarm play a favorite song or wake your child up gently with a hug and cuddle. Harsh alarms or abrupt wake ups can start the day off poorly.

Getting ready

  • Create a get ready routine: Wake Up, Get dressed, Eat breakfast, Brush teeth, Review the day and backpack, Leave for school.
    1. Get dressed first as this is often the biggest hurdle in the morning
  • Post a visual chart or checklist of each step. Laminate it or hang it in a plastic folder. Your child can use a dry erase marker to check things off when done.
    1.  Can use pictures of your child doing each step
  • If your child is more interested in music, create a playlist of songs. Each song goes with a different task in the morning routine.
  • Use a timer showing your child the time left for each step.

Getting Out the Door

  1. Use a silly sound (a wolf howl) to warn your child 5 minutes before it is time to leave.
    1. At first, you will need to use the sound and a warning “five more minutes”. Eventually just the silly sound will work.
  2. Use a different silly sound (duck quacking) for when it is time to leave.
    1. At first, you will need to use the sound and a warning “Time to go”.

Make It Funreward ribbon

  • Praise your child for completing steps in the routine. At first, the praise should be IMMEDIATE.
  • Create rewards for following the routine.  This can be a sticker chart or small prizes.
  • Your child can do a favorite activity as a reward if finish early.  This can be very motivating.
    1. No TV or tablet until your child is dressed and ready for school. If your child is ready early, he/she could watch a short clip.

Stick to It

    • Creating a new routine or habit takes 3 weeks.  Work towards the same goal for 3 weeks.
    • Once you have mastered the morning routine, create a bedtime or homework routine.

Additional Information and References:

“Time to Potty”: Tips for Toilet Training

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As a pediatrician, I work with all children including those with disabilities. This blog shares tips for toilet training. Toilet training can be difficult for all families. It can be especially challenging for children with disabilities. They often need more time, directions, practice, and patience to learn these skills. Each family will need to change these tips to work in their home.

Strategies for Toilet Training:picture of toilet arrow pointing to car

Create a Schedule

  1. Schedule toilet times, with a goal of 4-6 sits a day.
  2. Use a visual schedule or pictures to help your child understand toileting.
    1. Pictures of your child doing each step: going into the bathroom, sitting on the toilet, reaching for the toilet paper, flushing, and washing hands.
  3. Use first…then statements. First toilet then something your child enjoys doing. “First toilet then play with cars”.
    1. Create a picture board with simple pictures (see example)
  4. Instead of asking if your child needs to go to the bathroom say, “Time for the toilet.”

Sitting on the Toilet

  1. At first, the sits on the toilet are short (5 seconds per trip) with one long trip to stopwatchpractice having a bowel movement. Over time increase the sitting time (e.g., up to 5minutes).
      1. Setting a visual timer lets your child know when the sitting ends.
  2. Sits at first can be in clothes. Then underwear. Then without underwear.
    1. If your child uses the toilet then your child can get up right away.
    2. Boys are taught to sit on the toilet to urinate until regularly having bowel movements on the toilet.
  3. Keep track of bowel habits to create your schedule. Watch for signs that your child needs the bathroom (crossing legs and dancing or going to a corner)
      1. 20-30 minutes after dinner or a snack, your child should go to the bathroom and sit on the toilet.
  4. Drinking more fluids and eating more fiber will help your child toilet more.

Make It Fun

award ribbon

  1. Move to underwear. It helps your child realize when he/she is wet or soiled. If able, have your child pick out the underwear.
  2. Bring a favorite book or sing a favorite song that is only read/sung in the bathroom.
  3. If your child does to the bathroom, give IMMEDIATE praise. At the end of the timer, praise your child for sitting on the toilet.
  4. Create rewards for toilet training, one for sitting and two for going. Can use sticker charts or small prizes only used for toileting. Give the reward IMMEDIATELY after the bathroom trip. Reward even small successes.
  5. After sitting on the toilet, your child can do a preferred activity. Using first then statements (above).
  6. Read fun books about toilet training with your child at bedtime.

Stick to It

      1. Accidents happen. Let your child know it is no big deal. Change your child in the bathroom to learn the bathroom is for toileting.
      2. Work towards the same goal for 3 weeks.

Create a Team

      1. Make toileting a team goal with school teachers, therapists, and your doctor.
      2. Working on toileting at home and school will increase learning.
      3. Watch for constipation and talk to your pediatrician. Constipation can slow toilet training progress

Additional Information and References: