Module 5: How to Use Daily Routines
In this module, we are going to give you lots of examples that show how you can teach basic skills while doing your family’s daily routines. These routines include waking up and going to bed, mealtimes, bath time, dressing and changing diapers, daily errands and chores, and play time inside and outside of the home.
We will give you ideas on how to teach important concepts, using games or activities during each of these daily routines. Choose the games and activities that you think your child will like the most. Focus on prompting and reinforcing social interaction with you, with other adults, and with other children as you move through the day.
If you like, you can make a summary of suggested games and activities for each room in the house and keep a list in each room. For example, you can keep the suggestions for mealtime activities in the kitchen. You can keep the suggestions for waking up and going to sleep in the room where your child sleeps.
In addition to the ideas included here, we describe more activities in a book, The Activity Kit for Babies and Toddlers at Risk: How to Use Everyday Routines to Build Social and Communication Skills, published by Guilford Press in 2016.
After the story about Mari, below, that shows you examples of teaching through the family’s morning, we’ll talk about the common parts of the child’s day, one by one. At the end of each section, you will find a link to the next. We’re going to give you suggestions about how to teach important ideas, using 5 to 10 simple games for each of these daily activities. We hope that once you try some of them you will begin to think of more teaching ideas on your own.
But just remember, as you work your way through this module, that teaching anything takes time. And establishing routines can take a little extra time. Be patient! You won’t know whether your child enjoys these routines until she is familiar with them. As you try out the various suggestions, you can make your own daily routines based upon the ones that your child seems to like best.
Games For Diaper Changing And Dressing
Games For Learning While Doing Errands
Module 5 Vignette: Marianna’s Busy Morning
It was early on a Thursday morning and Marianna’s (Mari’s) mother had a busy morning planned. She had read through the ideas in Module 5 of Opt-In Early. She thought many of the ideas would work well for her and Mari, who was almost three years old. She had taken pictures of their apartment building, the local supermarket, the playground at the park in their neighborhood, and the building where their weekly early intervention group was held on Thursdays at 10:00 AM.
She printed and laminated the pictures along with a picture of her car
and some of Mari’s favorite foods that they would shop for later that morning.
It was just about 6:30 AM when she heard Mari waking. She gave her a minute or two to wake up and walked into Mari’s room just as she was beginning to sit up in her new toddler bed. Mom picked Mari up and gave her a cheerful good morning greeting and a big hug and kiss. Then Mom pointed to several things in the room, starting with Mari’s teddy bear. “Good morning, Teddy!” she said as she pointed to the teddy bear. And then she pointed to a stuffed giraffe and said, “Good morning, giraffe!” Next, she pointed to Mari’s stuffed dog and said, “Good morning” and paused to see if Mari would fill in the blank. “Doggie!” said Mari smiling. “Good job talking, Mari! Good morning, Doggie!” said mom, giving Mari another squeeze and a little tickle.
Mari was still in diapers at night and during outings, but they had started to do some toilet training sessions during the day. So, mom brought Mari into the bathroom and prepared to take off her diaper. As she did this, she sang a little song, Time to Take the Diaper Off, sung to a tune she picked (or any tune that you know). Her mom emphasized the words “diaper” and “off.” She paused periodically during the song for Mari to fill in a word or two.
It’s time to take the diaper off,
Diaper off,
Diaper off,
It’s time to take the diaper off,
Diaper off!
When the song was over, she removed the diaper with a flourish saying, “diaper is….” Then she paused and waited for Mari to say “off!” She cheered for Mari and then showed Mari the wet diaper saying, “Diaper is wet.” Then she rolled the diaper up tightly. Before she reattached the sticky tabs to keep the wet diaper rolled tightly, she gently took Mari’s hand and guided her pointer finger to touch one of the tabs. She moved Mari’s finger on and off of it a few times. “Sticky,” she said. “It feels sticky.” Then she asked Mari to say the word “sticky,” giving her the “S” sound as a prompt. Mari tried and did manage the “S” sound. Mom praised her warmly but didn’t press for another try. She decided to wait until the next diaper change.
She handed the rolled-up diaper to Mari and pointed to the wastebasket saying, “Throw it away please.” Then she said. “Bye-bye diaper!” Mari waved bye-bye to the diaper and said, “Bye-bye!”
Then mom put Mari on the toilet and sang another little song as she sat there. She was surprised to hear a little tinkle sound and praised Mari warmly as she helped her wipe. Then she put a pair of cotton training underpants on Mari and they headed to the kitchen, still in their pajamas, to make breakfast.
Mom had planned to make scrambled eggs with sauteed onion, pepper and tomato. This was a favorite of Mari’s. Mari had a small, pretend play kitchen that Mom kept in the kitchen of their apartment. She took an onion, a green pepper and a tomato from the refrigerator and showed them to Mari, one at a time. Each time, she labeled the item and then worked on matching skills by asking Mari to find the toy onion, pepper, and tomato in turn. Then it was time to chop. Mari’s toy fruits and veggies were made in two pieces with Velcro connecting the pieces. They also came with a plastic toy knife and Mari enjoyed cutting the fruits and veggies and putting them back together again.
Mari played with her toy fruits and veggies while mom diced and sliced the real veggies and then broke some eggs into a bowl. She used a little bigger bowl than she needed because she planned to have Mari help stir the eggs. She thought a bigger bowl might help avoid a mess. Then she told Mari she needed some big girl help. She stood her up on a chair and kept a gentle hold on her while Mari happily stirred the eggs. Then mom said, “mamma’s turn.” Mom then stirred the eggs for a little while and then said, “Mari’s turn.”
When it was time to cook the eggs, she led Mari back to her pretend play kitchen. They found Mari’s pan and wooden spoon. Mom asked Mari to watch her while she stirred the pretend eggs and veggies in Mari’s toy pan. Then she gave Mari the spoon and mom went back to the stove to cook their eggs.
Then it was time to eat. Mom placed only a spoonful or two of scrambled eggs in Mari’s bowl. She also placed more of the eggs, with the small serving spoon, in a clear glass bowl, just out of Mari’s reach. Mari could see the eggs but couldn’t quite reach them. She wanted to give Mari plenty of chances to ask for more eggs. Mari could already feed herself with a spoon and fork.
She ate the eggs and then looked at mom. Mom prompted her to point to the bowl of eggs and said, “Oh! Mari wants more eggs!” She spooned more eggs into Mari’s bowl and held it up just out of Mari’s reach as if to hand it to her. Mari pointed to her bowl and mom handed her the bowl as she said the word, “eggs.” They repeated this routine twice and the third time, Mari said the word “eggs” as she pointed to the serving bowl. Mom was so happy and praised Mari with warm enthusiasm for saying “eggs.” “Wow Mari!” she said as she spooned more eggs into Mari’s bowl. “You said eggs! Mari wants more eggs! Mmmm! Yummy eggs!”
Mom let Mari watch some short YouTube videos with songs about clothing while mom cleared the table and did the dishes. There are many such videos available. Here are some to check out.
Then it was time for another trip to the bathroom and then to get dressed. While in the bathroom, Mari sat on the toilet for about two minutes but didn’t pee or poop. She wanted to get off the toilet and mom said, okay, but first we will count to three. Mom counted to three slowly, holding up one, two and then three fingers before labeling the numbers. This was a familiar routine and by the time mom got to two, Mari said the words “two” and “three” with mom.
Mom then put a diaper on Mari because they were going for an outing. She got a dry diaper and had Mari touch it. “This diaper is dry!,” she said. “It’s clean and dry.” As she pulled open the sticky tabs, she repeated the “sticky” routine too.
She washed Mari’s face and brushed her hair, counting out three brush strokes each on her bangs, and the sides and the back of her head. Then it was time to brush Mari’s teeth. They had a little tooth brushing routine mom called the “E’s and Ah’s.” In this routine, Mari said the “Eeeee” sound while mom brushed the front of Mari’s teeth. Then she held out the “Aaaaah” sound while mom brushed the chewing surfaces and the backs of Mari’s teeth. Mom praised Mari and hugged and kissed her, telling her what a good job she did with her “E’s and Ah’s.”
Then it was time to get dressed. They went back into Mari’s room. Mom held up two shirts, a yellow one and a pink one. She asked, “Which shirt?” Mari pointed to the pink one and mom said, “Pink shirt! Mari wants the pink shirt!” Then mom gave Mari a choice of pants to wear. She held up a pair of blue jeans in one hand and a pair of purple pants in the other. Mari chose the blue jeans. Then mom got a pair of socks from the drawer, and they started getting Mari dressed.
As mom helped her with her clothes, she asked her to point to various body parts. For example, while holding the shirt, mom asked, “Where’s your belly?” and Mari pointed to her belly. Mom gave Mari’s belly a little tickle. Then she asked, “Where is your back?” and mom helped Mari to point to her back. She praised Mari throughout this routine, even when Mari needed help to point to the right body part. “Arms up,” she said as she helped Mari put on the shirt.
When Mari was all dressed and ready to go, they walked together to mom’s room. Mom sat Mari on the bed with some favorite books and a couple of favorite puzzles and got herself ready to go out.
Mom packed a couple of snacks, and a bottle of bubbles to blow in the park. She put them in her diaper bag. She had also made a picture schedule for Mari.
She wanted Mari to know where they were going and how they would spend their morning. Mari LOVED the park. She usually didn’t want to leave the park and sometimes cried when it was time to leave. But she also really liked riding in the car, and she enjoyed her early intervention group a lot. Mom hoped knowing good things were coming after the park would make it easier when it came time to leave the park. She used Velcro to attach each of the five pictures to a piece of laminated cardboard. Then she attached a small Ziplock snack bag to the bottom of the schedule board. Her plan was to have Mari remove each picture when it was time to leave that place and move on to the next. Then Mari could put it in the Ziplock snack bag and say, “All done,” for example, “All done park. Time for car!” Once in the car, mom could remove the car picture and point to the picture of the building where the early intervention group was held. And when they arrived at the building, she could hold up the picture and point to it and the building in turn. She hoped Mari would soon make the connection that each picture represented a specific place.
Mom pointed to the first picture on the schedule and Mari seemed to recognize it. She smiled and cooperated happily as mom helped her with her sneakers and jacket. “Park!” said mom. “It’s time for the park. Let’s go!” They walked to the park together.
Once at the park, mom and Mari did several of their favorite routines there. Many of these routines are described later in this module. Mom worked on eye contact with Mari on the swings and using the bubbles she brought along. Mari very much enjoyed both activities. Then she wanted to slide down the slide. There they worked on the words up and down, and the phrase “ready, set, go.”
When it was time to leave the park, mom showed Mari the schedule board again. This time she said, “All done park. Time for car!” She also pulled out a small bag of crackers she had packed which was a favorite snack of Mari’s. “First car, then crackers!” she said, pointing to the picture of the car and then holding up the snack of crackers. She helped Mari to remove the picture of the park from the schedule board and again said, “All done park.” Then she helped Mari put the picture of the park into the Ziplock bag at the bottom of the schedule board. Mom waved and said, “Bye-bye park.” She repeated this a couple of times, pausing to let Mari say the words “bye-bye” or “park.”
Then she pointed to the picture of the car and said, “Time for the blue car!” It had worked! Mari walked nicely back to the parking lot of their apartment building, found their car, and climbed into her car seat. Mom praised her all the while. Once buckled into her car seat, mom gave her the small bag of crackers she had packed for Mari to eat on the way to the Early Intervention Center.
Mom removed the picture of the blue car and put it in the “all done Ziplock.” Then she pointed to the picture of the Early Intervention Center and said, “Time for group!” and off they went.
Mari and mom had been going to the Early Intervention Center, once a week, for nearly a year. When they first started there, Mari always cried when it was time for the parents to leave the big activity room for the parent group. Now, however, Mari waved bye-bye to mom and walked happily toward her spot on the circle-time rug. She knew the routine and she enjoyed it. And she knew that mom would be back soon. Mom was happy too. ‘Things do get easier with time,’ she thought.
When the early intervention group was finished, mom and Mari walked back to the car together. It was 11:00 AM and they had one more quick stop to make before going home for lunch. Once in the car, mom held up the schedule board and showed it to Mari. There were two pictures left on it, one of the local food market and the other, the picture of their apartment building. Mom pointed to the picture of the market and said, “Time for the market!”
Mari had eaten a snack during group and mom had one more small snack left in her bag. She didn’t want Mari to be hungry in the market as this could make Mari upset. So, she quietly moved some fruit from the diaper bag into her handbag.
Once at the market, mom pulled out the pictures she had laminated of some of Mari’s favorite foods. Their local market didn’t have the child sized shopping carts Mari liked best. So, mom got a small cart as she planned to buy only a few things. Mari was a little tired and mom wanted their morning to end on a positive note.
They started in the produce department. First, she handed Mari the picture of the red apple. “Can you find the red apples?” she asked.
Then, she pointed toward the red apples. Mari was getting better and better at following a distal point (pointing to something a little far away) and this was good practice for her. When she spotted them, she ran over to them with mom following. “Yay!” mom cheered. “You found them! You found the red apples!” Then she held the picture up to the pile of apples and said, “Look! They match! Apples! Red apples!” She showed her green apples and also yellow apples and labeled each as she pointed them out. “The red ones are the ones we want today,” she said. Then, she held out a plastic bag and said, “Let’s count two apples.” She handed one to Mari and Mari dropped it into the bag as mom said, “one.” Then she handed Mari the second apple and Mari placed it in the bag as mom said, “two. Let’s put them in the cart.” In the cart went the apples.
Then mom took back the picture of the apple and handed Mari the picture of the banana.
She pointed to the bananas across the aisle and Mari found them. Then mom selected a bunch of three bananas and counted them, gently guiding Mari’s pointer finger to touch each banana as she counted. “Three bananas! One, two, three! Three yellow bananas! Let’s put them in the cart.”
Then they found the grapes and headed off to find the matches for the remaining pictures. Mari did a great job following Mom’s points and enjoyed being the one to put the Cheerios and crackers into the cart.
While they waited in line to pay for the food, mom opened the fruit she had packed and gave it to Mari, praising her for being such an awesome shopper.
Then they got back into the car. It was time to go home. Mom helped Mari remove the picture of the market and put it in the ‘all done’ bag. Then, mom pointed to the picture of their apartment building and said, “Home! It’s time to go home!”
As the car pulled into the parking lot of their apartment building, mom thought about their busy morning with happiness. She had worked so hard these past months trying to make sure that she was doing all she could to give her beautiful little girl the extra help she needed. Mari was making progress and things were getting easier. They really were.