Why is structure important for someone with a learning disability?
Good structure enables people to anticipate what is happening, provides a shape to the day and an organised framework for support.
A learning disability affects a person’s ability to understand or remember the information they need to create and maintain their own personal structure. So people requiring support will have at least as great a need for structure as everybody else but without all (or many) of the skills to manage it for themselves.
Routines dominate most of our day from the moment we wake up and the time we go to sleep.
Everyone has routines that they are required to complete each and every day, whether it be going to shops/ to groups/ recreational sport or outing on the weekend. Adults with LD can struggle with routines, so they need a little extra assistance in knowing what needs to be done to complete and tasks.
Each and every one of us complete a set of tasks throughout the day. This is to ensure we’re remaining productive and taking care of ourselves and those around us. Simple things such as brushing our teeth, getting to and from activities, going shopping and visiting family. . An effective way of supporting a young person is to structure the environment around them with clear routines.
Why are routines helpful?
A routine is a sequence of actions or activities that regularly take place in the same order. Most of us like life to be predictable as it helps us feel more secure. This is even more important for people with learning disabilities.
Routines can help young people to understand what is expected of them in specific environments and situations. Well established routines can help to reduce a person’s anxiety as they can be confident in knowing what will happen next, how people around them will behave and what they will need to do.
Examples of routines and how to implement them
Different people will be able to cope with a different amount of information in a routine. Some people may be able to cope with information about the whole week ahead whereas other people may only be able to cope with information about the current day or even the next activity.
Lots of changes can make routines unpredictable and will not give the stability the individual requires. This could result in the person becoming confused and anxious. If there is going to be a change to a routine or plan, clearly communicate this to the individual before it happens, using simple language that is supported with pictures/symbols if possible. Pictures and symbols remind the individual and make it more real.
- Once a routine has been decided it is important that it is followed through in the same way each time. Some individuals may only need to complete a routine a couple of times to be confident about it, whereas for others it may take many repetitions of the routine.
- Ensure there is enough time for the individual to complete tasks without feeling rushed. If needed, allow time, or build time into the routine, to relax. This will further reduce any anxiety that the individual may have.
- When a new routine is first introduced an individual may increase their challenging behaviour until the routine feels familiar and safe to them.
- The increase in challenging behaviour may be a result of the individual being unsure of what is happening. Therefore it is important that this is communicated in a clear and simple way.
Challenging behaviour may also occur as a way of challenging the new boundaries of the routine. With perseverance of using the structured routine this should reduce with time as the individual learns to accept the new boundaries and feels safe in the routine.
What is a visual planner?
A visual planner is used to enhance an individual’s understanding of the upcoming plan and give them a sense of predictability. It provides ongoing information tackling the steps within a desired activity, the day, week or month in the vibrant form of images. It’s extremely beneficial in assisting individuals with acknowledging what is going to happen and the order in which they will occur.
Benefits of a Visual planner
By incorporating visual planners into an individual’s daily routine, it provides them with a clear way of understanding the process involved in tasks and anticipating future events so they’re able to organise their thoughts.
- Further benefits of a visual planner include:
- Provides predictability & structure.
- Assists individuals with transition between tasks with ease.
- Promotes emotional regulation in individuals, who may otherwise display feelings of anxiety.
- Move between activities with the guidance of a schedule, rather than relying on others to prompt them.
- Develops the individual’s independence & reinforces the habit of seeking information;
- Visual Planners are adaptable and can be used in a variety of settings!
Using objects as visual prompts
Some individuals may find it helpful to have a clear prompt that they are about to start a familiar routine. An object that the individual closely associates with the routine could be shown/given to them before starting the routine. For example, a sponge for a bath time routine, a specific cup for a mealtime routine.
Reward systems
Providing a reward for completing a routine can help to make it a positive experience and it can serve as positive reinforcement for understanding the routine. The reward can be anything that the individual enjoys. Examples include: praise e.g. “well done”. Time doing a favourite activity (e.g. watching a film); and attention (e.g. smiles, high five, fist pumps).
TOP TIPS to help you build a good daily routine
- Organise your week using a planner
- Set a day at the weekend to fill your planner for the week
- Add all the appointments and visits and activities you have that week to the planner
- Add the time you plan to get up in the morning and when you plan to go to bed
- Add breakfast, lunch and dinner to the planner
- Have a look at days you may not have much to do (you could plan another activity i.e. visit friends or family or just have a quiet day)
- Your planner will help you structure your week
Your Feedback – comments, concerns and complaints
NHS Lanarkshire is committed to improving the service it provides to patients and their families. We therefore want to hear from you about your experience. If you would like to tell us about this please visit our feedback page.
