Level 1 Routines – Beginning to Trust & Attend

A young man watches closely as his teacher uses a hand-mixer during a cooking routine.
A young man watches closely as his teacher uses a hand-mixer during a cooking routine.

Routines are an important part of any child’s life because they help children develop a sense of stability and order as well as give children the information and experiences necessary to complete tasks with increasing independence. They’re especially important for visually impaired children, who often have difficulty observing what’s going on in the world around them. When things are predictable—when the same things happen in a certain order at a certain time of day—children are reassured that the world is a safe place in which they can learn to make their way. Routines can also give visually impaired children essential information about what causes lead to what effects, can help them develop patterns of behavior, can help them develop skills in sequence from beginning to middle to end, and can help develop confidence as whole processes.

The Importance of Routines for Children with Visual Impairments

APH Family Connect

Developing Level 1 Routines – Anticipation of an Activity

Students may not be ready or able to participate in a formal routine, so the first step is to assess their readiness. A good place to start both in assessing and introducing routines is to look at activities in their daily life that already have the qualities of a routine. Often these are activities of daily living like dressing, grooming, eating, bathing, and toileting.  Talk to the family to identify the steps they use in completing these activities then develop a routine that has the following characteristics:

    • Beginning and end steps are clear
    • Sequence is simple, predictable, and repeatable – can be expanded later
    • Communication and language is embedded into the activity and a common language is used
    • Interactions are reciprocal with balanced adult/child turns – serve and return
    • Key features are consistent – language, people, actions, objects, locations, time

As you complete the routine, make sure not to place any demands of the student to actively take part. In the beginning you are only asking him/her to trust you and  stay with you while you go through the steps of the activity.  Here are some things to look for to assess the student’s readiness for participation in routines:

    • The student demonstrates through his/her movements, vocalizations, or manner that he/she feels safe with the adult leading the routine and is willing to stay in contact with the adult.
    • The student demonstrates after several times of doing a routine that is based on familiar activities some recognition of what is about to happen through his/her movements, vocalizations, or manner.
    • If the child leaves or looses focus on the activity for a short time, he/she is willing return to the activity.

If a student is not demonstrating these traits, continue to do the activities of daily living in the routine manner, just be aware that more time might need to be devoted to developing a bond and interaction activities such as simple turn-taking games.

When the student attempts to participate in one or two steps of the routine or shows awareness of what should happen next in the activity,  he/she is ready to work on routines at the next level. Depending on the student, this may happen quickly or it may take a longer amount of time, especially if routines have not been a regular part of his/her day.

Here are some examples of behaviors that indicate the student is anticipating next steps in a routine:

    • Moves a part of the body that would be involved in an action such as lifting a foot to put on a sock or opening her mouth when she smells the toothpaste.
    • Starts to travel to the location where the routine takes place when receiving the symbol for that activity. For example, heading towards the bathroom when given a diaper or to the table when given a spoon.
    • Imitates or approximates a movement that is part of the activity when given the symbol for the activity such as rubbing an arm for lotion or moving a hand in the motion of slapping water.

Pacing is an Art

Pacing is critical! The child’s attention span may not be very long so you don’t want to drag the activity out if the child is having trouble staying with you or if this is a non-preferred activity. At the same time, you don’t want to hurry the child through a step that he/she finds interesting. Be flexible and let the child guide the pace of the activity. This is when the instructor has to really practice the art of instruction.

The materials used in the activity may be of interest to the child and may help the child anticipate what is about to take place. At the earliest level, object symbols are generally used to represent the entire routine and other objects are used to represent a step in the routine. So for example, the toothbrush might represent the entire grooming routine. In the sequence box each step would be represented: toothbrush for brushing teeth, hairbrush for combing hair, face cloth for washing face, lotion bottle for putting on lotion. Allow the child time to explore each symbol or material used in the activity. This might include tapping on the container, smelling it, mouthing it, manipulating it with hands and exploring its surface for shape, texture, temperature, etc.


Hagood, Linda 1997. Communication – A Guide for Teaching Students with Visual and Multiple Impairments, Texas School for the Blind & Visually Impaired.


Taylor’s Grooming Routine

In this video, narrated by Chris Montgomery, we see Taylor and his teacher Amy doing a grooming routine. Note the pacing of this routine and the time Amy allows for Taylor to explore the materials. Taylor indicates anticipation when he rejects some of the items that are part of a preferred step (sensory integration with loofah gloves)  and non-preferred step (e.g., brushing teeth).