Engaging Families, Intervention Visits, Practical Strategies

7 Specific Questions to Ask When Exploring Family Routines

Ask any 3 families what bathtime is like for their child, and you’ll get 3 different responses. For one family, bathtime might be a long, fun, wet playtime each night for the parent and child. For another, it might be a very busy time of bathing 3 young children, getting them in and out of the tub and to bed. For the third family, bathtime might happen every other day with the child bathed after lunch while sitting in the sink.

Say you give the same communication strategy to each of these families to try at bathtime; HOW it’s implemented will look differently for each family. The first family might find it fits well and use the strategy every night. The second family might find it very difficult to remember to use the strategy, to squeeze it in during their very busy routine. The third family might not use the strategy very often, but could use it if they were helped in planning for another routine that happens more frequently.

Routines-based intervention is regarded as best practice in early intervention because we know that embedding strategies in everyday routines results in increased opportunities for the child to learn. When you think about family routines, you can think general or specific. If you think more generally, you might think that all families eat meals, have snack times, change the child’s diaper throughout the day, give their children baths, etc. While this is generally true, HOW each routines works for each family will be unique.  In order to really understand how each family’s unique routine works, you’ve got to ask specific questions to find out what makes them tick. Here are 6 questions to help you focus intervention:

1. How does bathtime work for you and your child? Tell me about what happens before, during, and after bathtime.

Use this question to explore the specifics of the routine. It’s always best if you can actually observe the routine, but if not, these questions can help you think it through too. Think more broadly than just the routine; explore what happens before and after it, especially when a routine is difficult for the family.

2. Which parts of bathtime do you think go well? Not so well? Why?

Help the parent reflect on his/her thoughts about the routine, rather than making assumptions. These types of questions help parents learn to think through how to solve problems and use strategies during routines on their own.

3. What do you do during bathtime? What does your child do? Why?

Finding out what each person does (or doesn’t do) during the routine can provide great insight into interactions and expectations.

4. What does Sam like to do during bathtime? What does he not not like to do?

Finding out what the child likes to do helps you and the parent build intervention around the child’s interests and what is naturally motivating. It also can help you and the parent figure out where the problems are and what might be causing them.

5. If you could change one part of bathtime, what would it be? Why?

This question also promotes the parent’s ability to problem-solve and plan for using strategies independently. That’s our goal, afterall.

6. How do you think Sam could learn to ______ during bathtime?

Rather than providing all of the answers, help the parent think through how a strategy could work, what the child could learn, etc. Parents have some fantastic ideas and know the child best.

7. What strategy would you like to try during bathtime this week?

Always purposefully plan with the parent for how to use strategies between visits. Encourage the parent to identify which strategy(ies) he/she wants to try. Plan together for how the strategy will be implemented and check back in about how it went at the next visit.

Of course, you can substitute “bathtime” in these questions for any routine you and the family are exploring. If you keep in mind that you are there to help the family think through how to support the child, rather than being the expert with all of the answers, you’ll find that intervention strategies become more individualized because you and the parent work together to figure out what to do. With this individualized approach, you’ll be taking routines-based intervention to a deeper, more meaningful level!

What specific questions do you ask when talking with families about their routines? What do you ask when you are observing or joining a routine? Share your questions in the chat below!

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34 Comments to “7 Specific Questions to Ask When Exploring Family Routines”

  1. Thanks, This was helpful

  2. As a graduate student in the midst of my first placement in early intervention, I have found that this model truly enables families to learn to problem-solve and incorporate goals and strategies into their own daily routines. In thinking about one of the families I work with, the question, “How do you think your child could do this during the routine?” has been valuable in allowing the parent to identify what works best for their family and visualize using a particular strategy. Implementation of this strategy, despite encouraging the parent to think about a plan ahead of time, has been challenging in some cases. However, in general I have observed that parents know their child best, and intervention is most effective when it stems from the interests and routines the family already has in place.

    • Laura, you sound like you have a wonderful handle on early intervention so far! What you said in your last sentence is the key. Asking a question like the one you mention can put parents on the spot because you are facilitating their reflection – and most don’t expect you to do that. Implementing this kind of question requires that service providers get comfortable with silence and give the parent space to think about his/her answer. If the parent isn’t sure how to answer, what would you do? We know we shouldn’t jump right in with an “answer” to our own question, so what would be your next move? I’d love to hear more about what you think!

  3. I love these questions and find they are great to get more information from families and to help them to identify opportunities. Recently I was working with a family and talking about their morning school routine as they start their day (they home school all of their children). Using these questions, particularly the “which” and “how” questions, we were able to identify an opportunity for the child to request to use his wheelchair. Instead of me as the clinician saying “I think you should work on signing the word wheel chair”, the father was able to identify part of this routine was for the child to get in his wheelchair, and that since he loves his wheelchair so much, this would be a word he would be motivated to use to make a specific request. The child was already using natural gestures and showing that he wanted to get into his wheelchair so the family can layer the language/signs on top of what the child is already doing. Also, since the family has the same routine everyday, it’s an easy thing to practice and reinforce everyday. Although the process to encourage the family to work on this sign took longer, the family has more ownership of this and will carryover it over with more ease. The family has now added more words to work on during different routines, identifying them on their own and taking strong ownership of helping their child to build words for interacting, demonstrating what he knows, and making requests.

    • Thanks for sharing this wonderful example, Jessica! I especially love how you say that you could have directed this activity, but it was so much more impactful when the father identified the routine. The family “owned” it with your guidance. Well done! 🙂

  4. Often times, I find it quite challenging to “tease” out family routines to effectively problem-solve and build upon strategies aimed at improving the level of support the family provides to the child at those moments. I have found this most challenging with my discussions with families who readily share’ I don’t really have a routine” especially for the younger children where specific gross motor concerns need to be addressed. I then find myself asking about “child’s interests” to then try to discuss ways to incorporate above into the family’s daily interactions. As such, the first questions ” how does …. work for you” often takes a bit of time to tease out but I have found the follow up questions helpful in trying to build the parent’s capacity for reflection and then build upon that with appropriate movement strategies.

    • Thanks for bringing this up, Camille. It sounds like just starting the conversation to find out an overall picture of family routines is challenging – even before you’d be able to use these more specific questions. When I had families who struggled to answer my more broadly worded questions – like tell me about your daily routines (not a great question really) – I’d sometimes try more specific questions right off the bat. For instance, I might ask the parent to walk me through the day she just had, from what happened since she and the child got up this morning. Then, we could hone in on some specific aspects of their daily routine to think about how to embed intervention. Or, I might just pick a specific routine or activity and start there – like “What is bathtime like? Can Sam sit in the tub?” to get an idea of what he does, where he’s placed, etc. Before getting specific, you might also start with something like “what are the challenging parts of the day?” or “when you think about Charlie’s movement skills, what would you like for him to be able to do?” Every parent has struggles with raising her child. While we don’t always want to be focused on challenges, it can be an easy place to start the conversation. Then you can branch out from the routine/activity in which the struggle occurs to find out about if a similar struggle happens at any other times, in other places, during other activities. And sometimes, it’s just going to take some time to build rapport with the parent and help the parent understand why you’re even asking about routines. My advice – make sure the parent understands why you’re asking and how the info will help you and her in individualizing intervention. Keep in mind that adult learners need to know “why” to understand and participate – and in this case, share information. Good luck!

  5. Of these questions, the one I most frequently neglect to ask is “How do you think your child could learn to ___,” followed by “What do you want your child to learn from _____.” I have found that when I do ask those questions, I get thoughtful answers from parents that really reflect their family’s needs (related to that routine) and give me more information about what is valuable to them. For example, naming toy ducks in the bathtub may not be a priority, but taking turns with a sibling to fill and dump a water cup may be!

    • Yes, Lauren, asking these additional questions can be hard to remember. I think that’s often because they require us to continue to pull back before we jump in with our ideas. We know what children can learn from different activities and all of us, whether we are educators, therapists, or service coordinators, are “teachers” at heart. We like to help and share what we know. The questions you mention help us build up the parent’s knowledge and reflection – and that’s so important because that’s how we help the parent learn how to think about development in ways that they’ll carry with them long after EI ends.

  6. This questions are so useful to help us get stated in our journey to use reflection with the families. I have noticed that parents are very eager to share their thoughts. Thank you for sharing them.

    • You’re welcome, Belkis. I like how you frame this – as a journey to using reflection. It’s a wonderful idea to allow yourself some time to absorb reflection and using these kinds of questions into your everyday practice. Thanks for sharing your insights in my EI Institute session too! 🙂

  7. I love these questions. I recently was trying to get an idea of what a family’s day looks like with their child. I then discovered that previously discussed routines of meal time were no longer applicable as the family didn’t eat together. They only really ate together before because mom was having to feed the child with a bottle, but now that the child has moved on to solids, it’s the family’s routine to just eat when you can. If I had taken the time to ask more thought provoking questions, such as the one above, I would’ve found that out earlier. When I did ask more questions during that same visit, we did find something else that the child loves to do, but can be a stress for family members (walking outside as she has recently discovered how to walk). We discussed what they do before going outside (shoes and socks), what they do outside (loves finding airplanes as they live near the airport), and where they go (playground). This provided lots of opportunities to discuss how there are a variety of learning opportunities within the simple activity of “walking outside”.

    • It sounds like your insights about what questions to ask, when to ask them, and what to do with the answers is right on target, Emilie. I really like how you asked about what the family does before, during, and after they are outside. Investigating all of these aspects of a routine is really key to getting the big picture. Combining good questions with joining the routine is always a great way to go too! Thanks for adding to the discussion!

  8. I love how open-ended the questions are! Asking questions in an open way requires that we, as interventionists, take ourselves out of the equation and focus on the family’s way of doing things. We must eliminate our biases or assumptions of what bath time (or any routine) “should” look like. Open ended questions allow the parents to answer honestly, rather than feeling like they need to answer a certain way.

    I recently had a conversation, following a similar pattern, about bedtime. Mom shared how their bedtime looks, parts that go well, parts that don’t go well, and what the parents and child do. She expressed her concerns. When we had shared all about the routine, I asked the question: “What could we focus on this week that will help us get bedtime to where you want it to be? It can be one small thing that is manageable to try.” Mom thought about it for a minute or two and then walked into the kitchen and changed the subject.

    Knowing this Mom, my best guess is that she left because she was overwhelmed with making a change. What other ways could I phrase the question to seem less overwhelming?

    • I agree that she was definitely communicating something and I think it’s great that you’re reflecting on the question you asked. I wonder if it might have been easier for her if you had picked one small part of the routine to focus on (if asking her to do that was too overwhelming). For instance, if she had reported that getting her child into his bed was a struggle because he kept climbing out, maybe just focus on that piece. Or, start with what went well and ask her why she thought it went well. Then you could see if there is a strategy you could borrow from that successful part and apply to the struggle. Another great question that someone else suggested in a comment is similar to what you asked: “If you could change one thing about bedtime, what would it be?” Another idea might be to gently bring up bedtime on your next visit and see if she’s had time to think about it and wants to tackle it now.

      I’d love to know how this goes if you get a chance to revisit the bedtime routine with this family!

  9. I have been surprise of the answers I get from parents when I formulate the right questions. The questions you presented are very helpful to stop and help parents and myself to take the time to reflect back on how an activity was helpful or not. Having several questions facilitate the analytical thinking. I tend to become distracted by the parents answers or by something that happened right at the moment and miss a more in depth reflection. Thanks for sharing them. I keep them written in a card in my folder to review them before hand.
    Thanks again

  10. The specificity of questions and ways or giving parents opportunities to problem solve are important. I am still learning to ask questions in this way, too, but have seen how they empower parents. One parent, whose
    bath time resembled your second description, reflected as we explored bathtime and dressing/undressing: “All my children would benefit from talking about what we’re doing. We just do it for them.” They started using these times for language (in their home language).

    • It sounds like your discussion offered a moment of insight for the parent. Whenever EI can improve overall family functioning – that’s when we know we’re really doing it right!

  11. I appreciate how this blog identified specific questions to ask rather than just using a question such as “what is your bath time routine?” I often hear from families that they do not have a routine and some families have shared that a lack of routine is a stressor for them. By asking questions and using reflective listening responses, families are often able to identify their own ideas for learning opportunities for their child. I was recently working with a family and asked “if you could change one part about _____, what would it be? Why?” Not only did this question allow for thoughtful reflection from the parents, but they told me that thinking about what they would like to change prompted them to look at their child’s strengths and build on them rather than thinking about the “problem” behavior. The parents shared that by coming up with their own ideas they were then able to plan for using the strategies in other situations as well. Thanks for this post 🙂

    • Wow, Naomi, it sounds like the way you framed your questions really opened up the discussion. The parents “ah-ha” moments about looking at strengths and coming up with their own ideas is profound. That kind of thinking is what parents can carry with them long after the child leaves EI. Thanks for sharing your great strategy!

  12. I have some families who often say “how can I get him to do _____.” In using a variation of this question “How does bath time work for you and your child? Tell me about what happens before, during, and after bath time.” I am able to share with them something like this, “I think we can come up with some things to try. Let’s talk about what you have tried so far. Since I haven’t seen him do this, tell me why you think that hasn’t been successful.” I find that telling caregivers early on in the conversation that we will come up with some ideas, reduces their pressing need for immediate answers and they are willing to walk you through their experience. Also, by reminding them that “I wasn’t there”, or haven’t seen the activity first hand, it opens the door to their willingness to give a more detailed description of the routine, activity or behavior that we are trying to problem solve together. Of course, I would like to join in the identified routine, but when those opportunities are not available and the parent is just firing “how do I” questions at you, this strategy has helped.

    • Great strategies, Yvonnie! This is a great way to diffuse the anxiety and immediacy that we and the parent both feel when discussing “how do I” questions, especially those that are emotionally laden, like “how do I get him to eat??” What you’ve done is help the parent step back a bit and give you both time to think and problem-solve.

  13. Thanks for the insight. I always struggle with adding new questions to dig further about routines.

  14. Thank you. This was very insightful and really appreciated the specific examples of questions to ask. I will use these right away and will be able to gain more pertinent specific information from families about their routines.

    • Glad to hear it, Chandra! Please let me know how it goes when you use them! I’d love to hear your impressions of whether or not the questions help you gather more or different info from what you’ve heard before.

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