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Making changes to routines, plans or expectations more manageable: A new 'Flexible Scheduling&#3

What is the project?

An exciting project which aims to develop a new system to help families address rigidity in their child’s routines and expectations. While maintaining the optimal level of structure to minimise

challenging behaviours related to change.

Why are we doing this?

Some children can find it very difficult to manage changes to routines, plans or expectations. These difficulties are common in Prader-Willi syndrome, as well as autism spectrum disorder and Fragile X syndrome, and can result in high levels of anxiety and temper outbursts. To support our children, we often create a structured environment to reduce their exposure to situations that might cause difficulty. However, rigid routines may enhance this anxiety through reinforcing this ‘fear’ of change. Also, having some opportunities to practise having flexibility in routines, may be important for the development of brain process involved in helping children deal with change successfully.

With this project, we are developing and testing the feasibility and acceptability of a game-like system, to help caregivers incorporate flexibility in a systematic way into their child’s routine. We are working with families to test the system to make sure we do all we can to make it useful and easy to use now. And to find out how to make it even more useful and easy to use in the future.

What have we done so far?

We have worked with parents to draw up a specification of how the system should look, feel and work. We have designed the system to be engaging for children, adaptable to individual preferences and needs, and which – in the child’s eye – places the responsibility for the flexibility with the game, not with parents. In other words, the caregiver programmes the flexibility, but for the child, the flexibility is all part of the system, so not the parents fault.​

We balanced the need for the system to be adaptable to families lives and easily integrated into their daily life. Along with the need for enough consistency in how flexibility is implemented, to encourage the development of the brain processes that are important.

Key concepts of the system:

  1. Provides structure into the child’s daily routine; allowing the child to track their own daily schedule (as shown below).

  1. Gradually exposes children to flexibility through a game-like experience.

  2. At a point in the day when the caregiver has programmed flexibility into a routine, the child sees a pointer spinning around various possible outcomes. The pointer lands on the alternative way of carrying out the routine that the parent has previously selected (illustrated below).

  1. We will incorporate in-built calming techniques available for the child to use to self-regulate before playing the game.

  1. Rewards are given to the child. Each star earned by the child gets them closer to a prize.


For further information on this project please contact:

Principle investigator

Dr. Kate Woodcock

Tel: 0121 414 6036

Project Coordinator

Siobhan Blackwell

Tel: 0121 414 3335

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