By: Laura Petix, MS OTR/LEPISODE 110


I’ve always said that when we understand what’s going on beneath a behavior, it opens up so many doors to empathy, patience, problem-solving and strategies.

The behavior we’re looking at today is difficulty with changes in routine.

You know, like when you read books before putting on pajamas, or when they have to sit at a different seat at the table, or when you have to take a different way home from school because of construction. None of these pose any actual threat or risk to your child, but their extreme reactions sure seem like it.

These responses that can appear so disproportionate to what’s going on can lead to parental dysregulation and frustration, and we’re in no place to coregulate with our child. It can get messy, and I absolutely sympathize.

So let’s shed some light about what’s going on beneath the surface so that we can best support our kids through it.

What you’ll hear in this episode:

Why does your child depend on sameness and routine?

I’m going to outline three concepts that can contribute to our child’s dependence on predictability: the sensory component, executive functioning and interoception.

1. The work of processing sensory information

As an OT, I have become painfully aware of all of the sensory triggers in all of the environments. And you mini-OTs out there may feel the same! And when we look at the settings our child are asked to function in through this lens (noticing the sounds of traffic, flickering lights, chairs scraping the floor, temperature differences, dogs barking, scratchy carpets, the list goes on!), we can start to understand that the sensory component of routines can play a big role.

Remember that a person with sensory processing differences has a brain that has to work harder at processing sensory information that is generally automatic for many people.

So when environments are the same day in and day out, when routines are predictable, parts of the brain can go on autopilot, which means that the brain is using less energy to process that sensory information. That leaves more mental energy to do other things such as control impulses, manage emotional reactions, being patient, using words, all the things!

And the opposite is true: When the sensory landscape changes, or when they’re in a different or new environment (think hotels, birthday parties), our kids’ brains have to expend a significant amount of additional energy to process all this unexpected sensory information, and that leaves less mental energy to access skills they might exhibit otherwise.

2. Executive functioning

Executive functioning is a huge and incredibly important concept that parents of neurodivergent kids would be wise to understand.

We’re going to zoom in on the motor planning aspect of executive functioning. Motor planning involves the ability to conceive, plan, and execute a complex, non-routine motor activity in the proper order, from start to finish. This process relies on input from the senses and surroundings, as well as on linguistic, memory, and cognitive abilities.

So for example, the simple act of putting on a shirt requires a ton of motor planning skills! It may seem like a single, simple task to many, but let’s really break it down: First, the shirt needs to be oriented the right way so that it can go over the head and be facing frontwards. The shirt must be picked up in such a way to separate the two sides creating a hole for the head to go into. Without looking, you have to process the sensory information you’re getting from the shirt to find where the arms can go. If the shirt bunches up somewhere, you’ll need to figure out how to straighten it out. There are so many steps.

The same goes for dribbling a ball, finding a toy in your room, buckling your seatbelt, tying your shoes.

Now let’s bring it back to routines.

When there’s a motor task that your child’s brain has automated because it is the same every time, this task then requires very little brain energy.

But when environments change, when sequences change and things are out of place, this puts more work on our child’s executive functioning skills. Here are some real-life examples:

When a process that is otherwise automated is unexpectedly disrupted, the brain needs to use its finite energy to use those motor planning skills to complete a task. That leaves less energy for other skills like emotional regulation, etc.

3. Interoception

Whether it’s a change in sensory input, motor planning demands or anything else, we can agree that the feeling of dysregulation itself is uncomfortable. And perhaps the way that dysregulation feels in their body (tummy gets tight, heart rate increases, getting sweaty and clammy) could be just as much a trigger for more dysregulation as the change itself.

This is the sense of interoception, one of the eight senses, the ability to sense what’s happening inside the body, such as your heartbeat, hunger level, bladder fullness, etc. When kids with interoception challenges experience a big emotion, the way that feeling is experienced in the body (chest, hands, belly, face) can be overwhelming and can lead to more dysregulation.

Two ways to support our kids

Now that we understand why changes in routine can be so difficult for our kids, let’s think about how we can support them. We want to take a two-pronged approach: accommodation and skill-building. One is just as important as the other.

When to accommodate

On high-stakes days where you really want your child to be able to access those emotional regulation skills, we accommodate. And by accommodate, what I mean is allow the routines, sameness, familiarity to dictate their day as much as possible. For example, during the morning routine before school, on the day of the big school play, or before a birthday party.

When you’re on vacation, we know that many things will be different and unpredictable, but we can accommodate our kids by maintaining familiarity as much as possible. For example, bringing their bath towel from home, their spoon and fork, the same packaged snacks they’re used to.

Remember that when we need our kids to use their executive functioning skills, emotional regulation skills, impulse control, then we have to help their brain function as automatically and efficiently as possible.

Skill building

We can practice skill building on days that are more low-stakes, like when you have a slow weekend day when not much is required from your child’s nervous system.

How to practice little changes

It’s important to remember where your child’s skill level is when practicing these changes. Try to start slow, evaluating how they’re handling it as you go.

Additional tips

Episode Links

Why does my child hate changes in routine?
Laura Petix 0:01 Just think that the days when you really, really I know we say we always want them to be regulated. But the days when you really, really need to depend on their executive functioning skills, or their emotional regulation skills, and their social skills, you've got to make the rest of their...

Laura Petix 0:01 Just think that the days when you really, really I know we say we always want them to be regulated. But the days when you really, really need to depend on their executive functioning skills, or their emotional regulation skills, and their social skills, you’ve got to make the rest of their brain function as automatically and efficiently as possible. Welcome to the sensory wise solutions podcast for parents, where parents can get real actionable strategies to support kids with sensory processing disorder. I’m Laura, OT and mom to Lilyana a sensory sensitive kid who inherited my anxiety and my love for all things Disney. Consider me your new Oh, T mom, bestie. I know my stuff. But I also know what it’s really like in the trenches of parenting a child with sensory processing disorder. Speaker 1 0:55 Okay, mom, enough about me. That’s the podcast. Laura Petix 1:02 Hey, everyone, welcome back to the podcast. Do you have a kid who not only thrives on routine, but it’s completely lost, and dysregulated without it, maybe they get thrown off moody or upset if something in the day to day has changed unexpectedly, or they have a meltdown if you decide to read books before putting pajamas on. Or they are extremely upset by having to sit at a different spot at the table. Perhaps they become extremely anxious if you have to take a different route to school because of construction. But what about when changes in routine are fun, like when you’re on vacation and sleep or wakeup times change or they have a cousin sleepover in their room? Or they’re visiting grandma’s house and skip bath time? Surely they’re okay with those changes, right? Like those are fine. Wrong? Well, mostly wrong neurodivergent brains don’t truly differentiate between fun changes in routine and less fun changes in routine. Both of them can get coded as a threat and a danger that their brain wants to protect them from. And that is what we’re talking about today. Why Some kids are so prone to dysregulation when their routines change when their environment changes when unexpected things change and come up. And of course, how we can best support them. I have to start out by saying that I myself as a neurodivergent adult I find myself sometimes perplexed and bewildered at like out of nowhere irritability or moodiness or exhaustion, and I’m thinking, Why am I so off today? Or why am I so tired? And then when I reflect on the week, or days prior, I realize how many things were out of my routine. Whether it’s some schedule change for Lily on a school pickup, or doing a coffee date with a friend in the middle of a workday or a doctor’s appointment in the middle of the workday, the more things that shift and change in my week and my day to day life, the more cognitive load, and exhaustion and then irritability I experience. Now this isn’t to say that neurotypical people don’t experience the same disorientation from changes in their routine, but neurodivergent brains, myself included, become even more dysregulated and may take a little bit more effort to climb out of that dysregulation and to get back on track. So why does your child depend on sameness, and routine? Let’s think about that from a nervous system perspective. First of all, there are the sensory components as an OT, I cannot unsee all the sensory triggers at any given time in any given environment. As soon as something shifts, changes, location changes place is added or is removed. It can create subtle, yet still noticeable for some people, changes in the sensory processing sequence and experience. Remember, a person with sensory processing differences has a brain that has to work harder at some things that should generally be automatic. And if the brain has to work harder at those things that should be more automatic. That means it has less brain resources and energy to do other things like control impulses control their behavior, manage emotional reading actions be patient use their words, all of the things. So when environments are the same, when routines are the same day after day, parts of the brain can go more on autopilot, which is great to conserve brain space. But once something in the routine shifts, the brain wakes up from autopilot and is like, hey, that’s new. Okay, wait a second, gotta process that. And then it takes a little bit more energy away from the rest of the brain. And trust me, this can be more exhausting than you think, especially like I said to a neurodivergent person. Let’s think about a few examples. What about changing seats in the classroom, teachers love to change seats, maybe quarterly, maybe some other pattern in the year, but they change seats in the classroom. When a child even sits in the same spot, let’s say for circle time, every day, but today, there’s a new kid sitting next to them for whatever reason, that can throw off the way that morning, Pledge of Allegiance sounds, maybe the kid next to them has a louder voice, or maybe the way that they sing a song during morning song Time sounds different. What about using a different blanket on the bed, even if it’s the same brand, same size, same color, but just a, like an extra blanket, and maybe the other one is in the laundry, whether it’s the way that that blanket feels, or how tightly or loosely it lays on the bed, maybe it’s more prone to wrinkles, maybe this one smells more like the cabinet versus fresh laundry or like their own scent, smell. Whatever it is that change in that sensory experience might keep your child up at night. What about just walking a different route to school, maybe today, the shortcut that you usually take is full of mud, and you can’t really walk through there. So you have to go the long way and pass by two houses with dogs in the front yard that are barking, and maybe neighbors who start conversation with your child that make them feel uncomfortable. Another reason why sameness and routine is preferred is because it helps automate a lot of the actions required for certain tasks. So I’m thinking motor actions and executive functioning skills. So think of how, right now if it was in the middle of the night, you could walk to the bathroom flip open the toilet seat, reach for the toilet paper without even fully opening your eyes like full zombie mode, half asleep. But when you’re in a hotel room, that’s not exactly the case, you might bump into things or you might have to fully open your eyes and really look around. Or maybe your route to work. When you’re driving to work, you take the exact same three, right turns one left turn, and then two stop signs before turning right into your into the parking lot. But when there’s construction, you have to be rerouted the back way and suddenly you’re unable to zone out and think about what you’re making for dinner and you have to actually focus on where you’re at, you have to focus on the stoplight, you have to focus on the streets. When routines, and sequences or environments change when things are out of place. This all puts more work on our executive functioning and our motor skills. So some examples of this for kids. If you give them the different cup, or the different plate or utensil, let’s say maybe this plate doesn’t have the same high lip as the last one. So when they scoop out their pasta, the pasta is falling over the plate. So they have to use their other hand to help scoop. Maybe the babysitter is putting them to bed that night because you’re out and they put the toothpaste on before wetting the toothbrush, how dare they. And that change in sequence throws off your child’s routines, the steps that they’re used to. So they might get upset and then have to start the whole task over. Let’s say there is a substitute teacher that day at school and the order that the substitute teacher does morning routine. Maybe they switch calendar time and whether time which confuses your child and made it difficult for your child to participate. Maybe they had prepared an answer for what day of the week it was and they were thrown off. And this can cause some moodiness, behavior challenges and dysregulation. Another thing that we want to think about when we are wondering why our kids have such big reactions, such big behavioral shifts around routine changes is interoception. So whether it’s the sensory element, the cognitive load or something else we can’t quite figure out. Something is triggering your child into this regulation around unexpected changes and routine changes. And whatever that underlying reason is, we can agree. They’re experiencing some discomfort in their internal sensations. So maybe they’re noticing their tummy getting tight, their heart rate increasing their hands or face getting sweaty and clammy. And those sensations are uncomfortable to them. And they might be having reactions to those sensations just as much, if not more than they are to the actual changes themselves. So how can we support these kids? What is the best way to handle this as someone who is resistant to change, and very, very much prefers familiarity and routine, over novelty and surprises, and also someone who works with these kids professionally, I can say that the best way to support them is finding a balance between accommodating and some skill building practice scenarios. So here’s how I tackle this on high stakes days, or when days that your child really, really needs to be the most regulated, we accommodate them, which means, you know, allow the routines, the sameness, the familiarity to dictate their day as much as possible where we can. So I’m thinking school days, or days when they have a play or an assembly, or birthday party days, or travel days, when you know, there’s they have to be on a lot that day, or when you know, there’s already going to be an outstanding amount of pressure and stress on their nervous system more than normal, then you want to try to preserve sameness and routine wherever you can. When you go on vacation, keep as many things as you can familiar. But of course, when you’re on vacation, there’s going to be things you can’t control, like time change, weather, sleeping arrangements, food that’s available all of those things wherever you can keep sameness and routine, even in something as small as bringing their pillowcase from home, or making sure that they have their favorite pair of socks with them on vacation, whatever you can do to help them feel as safe and familiar as possible. That will help a little bit. Just think that the days when you really, really I know we say we always want them to be regulated. But the days when you really, really need to depend on their executive functioning skills, or their emotional regulation skills and their social skills, you’ve got to make the rest of their brain function as automatically and efficiently as possible. So then, on the days, when they are more low stakes, not much going on maybe a slow weekend or morning or on a Friday have a three day weekend, you try to build in intentional ways to practice little changes, the more that you can make time for this, the better they’ll get at understanding the changes, it might not mean that they’re less impacted or less reactive to the changes, but at least they’ll have a better strategy of coping with them. Maybe they’ll have more pathways to regulation around these changes. And they’ll be able to better understand why they happen. And they’ll also become better at understanding that they’re not really in control of some of these changes. So how can we practice little changes, like I mentioned on those low stakes, low stress days, the first thing I will say is try to tell them that it’s coming. This sounds counterintuitive. Most changes that happen are unexpected. And so don’t we want them to to practice it as it’s unexpected. Yes, but those times are going to come when we want to practice this intentionally. We want to do it very slowly and in a way that’s gentle to them. So when we are planning to do something different, tell them it’s coming prepare them, maybe you might say something like today we are going to do bedtime routine a little different. I know it might feel scary because it’s new, but I promise we’re going to do everything on the bedtime list. It’s just going to be in a different order today. A couple ideas for you to do at home. You could do backwards de and do everything and backwards order. Maybe you wear T shirts backwards, sit at the table backward, walk backward, do the order of brushing teeth backward. Anything that’s silly and fun and backwards. Of course it’s playful and fun. So they’re going to buy into it but it is actually doing things in a different way. You could do something as small as having breakfast food for dinner or having dinner food for breakfast. You You could rely on randomization. So rolling a dice, pulling a card, picking straws, doing a spinner from a game. And maybe you all randomly choose what seat you’re sitting at for dinner, or what color plate you get for dinner, whatever the normal issue or routine is, but you randomize it, so it’s out of their control, but in a fun way, and everybody is participating in the change. Lastly, you could intentionally change things on the schedule. So you lay out the schedule for the day, maybe you say, maybe you put park on a visual schedule, or you say, we’re gonna go to the park, intending to go to the one park that they know if it’s a familiar park that they like, but then you intentionally change parks last minute or change to maybe an indoor play space instead. So you might overly narrate it, like, oh, man, you know what I just realized, I need to fill up on gas, we’re not going to get to that park that we plan to go to on the corner. Instead, we’re gonna have to go to the one by the gas station, oops, that’s gonna feel different. But we can still have fun. Let’s go and you’re going to go do the thing. And, again, there will be feelings that come with this, it doesn’t make it that it’s a smooth process. But this is how you practice it at in a controlled way. Ideally, over time, they learn how to process the feelings that come with routine changes. Definitely not overnight. And it’s definitely a process, but it should be practiced when you can. A few other tips to help before I sign off. Today, I’m gonna put in another plug for using things like social stories, and verbal preparation for the possibility of plans changing. If you want more ideas about social stories, head to Episode 85. So just the OT 85 That tells you all about how to use social stories and what exactly it is. But that can definitely help with this kind of scenario. Something else that I’ve done. Since Liliana was younger, and I still sometimes do this to this day is I use language like, okay, the plan and I emphasize the word plan. I say the plan is to go to the park and then the carwash. sometimes plans change, we’ll see what happens. Like we have this ongoing thing. What happens with plans, plans change, sometimes plans don’t go as we expect, so she knows that. So I emphasize the word plan. Here’s the plan for today. But you know, sometimes, like the weather or traffic or things like that. So I introduced her to that that language. I also did a lot of narrating when things changed. Like for me it and I did not expect it to be a lesson or conversation. I was just saying things out loud. And it was exaggerated. Okay. But I knew it was a moment to teach her. So I might, as I’m ordering and Instacart I might say, Oh man, they didn’t have my favorite brand of coffee creamer. I have to use a different brand or a different flavor bomber. Again, not expecting her to say anything but just having her witness. Things change and gotta go with the flow. Or I might say something like, Oh man, I didn’t get to go to the library today before it closed, my phone call took a lot longer than expected. And literally just saying that, the more that that happens, I promise it sinks in for them and they don’t have to be mentioning anything or saying anything back. Lastly, don’t forget about proactive sensory regulation tools. This is where putting in the work proactively and exploring all of the sensory regulation tools can come into play. So when you find a good set of tools that work for your child, whether it’s something to squeeze, whether it’s a breathing technique, whether it’s gum, whether it’s a tight hug, or any sort of sensory tool that you know works for your child, the more that you can proactively practice them and explore them. And the more that they know how to use them, the more likely they are able to access them and use them when things like an unexpected schedule change happens and you’ll know what tools to try out to help them regulate through that change. All right, that is it for this episode. I hope it was helpful. I will see you all next week. If you enjoyed this podcast, please consider rating it and leaving a review which helps other parents find me as well. Want to learn more from me. I share tons more over on Instagram at the OT butterfly. See you next time. Transcribed by




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Laura Petix, MS OTR/L

I’m an enneagram 6, so my brain is constantly moving. My OT lenses never turn off and I can’t “un-see” the sensory and other developmental skills that go in to literally every activity. I love taking what I see and breaking it down into simple terms so parents can understand what goes into their child’s behavior and skills.

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