The Routines Based Interview
Written by Koh Kah Yong and Jewel Yi
Starting Your Therapy Journey With Us and Routines
Imagine meeting your occupational therapist for the first time, and they ask what they can help you with. Your mind races through a few examples, and you pick one that worries you. Your child has difficulties focusing on their homework - so homework is either not completed or it takes an unsustainable amount of time, energy and emotions to get it done. Thus, you tell the occupational therapist “I would like to see my child complete their homework quietly before dinner.”
Next, you get reminded of how you have to help your child get ready for school every morning. It causes a significant amount of stress for you because of the rush, and so you add: “I’ll also like my child to be more independent and to get ready for school in a shorter amount of time”. All these responses and goals are great, and can definitely be addressed in therapy sessions. However, there isn’t a lot of information regarding underlying factors.
Is your child facing issues with handwriting skills?
Does your child have difficulties focusing their attention?
Does your child need more breaks in between compared to other children?
Does your child need additional aids in understanding the material?
Does your instructions or encouragement need to be modified?
Is the environment too distracting?
Is your child’s sitting position too uncomfortable for homework?
and the list can go on indefinitely….
Take the example of completing homework - many factors could be hindering that task:
That is why at Wonders Therapy, we perform a preliminary observation session of your child, and a Routines-Based Interview with you before we commence occupational therapy sessions. This ensures that there is a holistic understanding of the child and family and that interventions planned will be relevant and specific to your routines. It also serves as a systematic way for clients to think through their concerns and not forget details that might be important for them.
The Routines-Bassed Interview (RBI) is a semi-structured clinical interview that is conducted by occupational therapists or other trained personnel. As the name suggests, the aim of the interview is to find out about the child and family’s routine in great detail - right from when a typical day starts till when it ends. This provides a rich description of the child and family functioning and allows the therapist to form a deeper understanding of their client (Mcwilliam, 2009). This comprehensive interview can take up to 60 minutes or more to complete.
Why the Routines-Based Interview?
Occupational Therapists (OTs) are focused on helping children participate optimally in their everyday tasks e.g. grooming, play skills, coping with schoolwork. Thus, information regarding how a child performs these activities as well as details about the moments before and after the activities can be very helpful in identifying causes of parent concerns and intervention formulation. In addition, the Routines-Based Interview allows therapists to gather valuable information such as the environmental setup where these activities happen, and the level of support available to the child at the time of activity.
What is the Routines-Based Interview?
The Routines-Based Interview is also a very relevant tool to use when conducting therapy in the natural environment. Knowing the family’s routine allows OTs to plan therapy sessions around specific challenging tasks, and to involve the people around the child (e.g. parents, teachers, peers, or siblings). These daily routines serve as meaningful contexts for the child and their family members to practice skills discussed during therapy sessions as they are predictable, functional, observable, and occur frequently (Jennings et al., 2012).
Lastly, routines not only inform therapists about the range of occupations family have to fulfil; it also provides information such as family attitudes, beliefs, and habits. These are all very valuable information for therapists to suggest interventions that will work for the family (McWilliam et al., 2009).
At Little Marvels, we pride ourselves in having a family-centered and person-centered therapy approach. Hence, it is paramount that we get to know you and your child well; and part of that understanding is gathered through knowing your routines. If you have any questions about the Routines-Based Interview or just want to get started, do feel free to contact us! In-person therapy services are based in sunny Singapore but we are happy to consult you wherever you are!
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Jennings, D., Frances Hanline, M., & Woods, J. (2012). Using Routines-Based Interventions in Early Childhood Special Education. https://www.wvsha.org/wp-content/uploads/events-manager-uploads/session-handouts/Handout%20Preschool%20Language%202.pdf
Mcwilliam, R. A. (2009). Protocol for the Routines-Based Interview. https://inclusioninstitute.fpg.unc.edu/sites/inclusioninstitute.fpg.unc.edu/files/handouts/McWilliam%20-%20Protocol%20for%20RBI.pdf
McWilliam, R. A., Casey, A. M., & Sims, J. (2009). The Routines-Based Interview. Infants & Young Children, 22(3), 224–233. doi:10.1097/iyc.0b013e3181abe1dd