Routines as a Protective Factor for Emerging Mental Health and Behavioral Problems in Children with Neurodevelopmental Delays

Objectives Children with neurodevelopmental delays show higher levels of externalizing behavioral problems, resulting in increased parental stress. This study aims to determine if the frequency of family routines moderates children's externalizing problems and associated parental stress based on children's cognitive ability longitudinally. Methods Children with neurodevelopmental delays and caregivers (N = 202) participated in assessments that included the Wechsler Preschool and Primary Scale of Intelligence-Forth Edition, Child Behavior Checklist, Parent Daily Report, and Family Routines Inventory. Child participants were 28 to 72 months old (M = 48.00, SD = 10.652) and predominantly male (69.3%). Results Frequency of family routines at baseline (b = - .375, SE = .112, p = .001) was associated with lower child externalizing behaviours at baseline (b = - .104, SE = .047, p = .031). Frequency of family routines moderated parental stress for children with average (i.e., at the mean; b = - .211, SE = .119, p = .08) and above average (i.e., 1SD above mean; b = - .436, SE = .177, p = .02) nonverbal skills. Longitudinally, increased frequency of family routines (b = - .193, SE = .092, p = .04) was associated with less child externalizing behaviors. Conclusions Findings demonstrate that routines may reduce parental stress, but the use of routines alone may be less practical for children with lower verbal skills. Additionally, the importance of routines for minimizing behavioral problems in children was significant for children with average or higher nonverbal skills at baseline, suggesting that nonverbal skills are protective for these children.

Automated summary

This study found that family routines can reduce parental stress, but may be less practical for children with lower verbal skills. The importance of routines for minimizing behavioral problems is significant for children with average or higher nonverbal skills.