Increased Exposure to Rigid Routines can Lead to Increased Challenging Behavior Following Changes to Those Routines.

The team worked with three boys who have Prader-Willi syndrome. Each boy followed the same daily routine for either 2, 7, or 14 days.

On the last day the staff changed one small step in the routine. They counted how many temper outbursts happened and measured heart rate.

The longer the boy had lived with the routine, the bigger the meltdown when it changed. over the study period of the same schedule, one child had 12 outbursts in one hour.

Heart rate also jumped higher for the kids who had the routine longest.

Mansell et al. (2002) saw the same pattern with people who have severe ID. Staff said kids who clung to one caregiver had more challenging behavior.

Van Keer et al. (2017) showed the flip side: when parents stayed flexible and responsive, toddlers with delays paid more attention and started more play.

Together the three papers tell one story: fixed patterns—whether routines or relationships—raise problem behavior, while flexible ones help kids stay calm.

You can’t avoid every schedule change, but you can build wiggle room into the day. Switch the order of tasks, swap staff, or change the snack item on purpose. Start these mini-changes early and often so the child learns that ‘different’ is safe. Fewer meltdowns mean more time for teaching and less stress for everyone.