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For people with Down syndrome, family members, caregivers and professionals.

The Groove in People with Down Syndrome

November 2023 | Brian Chicoine, MD and Katie Frank, PhD, OTR/L - Adult Down Syndrome Center

Key Points

  • The groove is a preference for sameness, repetition, or routine.

  • Many (but not all) people with Down syndrome have grooves.

  • There are advantages and disadvantages to having grooves.

  • Flexibility is important to help prevent a groove from getting "stuck" or address a groove if it gets stuck.

  • There are strategies to prevent or address a "stuck" groove.


What is the groove?

The groove is a preference for sameness, repetition, or routine. Many (but not all) people with Down syndrome have grooves. Here is an example of the groove of a person with Down syndrome from Mental Wellness in Adults with Down Syndrome:

Don would wake each workday at the same time and invariably follow the same routine. First, he would have his toast and juice, then shave, shower, and dress in the same meticulous way. He was always clean and well-groomed for work, and his boss could count on him to be punctual and reliable. After work Don would have a snack, do his chores (take out the garbage, set the table), and make sure everything in his room was put away. Each Tuesday he would wash his clothes; Wednesdays he would pick up and vacuum the house. After dinner Don would relax in his room with his favorite movie or music while writing in his notebook or doing word search puzzles. Saturdays he would get up at the same time to eat breakfast; shave, shower, and dress; then head off to bowling and later to social club. Don’s family was accustomed to his regularity; he was very reliable with his routines.


Other examples of the groove are:

  • Completing a task in the same way each time it is done

  • Starting a task over if they are interrupted during the task

  • Listening to the same music

  • Watching the same TV shows or movies

  • Repeating familiar phrases

  • Writing words repetitively in a journal


What are possible advantages of the groove?

The groove can...

  • Give order and structure in daily life

  • Help with completing tasks successfully

  • Increase independence

  • Help manage stress


What are possible disadvantages of the groove?

The groove can make it difficult to...

  • Be flexible

  • Transition from one task to the next

  • Deal with changes

  • Take skills learned in one setting (such as school) and use them in another setting (such as at home)


Some people become “stuck” in their groove. It may take them longer and longer to complete a routine. They may spend so much time on their groove that they stop participating in activities or interacting with others.


What can cause a person's groove to become stuck?

A change in a person's groove can be a sign that something else is going on in the person's life. It can be caused by...

  • Stress

  • Physical pain or ailment

  • Mental illness

  • Dementia

  • Sensory issues

  • Situations at home, school, or work


Can you prevent grooves from becoming stuck?

Flexibility is important for preventing grooves from becoming stuck. Teaching flexibility is an ongoing process. It involves respecting the groove while also helping the person see other options. One way to do this is pointing out examples of being flexible. For example, you might say, “Dad usually rides his bike on Saturday mornings. He is going to be flexible and ride his bike on Sunday so we can go to the beach on Saturday.”

You can also build in opportunities to change the groove and be flexible. For example, you can change up the dinner menu. If a person eats pasta for dinner every Thursday, make a different meal occasionally. Involve the person by asking them to pick from two other meal choices.


How can problematic grooves be addressed?

Teach others about the groove.

The groove may not need to be addressed if it does not hurt the person or other people. For example, some employers are willing to make changes to allow for an individual’s groove. The employer might assign tasks in the same order during each of the person’s shifts. They might avoid assigning a new task before the person has completed their current task.

Use visual supports.

Calendars, first then boards, and social stories are just a few examples. For example, if a person only wants to watch the movie High School Musical, you could talk with the person about picking one day during the week to watch the movie. Then you could write it on a calendar, so they know which day is High School Musical day. You could also use a first then board. First, we go on a walk, then you watch High School Musical. Our Visual Supports article provides additional examples and suggestions.

Set time limits.

This can be helpful for grooves that take a long time. Set a timer. When the timer goes off, it is time to move to the next task. Songs can also be used. When the song ends, it is time to move to the next task.


These are just a few strategies. Additional strategies are shared in:

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Please note: The information on this site is for educational purposes only and is not intended to serve as a substitute for a medical, psychiatric, mental health, or behavioral evaluation, diagnosis, or treatment plan by a qualified professional. We recommend you review the educational material with your health providers regarding the specifics of your health care needs.