Sleep is something that we all desperately need but it can be difficult to get enough of it. According to sleep experts a 7-12 year old should be getting approximately 10-11 hours of sleep every night. Unfortunately there are many children, and even more children with autism, that are simply not getting anywhere near enough sleep.
The way that each child's sleep is affected is unique. For example, for one child it may be that they have a really hard time falling to sleep. They may cry for long periods of time, call out for a parent incessantly and/or repeatedly get out of bed. Yet for another, it might be that they wake up several times in the middle of the night, and have a hard time falling back to sleep.
As a mother of two young children I know what it is like to deal with the bedtime and sleep woes. If any of the situations described above sound familiar to you, I am here to tell you that there is hope. As a Board Certified Behavior Analyst (BCBA), I have learned through the work of other experts in the field and from working with families, that falling asleep relatively quickly can be learned, and that waking up in the middle of the night and going back to sleep can be learned. In this article I share tips and strategies that have been adapted from the work of experts in the field of Behaviour Analysis that will hopefully lead to you and your family getting proper sleep and feeling well rested every morning!
Tip #1 Keep the bedroom cozy and calm
It is important to create a calm and comfortable bedroom that includes the ideal conditions to facilitate sleep. This means that we should keep the activities in the bedroom, particularly on the bed, to things that are calm. For example, I would not be playing any games that are physically stimulating like jumping on the bed just before bedtime. It is also a good idea to put the more stimulating activities in a different room. This means keeping the television, technology, and favourite toys out of this room as well. Some experts say that the ideal conditions for sleep include a temperature that is a little on the cool side but not too cool. That lighting should be from a nightlight and not too bright. I once worked with a child with autism that experienced more night awakenings right after we replaced the bulb in the night light because it was just different enough to affect his sleep.
Tip #2 Develop a consistent routine
A routine that is consistent is predictable, and this may help prevent some of the bedtime woes described above. When deciding what your personal routine will look like make sure to factor in some winding down time. The activities that are done just before you get into the routine should be less stimulating and more calming. You know your child and your family the best so you would create a routine that is consistently used most nights that reflects the types of things you do. Check out our blog on setting goals for more tips on developing a bedtime routine.
Tip #3 Sleep dependencies
Experts suggest that sometimes our children have sleep dependencies that affect his/her ability to get a proper rest. Sleep dependencies are essentially things in the environment that your child needs to have in place to fall asleep. For example, this might be a soother for one child or it might be you rocking them to sleep. If in the middle of the night they wake up, which happens quite regularly for most, they are unable to fall back to sleep if that thing/person is not there. Experts suggest using things that are readily available in your absence and can be there if you happen to be at a relative's home or somewhere else. Examples include: pillows, or a stuffed animal. For more information on sleep dependencies please take a look at the references cited at the end of this article.
Tip #4 Bedtime pass
If your child is getting out of bed a lot at bedtime or calling out to you and asking for a number of things, your family might be a good candidate for the bedtime pass. This strategy involves giving your child a bedtime pass, literally in the form of pass card that they can use to ask for something that they want. In some instances you might start out with 3 passes and gradually after a few nights reduce it to 2 passes then 1 pass. They can ask for you to bring them something like a drink of water or to leave his/her room for as many times as they have a pass. The cool thing about the pass is that it appears that children really like this strategy as well. Check out the article below for more information on how to use the bedtime pass.
Sleep is critical for all of us. If you try the tips listed above and you are still having challenges then you may wish to contact a local BCBA to help you assess the real reason for your child's sleep problem. Once they have identified the reason they can help you develop an individualized plan that addresses your unique situation. Everyone deserves to feel rested in the morning!
Sarah Kupferschmidt, MA, BCBA
Many of the tips and strategies discussed were adapted from a variety of resources published by leading experts in this area. Here is a list of the resources that were used.
Durand, V.M. (1999). Sleep Better! A guide to improving sleep for children with special needs. Baltimore MD: Paul H. Brookes Publishing Co.
Friman, P.C., Hoff, K.E., Schnoes, C., Freeman, K.A., Woods D.W., & Blum, N. (1999). The bedtime pass: An approach to bedtime crying and leaving the room. Archives of Paediatrics & Adolescent Medicine, 153, 1027-1029. doi: 10.1001/archpedi. 153.10.1027
Jin, C.S., Hanley, G.P., Beaulieu, L. (2013). An individualized and comprehensive approach to treating sleep problems in young children. Journal of Applied Behaviour Analysis, 46, 161-180.
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