Top Ten Bedtime Strategies for Your Child with ASD

child sleepingBy Kristin Giglio, M. Ed., BCBA

Sleep is an essential component of good health and overall wellness.  Even though we do not completely understand all of its unique functions, sleeping is critical for growth, the restoration of our body, mind, and immune systems, and it enhances our memory and ability to learn.

All parents periodically have to deal with children who have ongoing difficulties falling asleep or staying asleep through the night and/or naptimes. These temporary sleep patterns and difficulties are completely normal. However, children with autism spectrum disorder (ASD) appear to have more sleep-related difficulties.

These difficulties can include:

  • Irregular sleeping and waking patterns.
  • Sleeping much less than expected for their age, or being awake for more than an hour during the night.
  • Getting up and playing, walking, and making noise for one or more hours during the night.
  • Excessive sleepiness during the day; can include naptime issues which can also affect sleeping through the night when age appropriate.

According to the Sleep Heath Foundation, the amount of sleep you need is based on your age:

sleep required chart

For children with ASD, inadequate sleep can have negative effects on daytime routines and behaviors, making some challenging routines or behaviors worse. In addition, sleeping issues for the child can lead to sleeping difficulties for parents as well as siblings, contributing to the overall challenge and stress of parenting. No one can function their best when they are deprived of adequate sleep, especially on an ongoing basis.

Ten bedtime strategies to help lessen sleep difficulties and restore sleep:

  1. Start a sleep diary/journal> Describe how and when the issues occur. Define the issues in order to help identify the problem:

*Going to sleep

*Staying asleep

*Irregular sleep phases (hours the child is asleep)

  1. Look for any patterns or physical problems that could be impairing sleep; consult your Doctor/Neurologist/Occupational Therapist/Psychiatrist/etc. to rule out any underlying issues if there are concerns, prior diagnosis, or if there are medications involved.
  2. Consult with a Behavior Analyst (BCBA) to address any behavioral issues associated with sleeping, gain assistance in identifying environmental factors, and receive guidance in creating an appropriate schedule and bedtime routine.
  3. Build a bedtime routine:

*Be consistent. Set a regular bedtime and stick to it.

*Implementing the use of a social story or visual schedule that your child can understand can assist with establishing a regular bedtime routine. Some children are not able to use a visual schedule that uses photos, icons, or words.  If that is the case, objects can be used instead.  Some examples of bedtime visual schedules include:

 

bedtime visual schedule 1  bedtime visual schedule 2

bedtime visual schedule 3  bedtime visual schedule 4

 

  1. Avoid excessive stimulation and play before bedtime. During the day, help your child get plenty of exercise and engage in outdoor activities.

*Fun outdoor activities such as, swimming, riding bikes, water play, walking the dog, running, playing on the swings and slides at the park, and engaging in ball play, etc. can help expend your child’s energy, assisting in healthy regulation later in the day.

*Prior to bed, attempt to engage your child in calming and relaxing activities for 1-2 hours prior to their scheduled bedtime. These activities could include taking a bath, reading, listening to music, yoga, keeping the lights down low, massage, and eating a light snack.

  1. Designate a place for your child to sleep and enforce that your child sleep in that area during each nap/bedtime. Obviously, life happens so try and maintain as similar routine and sleep environment (ex. separate room, low light, common toys/blankets, etc.) as possible when you are traveling or staying in alternate environments.
  2. Create a calm and relaxing sleep environment. Here are some ways to make bedtime welcoming and comforting:

*Use pillows, blankets, sheets, and fabrics that your child likes. Using extra blankets and pillows can provide a comforting level of pressure that can promote the bodies calming and regulatory processes.

*Using night lights can be calming and promote a relaxing atmosphere.

*Adding white noise such as a fan, CD, or instrumental music, can be helpful; however, note that it should stay on all night if on if at bedtime and be sure it is not over stimulating.

*Provide a comfortable mattress to sleep on. We all know how wonderful sleeping on a good mattress feels and how good we sleep.  We feel more refreshed and have more energy and that affects everything we do.

*Make sure bedtime clothing isn’t restricting and is fitting and comfortable. Take note if your child is sweating or removing clothing during the night; adjust bedding, clothing choices, and temperatures as needed.

  1. Do not allow wandering out of designated sleep area or room. Use a gate, or alarm/bell on the door if necessary to deter wandering at night.  You can use a video monitoring device/camera to monitor sleeping as well.
  2. Remove all distracting items from the sleep environment. This includes: televisions, computers, hand held games and devices, stimulating toys, etc.
  3. Maintain the sleep environment and the bedtime schedule on a regular basis.

Use these strategies on a consistent basis to promote healthy sleep patterns and encourage a bedtime routine for your child and family that is welcomed and comforting to everyone in your home.

Carolina Center for ABA & Autism Treatment has Board Certified Behavior Analysts on staff that can write an individualized program to address your child's specific needs. Please don't hesitate to reach out to us if we can be of assistance.

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References:

Jin, C.S., Hanley, G. P., & Beaulieu, L. (2013). An individualized and comprehensive approach to treating sleep problems in young children.  Journal of Applied Behavior Analysis, 46, 161-180.

Pierce, J. & Bidder, J. (1999). Baby & Toddler Sleep Program: How to get your child to sleep through the night, every night.  Tucson, Arizona: Fisher Books.

Notbohm, E & Zysk, V. (2010). 1001 Great Ideas for Teaching and Raising Children with Autism or Asperger’s.  Arlington, Texas: Future Horizons.

Powers, M. (2000). Children with Autism: A Parent’s Guide, 2nd edition. Bethesda, Maryland: Woodbine House.

“Quick Tips: Improving Sleep for Children with Autism”- www.autismspeaks.com

“Quantity vs Quality - How much sleep do you really need?”- www.sleepclinicservices.com

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1 Comments
  1. Denise DeCandia
    January 27, 2016 at 11:51
    Reply

    Thank you, Kristin for sharing these insights! So helpful and well-written!

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