Getting Autistic Child To Sleep
You can try the following steps to get your child to good sleep.
1. Begin a sleep journal: Describe when and how the issues happen. Define the issues so that the problem can be identified.
2. Find out any physical problems or patterns that may be causing impairment of sleep. You can consult your physician, occupational therapist, neurologist, etc. to rule out any medical conditions, prior diagnosis or in case your kid is taking any medicines.
3. Consult a Behavior Analyst so as to address behavior issues that may be causing sleeping impairment. It may also help in gaining assistance in identifying any environmental factors and receiving guidance in forming a bedtime routine and schedule.
4. Create an appropriate bedtime routine: Consistency is the key. Create a regular bedtime routine and try to stick to it. You can use a visual schedule, which your kid can understand to assist in establishing a bedtime routine. Some kids may not understand a visual schedule which uses icons, words or photos. In such cases, you can use objects.
5. Avoid excessive play and stimulation before bedtime in order to getting autistic child to sleep. Your child should be engaged in plenty of outdoor activities and exercise during the day.
6. Designate a fixed place for your kid to sleep and make sure that they sleep in that place only during bedtime. Try to maintain a similar sleep environment and routine as possible while travelling or living in different environments.
What About Medicine?
Assess Your Existing Bedtime Routine
Establishing a consistent bedtime and bedtime routine can help your child begin to calm himself down. This routine is important for all children, but even more so for children with autism.
A warm aromatherapy bath, short story, and lotion massage can help offer calming sensory input while providing visuals of the routine supports predictability and understanding.
Teach Your Child To Sleep Alone
Many parents of children with autism fall into the habit of lying down with their kids to get them to sleep. While this can be a precious time to connect with your child, it reinforces their perceived need to have you near them in order to sleep. That means you are indispensable at bedtime as well as when your child awakens in the middle of the night. And thats not good for either of you.
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Incorporate Physical Activity During The Day
Exercise is important for everyone, but especially for supporting your child on the spectrum. Its shown to not only improve anxiety and stress levels, but it will help increase melatonin production, which is needed to regulate our sleep-wake cycles. Increasing your childs physical activity level will help them use more energy which will help them to fall asleep faster at night.
Causes Of Sleep Issues In Autism
As with so many symptoms of autism, the causes of sleeplessness are not well understood. A few possible theories include:
- Genetics: The genetic causes of autism itself may have some impact on the ability of people with autism to fall asleep, stay asleep, and awake refreshed.
- Sensory issues: Most people with autism are hyper-responsive to sensory input perhaps they have a harder time sleeping because they can’t easily block out noises and sensations that disturb their rest.
- Lack of melatonin: Some studies suggest that people with autism produce less melatonin at night than do neurotypical people.
- Physical or mental illness: In addition to sleep-related challenges, many people with autism have other physical and mental illnesses that may impact sleep sleep apnea, acid reflux, seizure disorders, obsessive-compulsive disorder, ADHD, and anxiety can all make it harder to sleep.
In addition to these possible causes, people with autism may also find it harder to just “let go” of the day’s cares and interests.
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Treatments For Sleep Problems
While changes to the bedtime routine are probably best to help your child sleep, there are some treatments available if those dont work alone.
- Melatonin supplements can help some children fall asleep. If you want to try these, make sure you talk to your childs doctor first and follow their directions.
- Some doctors will prescribe certain medications to help children sleep better. Talk to your childs doctor about what medicine could help your child. Note that your child could be referred to a psychiatrist for medication management.
- Some parents have found that weighted blankets help their child sleep better.
- If you believe your child has sleep apnea, talk to your childs doctor right away. They may refer your child to a neurologist or other specialist for diagnosis and treatment.
Sleeping well is essential for our body and minds. If your child has trouble sleeping, try the bedtime routine changes first. Talk to your childs doctor if those dont help enough to make sure your child is examined for any underlying condition or for treatment of sleep.
Does your child with autism and ADHD have difficulty with sleep? What has worked well for your child to sleep better? Leave a comment so that we can share and encourage one another on this journey!
Sleep Is Critical To Health
“Without sleep nothing else goes right, really,” says Professor Sarah Blunden, a psychologist and head of paediatric sleep research at Central Queensland University.
“It’s much more difficult to control your emotions, to understand, to learn, to memorise, to concentrate, to regulate your behaviour. All these things that children have challenges with anyway, a child with autism has double-whammy.”
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Keep A Sleep Journal For Your Child
Its important to note that what works for one child may not work for another, so keep a sleep journal to help you remember what has worked and what has not. Maybe an 8:00 p.m. bedtime will allow your child to sleep until 6:30 a.m., but going to bed at 7:00 p.m. results in a 4:00 a.m. wake-up. Or maybe you need to change the bedtime routine to help your child get to sleep. Keeping a journal will help you to analyze your routine and wake-up times to make minor adjustments to make sure that everyone is getting restorative sleep.In addition to these recommendations, I would also encourage you to try to mitigate potential sleep barriers during the day, such as caffeine, excessive television, and rough housing . If you have more than one child, you may have to create multiple bedtime routines. For your children who are not on the Spectrum, you may want to consider separate, or stacked bedtimes.Stacked bedtimes allow you as the parent individual time with each child, and also helps each child learn to fall asleep using their individual resources. Be careful to observe a low noise level with any children that are still awake during each individual bedtime routine.I realize that there are quite a few suggestions here, so I would encourage you to take what works for your family, one suggestion at a time. If sleep is still an issue, please see your pediatrician.
An Imbalance In Melatonin Secretion
Another theory about what causes sleep disorders in autistic children relates to the production of the hormone melatonin. Usually, melatonin helps us fall asleep and regulate our sleep and wake cycles. To produce melatonin, the body needs an amino acid called tryptophan, which has been observed in low or high quantities in an autistic child.
This demonstrates a clear connection between autism and sleep problems. Usually, melatonin levels rise in the evening and decrease in the morning. Studies show that some children with autism dont secrete melatonin at the right time of day, with high levels during the day and low levels at night.
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Sleeping Routines For Older Children That Can Help
When I took the sleep course, Marc had not been diagnosed with autism yet. Knowing what I know now, I would recommend to try this sleep routine to any parent of a child with autism. Our children love routines and predictability.
- Use PECS symbols if they aid the process.
- Have special toys only for bedtime.
- Read a book that is only read at bedtime, which will make the book special.
- Be consistent and firm with your expectations.
- If your child is a night-waker, see if there is a disruption in a bedroom set- up such as a teddy bear positioned a certain way on the bed.
- Teach your child how to rearrange his things if they become dislodged in the night.
- Do not allow screens and tech toys to be played with in bed or right before bedtime as they are stimulating.
- Do not eat right before bedtime.
What Medications May Be Helpful In Addressing Sleep Issues
Medications
Medication is rarely the first line of treatment neither is it used in isolation when addressing sleep issues. Nevertheless, a trial of medication in conjunction with nonpharmacologic strategies is reasonable for refractory sleep issues after behavioral interventions have been exhausted.
When parents request medication to help with their childs sleep, be sure to discuss with them that there are no Food and Drug Administration -approved medications for pediatric insomnia. That being said, research has been done on the pharmacological agents melatonin and clonidine, supporting their effectiveness in improving the sleep of children with ASD.
Melatonin
Melatonin is neurohormone secreted by the pineal gland that is known to organize the bodys circadian rhythm and thus help promote sleep.
Clonidine
Clonidine, a centrally acting alpha-2 agonist, is another medication that has been studied to reduce sleep initiation latency and night awakening in children with ASD.
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Set Up A Bedtime Routine
A regular bedtime routine starting around the same time each night encourages good sleep patterns. A bedtime routine of bath, story and bed can help younger children feel ready for sleep. For older children, the routine might include a quiet chat with you about the day then some time alone relaxing before lights out.
Autistic children might need some extra support to get used to a bedtime routine. Here are some ideas:
- Give your child clear and consistent cues when its nearly bedtime. For example, 30 minutes before bedtime, start some quiet activities like reading or drawing in the family room. Then 15 minutes before bedtime, get your child to clean their teeth and go to the toilet.
- Use a visual support with pictures showing your childs bedtime routine, so your child understands the steps. For example, put on pyjamas, clean teeth, go to the toilet, get into bed, have a bedtime story, turn out light.
- Put stickers on the visual support to show when your child completes a step correctly.
- Praise your child for successfully completing steps in the routine. For younger children, you could use a reward chart.
- If your child gets upset or wakes during the night, quietly and calmly put your child back to bed. Settle them and remind them of the sleep routine using words or pictures. You might need to do this many times.
Gluten Casein And Other Reactive Foods
Gluten is found in barley, wheat, and rye casein is found in milk and some dairy products. If gluten and/or casein causes your child to experience a reaction, such as a change in behavior or digestive upset, there may be a chance that these foods are impacting your childs sleep.
A study published in BioMed Research International found that the immune systems of a subgroup of children with ASD are triggered by gluten and casein. An immune reaction will trigger the release of chemicals that both promote inflammation and disrupt sleep. This situation is not limited to just gluten and casein. Any food can trigger the immune system however, the more common culprits include soy, corn, and egg.
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Remember: Wanting Your Child To Sleep Is Not A Cruel Thing
It is a necessity for both you and your child in order to function at an optimum level the next day.
I did the sleep routine with my Julia when she was five months old and Ive never looked back. She also has autism. She is 18 now and also an excellent sleeper. We had issues with her around the age of 2 getting up at 3 am for the day and that took some time to stop. Julia also wound up in our bed at age 6 for a year until we bought her bunk beds for her 7th birthday. She liked the idea of sleeping up high. She is still sleeping in the top bunk.
There are many books out there on the subject of sleep, but I found this sleep training method worked for us. Everyone needs a good nights sleep to be at his or her best. Try the sleep routine, adapting it to make it personal for your child. Sweet dreams! See you in the morning
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Create A Positive Bedtime Routine
Routines are useful for human beings, autistic or not. But as we mentioned earlier, autistic kids are extremely fond of routine, and have trouble adapting when a routine changes. Also, if you establish a bedtime routine with positive rituals associated with going to sleep, they are more likely to know when its time for bed.
Its important to keep this routine consistent every night and to do activities in the same order every time. It might help to have a checklist that your child can follow and check off once tasks are completed to give them a sense of accomplishment. Ideally start this routine around 30 45 minutes before its time for them to shut their eyes.
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Autism & Sleep Problems
It’s remarkably common for people with autism to struggle with sleep problems. Those issues can look very different from child to child.
Some children with autism live with:
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Disrupted sleep. A 2019 study found that 80% of autistic preschoolers live with this problem. They may fall asleep, but they awaken over and over throughout the night.
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Delayed sleep latency. Many people fall asleep as soon as they climb into bed. But researchers say it takes a person with autism 11 minutes longer to fall asleep than someone without autism.
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Poor sleep quality. Deep sleep stages are restorative. When we slip into them, our tissues heal and our brain cells rest. Researchers say people with autism spend less time in these healing sleep stages and more time in the light stages of sleep.
Just as parents may come to dread the approach of bedtime, so do many children with autism. They envision long stretches of darkness where their minds race and their bodies tingle with activity. They might know they should be asleep. They may desperately try to fall asleep. But sleep eludes them night after night.
Researchers aren’t entirely sure why autism and sleep problems often coexist. But some new studies may shine a light on the link.
In 2019, researchers in Washington state identified a gene associated with sleep latency and sleep quality problems. In studies with mice, they found that eliminating this gene led to poor sleep quality. That gene is often missing in people with autism.
There Are Several Ways Parents Can Improve A Childs Sleep They Need To Establish A Good Sleep Hygiene
Over 50 to 80 per cent of children with autism spectrum disorder have either difficulty in falling asleep and/or staying asleep through the night. They may take hours to go to sleep, or get up in the middle of the night and start crying or playing. Inadequate sleep at night can cause behavioural challenges, irritability, hyperactivity, and it can interfere with learning and decrease the overall quality of life.
Sleep disorder happens more often in children having restricted and repetitive behaviours , with anxiety, or sensory problems. These problems should be addressed by an expert.
Watching shows or games which are scary or violent, can lead to trouble sleeping. Also screen-time during bedtime can disrupt the melatonin hormone secretion leading to disturbance in sleep initiation. Parents should share information about bedtime, wake-time, daytime and nighttime habits and routines, to find the cause of disturbance in the sleep cycle.
There are several ways parents can improve a childs sleep. Establishing good sleep hygiene by following the below tips can help them.
1. Sleep environment: The bedroom should be dark, quiet and comfortable. As children with ASD are sensitive to noises and/or have sensory issues, the environment should be adopted accordingly.
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Consider Your Childs Bedding
The textures of the sheets, pillows, and comforters should be sensory-preferred and snuggly soft.
Some parents find that oversized pillows or stuffed animals offer additional sensory input for squeezing, hugging, and burrowing.
Consider a heavy duvet/down comforter or a specifically-designed weighted blanket.
Weighted blankets have been found to offer deep touch pressure which can positively impact sleep behaviors.
Another option that provides deep touch pressure is a sensory compression sheet. These sheets wrap around the bed and offer compression to the child. Often times, it’s hard to customize the amount of compression your child is getting, but they are more breathable than a weighted blanket.
The choice between a weighted blanket and a compression sheet would depend on your child’s preferences.
How To Teach An Autistic Child To Point
Fact-checked by Vincenza De Falco, Autism & Learning Disabilities Specialist Coach.
Children use the pointing gesture as a means to communicate with those around them. In children with autism spectrum disorder/condition , this small gesture can go a long way since they often have trouble with verbal communication, leading to immense frustration. This is where nonverbal communication, like the pointing gesture, comes in it helps them get their point across to another.
Scroll down to learn how to teach an autistic child to point.
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