Wednesday, July 28, 2010

Sleep Tips & Tricks for Children with Autism

When running an Applied Behavior Analysis (ABA) program, parents find that they have many balls to keep in the air at the same time. In the midst of tracking behaviors, scheduling sessions, and thinking up new reinforcers, the more mundane aspects of life tend to go unnoticed. Things such as diet, exercise, and sleep often get pushed to the side because they seem like less urgent (or more difficult) issues to tackle. Think how you feel when you are deprived of sleep - cranky, lethargic, irritable, unable to think clearly. When you see an increase in your child's negative behavior or inability to focus on certain tasks, ask yourself how he or she slept over the last few nights.

It is common for children on the autism spectrum to experience difficulties falling and/or staying asleep. Below are some tips to increase the likelihood of your child getting a good night's sleep. If you already consistently implement these suggestions, but your child continues to experience sleep issues, speak with your ABA consultant for additional strategies. A good ABA consultant should be able to provide you with a behavioral plan to deal with issues such as bedtime tantrums and night awakenings. In addition, an excellent resource is Sleep Better!: A guide to improving sleep for children with special needs by V. Mike Durand.

Exercise at the right time:
There is a fair amount of research that documents the positive relationship between exercise and sleep. Be certain, however, that your child has time to calm down before bedtime. It is generally recommended that intense exercise (or playing, in the case of children) should end at least 1-2 hours before bedtime. While this is not realistic for some children, it is a good idea to institute some quiet time before the bedtime routine starts. Exercise raises the body temperature and it takes the body several hours to cool down to the temperatures associated with comfortable sleeping.

The sleep environment:
In order for your child's body to adapt to going to bed at a reasonable time, the environment needs to be conducive to sleep. The room should be quiet, dark, and cool. Remove any toys, books, or games that may tempt your child to get out of bed. The extra hours of sunlight during the summer can cause problems for some children, so consider making the room dark by artificial means, such as drawing the curtains or hanging a sheet over the window. Depending on the outside temperature, cracking a window, or turning on a fan or air-conditioner can help maintain a cool bedroom environment.

Be sure that the mattress and pillow are comfortable and free of allergens, such as goose down.

Establish a bedtime routine:
Human beings tend to be creatures of habit. Throughout our day, there are environmental cues that prompt certain actions and feelings. When the sun rises, our bodies begin to wake for the day. When we smell dinner cooking, we start to get hungry. We often go through a consistent routine in the morning - shower, get dressed, eat breakfast, brush our teeth. Why should bedtime be any different?

Start the bedtime routine at the same time each night and follow a consistent routine. Whether you choose to include a bath, brushing teeth, changing into pajamas, storytime, or songs - or all of the above - be consistent with the activities you include and the approximate duration of the routine. Taking a special stuffed animal or doll to snuggle with each night in bed can also help to cue sleep.

Waking up:
Consistent wake up time is just as important as a consistent bedtime. In order for the body's clock to be set, wake your child up at the same time on both weekdays and weekend days. Allowing your child to sleep in will affect his or her ability to fall asleep later that night.

Research shows that eating a large meal within 2 to 3 hours before bedtime can cause disruptions in falling asleep. In addition, eating spicy foods can cause heartburn, which could cause night awakenings. Consider serving a light meal for dinner, avoiding heavy sauces, fatty foods, and an overabundance of sugar.

Sugary or caffeinated drinks should be limited during the day and particularly before bedtime. Many children who drink a lot of fluids in the hours before bedtime are often wakened with trips to the bathroom. Caffeine is abundant in chocolate and many sodas. In some instances, caffeine can stay in the body for up to 12 hours, affecting the body's ability to relax for bedtime.

Limit media time:
Not only does watching an excessive amount of TV and playing video games take away from time engaging in imaginative play, physical activity, and engaging with family and peers, but research shows playing video games can increase respiratory and heart rates, and blood pressure. These physical changes can affect the body's ability to enter into deep sleep.

Experts recommend that televisions and computers are not used in the bedroom. Make the bedroom a sanctuary for sleep so that entering the room in the evening cues feelings of tiredness.

As mentioned above, the important aspect is to implement these suggestions consistently. It will take some persistence to make these changes, but the result is often a child who is well-rested and exhibits less negative behavior.
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