Is It Quiet in There Yet??? | KGH Autism Services: ASD Treatment Clinic, Chicago & Madison
Is It Quiet in There Yet???

Is It Quiet in There Yet???

By Joe on August 2nd, 2016
North Shore Pediatric Blog, Play Pals North Shore Blog, Madison Pediatric Blog

Whether it’s an occasional occurrence or a nightly struggle, bedtime can be anything but routine, even for children who aren’t on the spectrum.  As a BCBA and a parent, I can attest to two things: 1) Getting your child to bed without a struggle can improve greatly with a good plan and 2) It can be really hard!!  At the end of the day, the last thing anyone wants to do is implement yet another behavior plan.  However, the end result is often worth the time and effort, and some of the intervention can take place much earlier in the day.  Did you know that getting a modest amount of exercise during the day (about 30-60 minutes at least 2-3 hours before bedtime) can help improve sleep?  Building in some time for playground or ball sports during the day on the weekend can be part of the solution (and can help build up those motor skills, too).  Here are some additional daytime and pre-bedtime tips that can help get a good night’s rest:

  • Be sure that wake-up is approximately the same time each day.
  • Exposure to sunlight in the morning can help with wakefulness.
  • Avoid late-afternoon naps as this can interfere with nighttime sleep.
  • Avoid large meals or large amounts to drink right before bedtime.
  • Taking a hot bath right before bed can help prepare the body for sleep.
  • Include calming or relaxing events as part of the bedtime routine.  The important thing to remember here is that screen time does not count!  Watching TV or using an iPad will promote wakefulness.  Reading a book or listening to quiet music is more calming. 
  • Maintain a good sleep environment.  Eliminate any distractions including toys and electronics.  A slightly cool room helps promote sleep. Keep the room dark when it’s time to fall asleep.

When implementing your sleep routine, consistency is key.  Include the same key activities, for example, putting on pajamas, brushing teeth, then going to the bathroom.  Keeping the order of events consistent and at the same time of day can be helpful as well.  With all this in place, you’ve increased your chances of success.  However, it’s often a matter of when, not if, there will be a trip out of the bedroom.  Some strategies for managing this can include:

Extend bedtime by 1 to 1.5 hours if your child is consistently unable to settle in within 15 minutes of being put to bed.  This will increase the likelihood that the bed will be associated with restfulness rather than escape.  When being put to bed results in restfulness, start moving bedtime back to the regular time (this can be done gradually, in ½ hour increments).
Keep the same wake up time when extending bedtime.  This will help to make it likely that he or she will be tired for bedtime the next night.
Using a ‘Bedtime Pass’ can also be helpful for eliminating frequent trips out of bed.  A Bedtime Pass is simply a single-use ticket awarded before bed, good for one free trip out of bed for any reason.  After using the ticket, any further trips out of bed are ignored or redirected back with as little fanfare and interaction as possible.

Remember to consistently implement your solutions, because no matter what you try you can expect it to take days, if not weeks, before you notice a positive difference.  If you are experiencing long-standing difficulties, challenging or aggressive behaviors during the nighttime routine seek professional advice from your consultant or a BCBA.  Having implemented most of these tips myself with my own children, I’ve seen how it can make a difference.  Remember to hang in there and don’t give up, and everyone will benefit from a good night’s sleep.

Resources:

Your Guide to Healthy Sleep. NIH Publication No. 11-5271 Originally printed November 2005, Revised August 2011.

http://www.npr.org/sections/health-shots/2015/09/18/441492810/the-bedtime-pass-helps-parents-and-kids-skip-the-sleep-struggles

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.

Freeman, K. A. (2006). Treating bedtime resistance with the bedtime pass: A systematic replication and component analysis with 3-year-olds. Journal of Applied Behavior Analysis,  39, 423–428.