This guide is designed to provide strategic guidance to families of children with autism who are affected by their child’s sleep problems, which can have a significant impact on children and families with autism. The information in this booklet is based on the research and clinical experience of sleep experts who have experience with this issue. These strategies are effective for all children, including adolescents, but some of the suggestions are geared toward older children, such as those who do not need naps.
These suggestions can help your child get a good night’s sleep and develop good rest habits, including the following:
1. provide a comfortable sleeping environment for your child.
2. establishing a regular bedtime routine.
3. suggestions on how to maintain a routinized routine.
4. teaching the child how to sleep on his or her own.
5. advocating for behaviors needed during the day.
In order to get your child to sleep well at night, you need to get a good understanding of your child’s sleep habits, which means you should change your child’s sleep environment, and how to communicate with your child before he or she goes to sleep and after he or she wakes up.
Sleep problems, such as difficulty falling asleep, sleepiness, or waking up early, are common in both normally developing and autistic children, and some special cases, such as snoring, shortness of breath during sleep, or bedwetting, require further evaluation and treatment by a sleep specialist.
Many parents will be able to improve their child’s sleep simply by trying these suggestions listed in this booklet, but between your choices, please note the following.
1. choose those suggestions that will fit in with your family’s lifestyle.
2. be prepared to implement these plans only when you have the time and energy to do so.
3. Start with the smallest changes and then slowly implement others.
4. Be patient and often wait more than two weeks before you see any change.
Part I: Provide a comfortable sleeping environment for your child
Let your child have a safe and quiet sleep environment is very important, he needs to have a place to sleep, whether he sleeps with others in a separate bed, or he sleeps by himself, but it is best to sleep in the same environment every night.
1, the bedroom needs to be comfortable (not too hot and not too cold), quiet, but also black light, if the house is too dark, you can install a night light for the child, and always on at night, if the outside street lights or the morning sun to shine into the house, then go to change a thicker bed curtains.
2, the bedroom needs to be kept quiet at night. It is best not to listen to the radio, watch TV, computer or listen to music before bedtime, if these sounds stop at night, it may wake your child’s sleep. Some children may also notice those “background noise”, such as those low, quiet, continuous background sound sources, such as ceiling fans, or the sound of air conditioning units, etc., generally speaking, in his bedroom around the room should not have any noise, or television, computer games or music.
3. Take into account the child’s environment. Children with autism may be more aware than normal children of noises at night that we don’t normally care about, such as the sound of running water or other appliances. You can find out if there is a reason for this, for example, by observing whether your child prefers looser or tighter pajamas. Do you like thicker sheets? Or lighter?
The important thing is that you, your spouse, and other caregivers, such as grandparents or babysitters, all follow the same routine, and the more you can regularize the process every day and night, the easier it will be for your child to get a good night’s sleep.
Part II: Establishing a Bedtime Routine
These bedtime routines should be short, predictable, and predictable, meaning that the child can think of them on his or her own or with adult guidance, and “predictable” meaning that The child knows what to do next after doing a procedure.) A good routine can help your child relax and get ready for sleep. The stability of performing these routines every night of the day will help your child to calm down. It is also best to avoid stimulating games, attractive TV shows, computers, loud music, and even strong light before bedtime, and it is also best to avoid behaviors such as jumping, chasing, and playing.
Start the routine 15 minutes or half an hour before bedtime. Younger children can use shorter routines (e.g., 15 minutes for a one-year-old), and as they get older, they should prepare for bedtime for longer, but preferably no longer than an hour.
Part 3: Suggestions on how to keep a routinized routine
1. It should be done in the quiet of your child’s bedroom (except for things like bathing and brushing teeth).
2. If your routine is done one by one in the same order every day, your child will be able to calm down.
3, your child can also benefit from the “graphic planner” shown below to remind them to do each step, which can help them see clearly that they should do the same things in the same order every day, parents and other caregivers can also help children follow the order of the plan at a glance. Children who do not respond well to pictures can be replaced with objects, and each step can be represented by an object used in this place.
For example, if your child is excited about bathing, schedule him to do it earlier.
Part IV: How to achieve habitual sleep habits
1, choose a bedtime, …… and then to stick to it. There are always changes in our daily lives, but we need our children to go to bed and get up at the same time every day. If your child has a new schedule and has to change the bedtime, you can observe and record how it affects your child’s sleep. You can either make a new bedtime plan or go back to the previous plan as soon as possible.
2. Time should be counted. Many children (including adults) are suddenly excited in the hour before bedtime, and if they go to bed too early it will be very difficult to fall asleep. If your child has to take more than an hour to fall asleep, then delay sleep for half an hour to an hour.
When they grow up, they will sleep later and later, but they still have to get enough sleep. Older children will also sleep late and wake up late on weekends, so they need to make their weekend routine not more than an hour later than usual.
3. Early wakefulness. Even if your child sometimes sleeps late, you should try to get him up at the usual time, even if it is later, not more than an hour, although sometimes you may think that it would be better to let your child sleep a “back to sleep”, but in fact, the more regular he gets up, the better he will sleep.
4, nap problem. If your child is still young and still needs a nap, then also to keep the nap time on a certain regularity. If possible, naps are best also in the child’s bedroom, before 4 p.m. It is best to wake the child up, otherwise it may not be easy to fall asleep at night. When the child grows up and does not need to nap again, try to avoid sleeping during the day, unless the child is sick, it is difficult to sleep at night after sleeping more during the day.
5, diet problems. The timing of your child’s meals will also go a long way toward establishing a routine. Your child should want to eat breakfast at about the same time, whether it’s on weekdays or weekends, try to be consistent. Don’t give him too much dinner or snack if it’s too late in the evening. But some small snacks with carbohydrates (such as cheese, crackers or fruit) can also help your child fall asleep more easily.
6. Sunrise and sunset. Allowing your child to shine in the morning sunlight, as well as in the quiet moonlight at night, will also help your child to develop a routine. When your child wakes up in the morning, go open the curtains and let the sun shine in. Similarly, if your child sleeps during the day, you should turn off the lights and close the curtains to keep the room dark, or turn on a night light if your child has a night light.
Part 5: Guiding your child to sleep by himself/herself
1. Why do we need to teach our children to sleep by themselves?
Generally speaking, both adults and children may wake up naturally during sleep. We wake up during the night, subconsciously check our sleep environment, and then fall back to sleep quickly. But if your child can not fall asleep by himself, then he wakes up at night, without your help he will be difficult to fall asleep again, on the contrary, if he wakes up at night, but also can sleep again by himself, he will be able to sleep more during the night, wake up in the morning more full of spirit.
2, then how do we teach our children to sleep alone?
Just like the process of your child sleeping with your help, he needs a process to learn to sleep alone by himself. This will take some time, perhaps a few weeks. For example, if you used to lie in bed with your child, change it up by sitting in bed with him for a few nights, then switch to sitting in a chair next to the bed with him, and then move the chair further away from him each day until you can leave the room out of his eyes. While you are doing this, also reduce your attention to the child, such as less talking, less facial expressions, and less eye contact.
After you leave the room, if the child is angry or not sleeping, wait outside for a few minutes, then go back in for a short time (no more than a minute), give him only limited verbal and physical contact (for example, a quick hug), and then tell him in a calm but firm voice, “It’s time for bed, you’re fine, good night,” before you firmly leave the room. If you still need to go back in, try to wait outside for a longer period of time before going back in, and stay inside for as short a time as possible. You can also use the same method to deal with the problem of him waking up in the night and then not being able to sleep on his own.
3, a teaching aid to help sleep: sleep pass
Sleep pass can be used for older children’s sleep problems, children who wake up in the night can use it in exchange for something he wants, such as a hug or a glass of water, as a reward for him to go back to sleep. You should talk to your child about how this pass can only be used once a night, and let the parents take it away until the next morning to return it to the child. You should also set up a reward system so that if the child does not use the pass that day, he will be rewarded the next morning, for example, with a sticker, and if he gets a certain number of stickers, for example, after collecting five different colors of stickers, he can get a small gift or take him there to play as a prize.
Part 6 Promote behaviors during the day that can help you sleep at night
1. Physical activity. More exercise during the day can help your child sleep better at night. Those adults and children who exercise regularly find it easier to fall asleep at night and sleep better. If your child doesn’t have a regular exercise schedule at school, then plan it at home.
Be careful to arrange the exercise time should be during the day, if you do it again at night, it may stimulate the child excited, it is difficult to fall asleep, those more weighty exercise is best to do two, three hours before going to sleep.
2, containing caffeine food and drink. Caffeine is able to keep your body “alert state” stimulant, caffeine can remain in the body for three to five hours of effectiveness, and even up to twelve hours long. If your child eats and drinks caffeinated food and drinks in the afternoon or evening (such as chocolate, coffee, tea, soda drinks such as cola, etc.), then he or she is likely to have a hard time sleeping at night. Some children need to completely abstain from such foods and beverages to sleep well, but most children just do not eat them until three or four hours before bedtime.
3. What if there are other children in the family?
If there are other children in the home, the autistic child’s abnormal sleep habits may affect other children in the home, but a consistent routine will be beneficial to everyone.
① Little helpers. Always think of ways to get siblings to help and other children to join in using the “pictorial planner”. The child should learn better when the children in the family do the same thing together.
Stay together and play together. Siblings can help each other do activities that help calm people down and get them ready for bed.
(3) Bedtime can be spread out. Allow each child to have a different bedtime so that there is more “one-on-one” care, but be careful not to disturb the other children who are still awake.
④ Sleep environment. Some children like to sleep alone, while others like to sleep with their siblings, depending on their preferences.
4, if I have done all of the above, but the child’s sleep situation still did not improve how to do?
If what we suggest doesn’t have much effect on you, then you need to seek medical help. You will need to discuss with your child’s pediatrician if you need to recommend a sleep specialist to find out why your child is not sleeping well and see if there are other appropriate medical treatments. There are some small-scale drug studies that show melatonin can help your child’s sleep, and there are other drugs available. But all of these should be done under the guidance of a doctor.