This blog is about a four year old boy with ASD. It was written by mummy of two gorgeous boys hoping to help other families in a similar situation.
It's 11.45pm and my gorgeous little boy is still not asleep!
Yes, I've got a bedtime routine in place and have been returning him to bed continuously since 7pm but he couldn't care less, he's wired and totally happy running up and down singing to himself or trying to escape over the stair gate across his bedroom door.
I've actually given up now and plan to take him for a long drive as that is the only way we can get him to go to sleep.
My husband and I take it in turns to drive our son around in the car each night sometimes driving for hours only to find that he wakes up as soon as we walk through the door.
But even if we do finally get him to sleep it won't end there because in a couple of hours he will be awake again! Sound familiar?
However, fast forward a few months and for the last 16 days (yes I am counting!) my son is going to bed at 7pm and falling asleep in his own bed by himself!
He will still wake up during the night and is an early riser but life has suddenly become a lot easier for the whole family and of course cheaper as our weekly petrol bill has dramatically gone down!!
So what did we do? Initially, we started by bringing forward the drive slightly earlier each night until we were taking him out in the car for a drive at 7pm every night.
So on the advice of his OT, we started looking at introducing “calming and alerting” activities throughout the day which included plenty of opportunity to be outside to run, jump on his trampoline and climb as well as time to rest using a weighted lap pad whilst using the I pad and / or sitting for snack at preschool, rolling over an exercise ball and applying deep pressure massage throughout the day.
My son is also very easily distracted and in the night we could hear him jumping off his bed and playing with his toys so, we stripped back his room of any distractions.
All wall art was removed, a bookcase which he used to try and climb, the bed frame was taken away to stop him jumping and all toys boxed and put away.
So we brought a mood light and a light up tortoise for him to look at whilst he was relaxing and trying to fall asleep.
We also attended sleep clinic with a specialist who suggested adding a card next to his bed with a picture of lighting McQueen (his current obsession), some light up stars on the celling and our velvet throw from the lounge which he loves to cuddle up to.
We kept the bedtime routine short so he could learn each step and would know exactly what was happening next and in turn prepare himself for bed.
It consists of bath, get dressed, brush teeth, sleepy time and wake up, we use a visual time line to reinforce this message and after each step take off the visual card saying “finished”.
The whole routine is under 15 mins and we go straight from the bathroom to the bedroom where I cuddle and gently rock him in the velvet blanket before lying him down to sleep.
I started by staying with him until he had fallen asleep but now I leave the room straight away.
1. Keep a sleep diary – write down when your child was put to bed, how long it took to settle, how many times they woke during the night and what time they woke up in the morning. Don't forget to include naps and add any additional information e.g. activities, eating & drinking, constipation etc. You may see a pattern emerge.
2. Make a sleep plan – troubleshoot with yourself or partner and get the whole family on board.
3. Timing – it has to be the right time for you mentally and emotionally to tackle any sleep issues, especially as there are likely to be other goals you're working towards with your child.
4. Keep the bedtime routine short and at the same time every night - so it is a clear indication that bedtime will be imminent. Tip: if transition to bath time is difficult try introducing blowing bubbles or a special toys to only be used during bath time.
5. Use visuals – a visual timeline or now and next boards (depending on understanding and language ability), work really well to prompt and reinforce communication / understanding to your child. Try ending the sequence with “wake up” so your child knows they will wake up after their sleep. You could also make a social story and play simple games such as pretending to go to sleep by lying down then waking up.
6. Reduce language – many children on the spectrum have some language processing difficulties so keep language simple and repetitive and leave time for your child to process your requests / instructions.
7. Environment – look carefully at your child's sleeping environment is it too visually stimulating? Could mood lighting help create a more relaxing environment? Is the room dark enough? Or too dark? Think about the temperature of the room? Is the room noisy? Does your child prefer enclosed spaces? Tip: if using mood lighting, is the child able to turn it on if they wake in the night, to settle themselves? Think about what thing you will leave in the room and what you will take with you when you go.
8. Out of sight, out of mind - put the mood lighting / pillow / dummy out of sight during the day so the child connects the items with bedtime.
9. Sensory – many children on the spectrum have sensory difficulties and it could be beneficial to request an appointment with your OT who can advise on many different techniques suitable for your child's sensory needs. For example, alerting and resting exercises, deep pressure, etc.
10. Specialist interests & obsessions – tidy these toys up well before bed time, possibly posting them into a box, bag and then putting them away somewhere safe until the morning.
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