Sleep Training Tips for Neurodiverse Individuals

Having some knowledge of sleep training is incredibly beneficial for parents. Sleeping difficulties can be detrimental to an individual’s overall health and wellbeing. A good night’s sleep is critical for growth and advancement, especially in children. Anywhere between 10-50% of developing children experience sleep problems. That number increases significantly to 50-80% for children with Autism Spectrum Disorder. 

What is Sleep Training?

While that significant number may seem discouraging, the good news is that sleep problems are typically not a permanent issue. There are a wide variety of methods and techniques that can be applied and integrated into a child’s bedtime routine to improve sleep. These measures are collectively referred to as sleep training. Sleep training can be helpful for anyone, from children to adults. Both neurodiverse and neurotypical individuals can benefit from sleep training techniques. Before we examine some of the proven sleep training tips and tricks, let’s first review the differences in sleep between neurotypical children and children with autism.

Common Sleep Problems Regardless of Age or Diagnosis

• Early awakenings 
• Night awakenings 
• Delayed sleep onset
• Interfering behavior 
• Nighttime routine non-compliance
• Nightmares 
• Confusional arousals (night terrors)

How Sleep Impacts Children

Sleep problems can directly affect the following in growing children:

• Cognitive development 
• Memory 
• Behavioral regulation 
• Mood regulation 
• Attention

Recommended Hours of Sleep for Children Char

Common Sleep Training Concerns from Parents

Knowing the impact sleep problems can have on a child, many parents look for ways to improve their child’s sleep. The most common parent concerns related to sleep training are:

• Difficulty falling or staying asleep 
• Not following directions with nighttime routines 
• Problem behaviors that occur after saying goodnight that interfere with sleep onset

Assessing and Treating Sleep Problems in Children

There are several ways to treat children with sleep issues using a behavioral approach. If your child has a behavioral team, please collaborate with your team in establishing a plan. Some teams have used the Sleep Assessment and Treatment Tool (SATT) to assist with establishing the plan. Parents are encouraged to collect data by keeping a sleep diary for their child. 

Next, parents need to establish a sleep schedule. There are helpful charts that easily outline the amount of sleep their child needs in total every day (daytime sleep – naps, and nighttime sleep). 

Sleep Diary for Children

Create a Positive Bedtime Routine

To help create a positive bedtime routine and experience, parents should consider incorporating:

• Consistency
• Visual schedule of the nighttime routine (charts and lists)
• Cooler temperatures
• White noise
• Dim lights
• Keeping preferred toys out of view
• Positive reinforcement
  • Sticker Charts 
  • Visits from the sleep fairy

Not Following Instructions and Incompatible Behaviors

Without a doubt, some children will exhibit incompatible behaviors when beginning a new sleep training routine. These could include behaviors such as leaving the bedroom, protesting, crying or calling out, playing in the bed or bedroom, and talking to themself. Parents may experience some push back from their child when they first start sleep training. If so, parents should:

• Start the routine before the natural sleep phase
• Create opportunities for instruction during the following day
• Identify reinforcing items that can be present during onset of sleep and throughout the night

Solutions to these incompatible behaviors can include:

• Providing the reinforcer prior to saying good night 
• Removing the reinforcers for incompatible behaviors 
• After saying goodnight, disrupt the contingency between interfering behavior and reinforcement

Behavior Approaches to Sleep Training

There are a variety of behavior approaches that parents can use when sleep training in addition to implementing the above recommended strategies. Many of these require a schedule for parents to follow and consistency. Please work with your behavioral team on determining which strategy would be more appropriate. Some behavior approaches are included below: 

• Bedtime pass
  • The child is provided a bedtime pass to make one request after they are told goodnight 
• Quiet-based visiting 
  • Visiting the child for less amount each time as the night progresses based on how long the child has been still and quiet for
• Scheduled awakenings 
  • Waking the child 10-15 minutes earlier than they would during their normal nocturnal awakenings. Helpful materials for night awakenings include sleep training clocks
• Unmodified extinction 
  • Removing parent interaction as a reinforcer for undesired behaviors such as crying, while allowing the child the opportunity to self-soothe
• Graduated extinction 
  • Parents ignores the child’s awakenings for a set period of time based on a month-long chart

Food for Thought 

Finally, as a parent who is considering embarking on sleep training, it is important to note that there are no published studies that have shown adverse effects from behavior interventions for bedtime problems or night awakenings. Improving a child’s sleep through sleep training has a tremendous benefit for the child throughout the entirety of their life. If one approach does not initially work well for a child, it’s encouraging to know that there are a variety of methods to try before finding one that allows for improvement, and ultimately, success.