During my time as a behavior technician, I worked with many children with special needs. Most of these children had significant challenges regarding sleep.
In fact, children with special needs, such as those diagnosed with Autism Spectrum Disorder (ASD), ADD, ADHD, Cerebral Palsy, Seizures, etc., are the ones who need consistent and consolidated sleep the most! This is because chronically sleep-deprived children do not get the appropriate amount of REM sleep. And REM sleep is incredibly important for the health of the areas of the brain most often impacted in children with these diagnoses.
UPDATE as of 3/25/2020
In a recent guideline published by the American Academy of Neurology (“AAN”). The AAN looked at different research studies involving the treatment of insomnia and sleep behavior in children with Autism Spectrum Disorder (“ASD”). What it found were 3 key recommendations that I explain a bit more in detail below. It also looked at 2 very popular products that have been heavily advertised in stores: the weighted blanket and sound-to-sleep (“STS”) mattress technology. Unfortunately, these two popular products failed show any effectiveness in helping with sleep in the children with ASD.
Recommendation from the AAN on the Treatment of Insomnia in ASD
Recommendation #1: Address coexisting medical conditions
The experts recommend ensuring there are no other conditions that could worsen your child’s sleep condition. Children with ASD can also suffer from intellectual disabilities, sleep apnea, epilepsy, gastrointestinal disturbances (“GERD”), depression, anxiety, psychosis, bipolar disorder and ADHD. In addition, medications used to treat these can also affect sleep. For example, stimulants, anti-seizure medication and psychotropic medications. Talk to your medical professional to see if there are any alternatives or different times your child can take these medications before changing anything.
Recommendation #2: Behavioral strategies
The AAN recommended behavioral strategies as the preferred treatment option before medication. We will discuss some behavioral strategies to start in the next section. However, the AAN also recommend AVOIDING parenting strategies like child-rearing (the practice of being very strict to your child and not being open for discussion) and bedtime routines that are not conducive to good sleep. Examples of bedtime routines that are not conducive to good sleep are inconsistent bedtimes, watching TV for several hours during the day or sugar before bed.
Recommendation #3: Melatonin with or without behavioral strategies
Melatonin was shown to have a low impact at improving various aspects of sleep in children and adolescents with ASD. If you were to use melatonin, the AAN recommends to work with a clinician to prescribe pharmaceutical grade melatonin. This is different from melatonin found over-the-counter (“OTC”) without a prescription. OTC products are not regulated by the Food and Drug Administration (“FDA”), and therefore, do not have to adhere to potency standards. Work with your child’s pediatrician or medical doctor before starting melatonin.
Parents often ask me what they could do to help get their children sleeping better. Is it possible to sleep train special needs children?
The short and resounding answer is: YES!
5 Tips to Sleep Train Special Needs Children
Now that we’ve established that it is both possible AND helpful to sleep train children with special needs, here are a few tips to help you get started in your efforts:
Tip #1: Identify and Eliminate Sleep Props
Children are children first and foremost, not their diagnoses. That being said, the first thing to note is that many children with special needs, just like many neurotypical children, have developed some bad habits surrounding their sleep. Parents sometimes assume that their child’s poor sleep is inevitable because of a diagnosis. However, relying on a “sleep prop” may be more of a contributing factor. A sleep prop may include rocking the child to sleep or needing a parent to be present to fall asleep. Identifying and eliminating these sleep props will lead to more consolidated and restful sleep.
Tip #2: Be Consistent
Some of the most important things for all children who are learning independent sleep skills are consistency in a routine and setting expectations. But it is even more crucial for children with special needs. These children often live in a world that is chaotic and overwhelming to them. They experience the world in a totally different way. Having predictability and structure surrounding sleep is essential.
Tip #3: Monitor screen time
I recommend monitoring screen time for children with any kind of sensory processing disorder. Eliminate screen time at least a few hours before bedtime. Screen time overstimulates the brain and suppresses melatonin production, which is the hormone that makes us sleepy.
Tip #4: Ditch the Noise Machine
Furthermore, it is not recommended that children with sensory processing issues have a sound machine running in their rooms. Sound machines may also be too overstimulating. It is better to occlude the auditory pathway than to try to drown out the noise. So, ear plugs are a much better alternative!
Tip #5 Lots of Physical Activity!
As a special needs sleep consultant, I recommend your child spends time engaging in the highest level of mobility he or she is capable of throughout the day. Mobility sends more oxygen to the brain, aids in organizing the brain and in turn helps set the circadian rhythm. This is essential for restful sleep!
So, there you have it. YES, you can sleep train special needs children! Take some time to try implementing the tips above, and if you need someone to help guide you through the process, I’m here for you! Schedule your complimentary sleep evaluation to talk about how we can tailor a sleep plan to your little one’s specific needs and get them sleeping well soon.
To healthy sleep,
Your Special Needs Child Sleep Consultant
Edited and Updated by:
Adult Sleep Consultant and Health Coach