| By Maureen
Bennie
Parents at one time or another struggle with
a child who has difficulty falling asleep turning
bedtime into a stressful time of the day. Instead
of being a comforting time to wind down, tempers
flare and tears fall. Children with autism seem
to be particularly prone to poor sleeping habits
that surface when trying to go to bed, in the
middle of the night, or in chronic early waking.
I have several friends with autistic children
who struggle getting their child to sleep. "It's
awful," complains Andrea. "My son seems
to gain energy as the night wears on. Sometimes
he'll sleep from 11 p.m. until 1 a.m. and then
is up again running around the house. He's hyper
and I'm exhausted and unable to deal with the
demands of the day."
Chandra says bedtime routines for her son go
on forever. "First he needs to see a certain
video. Once that's over then there's some other
routine that needs to be done before he can go
to sleep. The worst part is I have to sleep with
him every night. Night waking is still a problem
and if he wakes up alone, he panics and it takes
a long time for him to fall back a sleep. Night
waking also wakes up my other children."
Do these stories sound familiar? My son Marc
went to bed late every night and he had to be
rocked into a deep sleep. Once that was accomplished,
the night waking began every two hours. Marc was
up an average of five times a night at a year
old. I was nursing him each time I went in to
see him. He was crying fitfully so I felt I couldn't
ignore him. I went into work everyday on four
hours of sleep. Teaching music to elementary school
children became a chore due to chronic sleep deprivation.
I felt like screaming at my students when they
were playing the xylophones or banging on drums.
Mastitis, a breast infection, was a recurring
problem too - probably related to fatigue. I was
hitting the wall. Something had to change.
My best friend Cori suggested I take a course
at the Infant Resource Centre in Calgary, Alberta,
Canada, the city where I live. I was desperate
enough to agree even though I was terrified at
some person telling me I had to let my baby "cry
it out". Headaches, Ibuprofen, and poor judgement
were taking over my life so I had to listen to
Cori and try the sleep course. It was the best
$15 I've ever spent. Here is what I learned from
the instructor Kitty Raymond.
A baby needs ten to twelve hours of sleep a
night, not including naps. If the baby is under
a year, two naps are necessary - a one hour nap
in the morning and a one to two hour nap in the
afternoon. After a year of age, a baby needs a
two-hour afternoon nap until age three. The best
time for the afternoon nap is 1 or 1:30 p.m. The
baby should sleep no later than 3:30 p.m. or it
will interfere with bedtime. The optimum time
for bed is 8 p.m.
The biggest no-no is nighttime feedings. It
takes approximately 2 ½ hours to digest
a bowl of cereal. Babies sleep best on an empty
stomach. If feeding occurs during the night, a
baby does not fall into a deep sleep because the
digestive system is continually working. Milk
feedings should be limited to no more than 2 ½
cups a day after a year of age. Milk feeding from
nipples should not be done close to bedtime or
that becomes a crutch for sleep induction.
A strong, consistent bedtime routine needs to
be established. If your child is having a bath,
it should happen by around 7:20 p.m. All milk
feedings need to be done by 7 or 7:15 p.m. Do
not do the feedings in their room. Get the child's
pajamas on, then read one or two stories maximum.
Remember the longer the bedtime routine is, the
harder it is to put your child to bed because
they want you to stay with them.
At 7:55 p.m., instead of nursing or giving the
child a drink, sing a song or say good night to
main objects in the room such as the window, clock,
lamp, dresser etc. I used the "Goodnight
Moon" book by Margaret Wise Brown as a routine,
taking Marc around the room in my arms allowing
him to touch each object as we said good night
to it. Now it is time for bed. Put some toys on
the bed, say "It's nighttime, I love you,
I'll see you in the morning", close the door,
and don't come back for a bed check for 45 minutes.
Make sure the non-nursing parent puts the child
to bed if you are still night nursing.
Closing the bedroom door may seem cruel but
there are two reasons for doing this. One is to
keep the focus in the child's room. If the door
is open even a crack, the light from the hall
will pour in and the child will draw his/her attention
towards the outside light. It is also better to
have the door closed in case of a fire.
On the first night of this routine, you'll experience
some crying or objection from your child as it
is a new routine with new expectations. Let them
protest for the first 45 minutes before you do
your second bed check. At this time, open the
door and say, "It's nighttime, I love you,
I'll see you in the morning." This should
take five seconds. Don't hang around in the room.
Spending more than the five seconds becomes cruel
for the child. Keep repeating this routine until
they are asleep.
If the child wakes up again in the night, do
a check after ten minutes of fussing or crying.
Say the bedtime phrase and leave. Start the checks
every 45 minutes again until the child is back
asleep. This process may sound cruel but by the
morning, everything is fine. The first night of
this routine will be the worst night but hang
tough. By the second night, the child will cry
half of what they did the night before. By the
third night, they might cry for five to ten minutes.
If the child wakes up at all in the night, it
will be for less than ten minutes.
I used this routine with Marc at thirteen months
after a year of very little sleep for both of
us. To my surprise, Marc was a much happier child
on more sleep. I used to feed him cereal before
bedtime and nurse him until he fell asleep. Cutting
those two things out made bedtime a breeze. Marc
cried only a few minutes the first night at bedtime
and by the second night he didn't wake up at all.
The interesting thing is after a year of this
solid bedtime routine, going to bed became a pleasant,
worry-free experience for us. Marc is now five
and requests his bed before 8 p.m. There are no
struggles or fights. It has become a time for
us to read a book, cuddle, say a good night prayer,
and say our "I love you's". Marc wakes
up in the night occasionally after a bad dream
or if he is sick.
When I took the sleep course, Marc had not been
diagnosed with autism yet. Knowing what I know
now, I would recommend this sleep routine to any
parent of a child with autism. Our children love
routines and predictability. Use PEC symbols if
they aid the process. Have special toys only for
bedtime. Read a book that is only read at bedtime,
which will make the book special. Be consistent
and firm with your expectations. Wanting your
child to sleep is not a cruel thing. It is a necessity
for both you and your child in order to function
at an optimum level the next day.
I did the sleep routine with my second child
when she was five months and I've never looked
back. She also has autism. I occasionally have
problems getting her into bed but she is also
in the "terrible twos", behaving quite
typically in that department. There are many books
out there on the subject of sleep, but I found
Kitty Raymond's method worked for us. Everyone
needs a good night's sleep to be at his or her
best. Try the sleep routine, adapting it to make
it personal for your child. Sweet dreams! See
you in the morning
|