| Lack of sleep can effect the functioning of a person | | | | once. |
| as well as carers. | | | | Involve everyone in planning for any changes and |
| There are many factors that can effect sleep | | | | warn them that it is going to happen. Discourage |
| patterns for people on the Autism | | | | bouncing on the bed; instead introduce a trampoline in |
| Spectrum and LD. This article is a collection of | | | | another part of the home. |
| advice and strategies from a variety of sources. | | | | Food and allergies stimulation |
| Sleep associations | | | | Look at diet. If they are eating and drinking foodstuffs |
| These are the mind and bodys way of telling us when | | | | that have a lot of sugar, caffeine or additives their |
| it is time to sleep. Each of us has there own | | | | sleep can be affected. Avoid these all together if |
| associations e.g lights on/off, cocoa before bed etc.. | | | | possible but definitely not around bedtime. |
| Often how we go to sleep will determine if we have | | | | If all else fails -Melatonin? |
| difficulty going back to sleep if we wake. It is not | | | | Melatonin (sleep hormone) can be irregular for |
| advisable if you wake during the night to fall asleep | | | | some people with AC and learning disability for |
| with the TV on. The sleep association will be with the | | | | various reasons. The use of melatonin as a short |
| TV therefore you may need the TV back on in the | | | | term method of helping to instigate a sleep routine may |
| middle of the night to fall back to sleep. People with | | | | be helpful. It could be used in alongside behavioural |
| Autism/LD are no different however there may be | | | | approaches described above. |
| other factors to consider. | | | | Some foods have melatonin in such as plums, bananas |
| Distancing approach | | | | and Brazil nuts. However, no research into the potential |
| When a child/person has difficulties settling to | | | | benefits of a diet that is high in melatonin and the |
| Sleep one way maybe to sit with them. This would | | | | effect on sleep has been carried out yet. |
| serve as a comfort but also to remind them it is time | | | | Relaxation techniques |
| to sleep. When sitting by them do not stimulate | | | | Massage can be helpful in reducing activity levels but |
| conversation but say'time to sleep....' At first it may take | | | | this depends on individual's sensitivity. |
| some time before the person settles however with | | | | Lavender oil drops on the pillow can help to encourage |
| consistency this should decrease. This of course | | | | relaxation and sleep but again sensitivity and seizures |
| creates a sleep association so the next steps are to | | | | need to be considered. |
| withdraw from the bedroom (slowly) step by step to | | | | Relaxation music or tapes can be helpful for |
| eventually out of the room. | | | | some people with AS. |
| Structure/Routine | | | | Some other General advice |
| Sleep can be disturbed due to a lack of routine and | | | | What to do if your Child gets out of bed |
| structure. For some people on the Autism Spectrum | | | | When young children move from sleeping in a cot to |
| LD who rely on structure for security and to make | | | | sleeping in their own bed they may need help to learn |
| sense of the world changes can have a great effect | | | | to stay in bed. |
| on sleep patterns. | | | | Waking in the night and coming into the parents' bed is |
| Advice | | | | also a common problem in young children. 30 to 40 |
| Have the same routine that everyone follows. Stick | | | | percent of children aged two to five get up at night on |
| to it at the weekend and even when on holiday | | | | a regular basis. They may express fears of the dark, |
| as people with AS/LD can find it hard to accept | | | | ghosts or monsters. |
| changes to routines. A visual/picture timetable may | | | | What to do. |
| be useful as it shows clearly what the evening routine | | | | - Stay calm and return your child to their own bed. If |
| is. For example the routine could be as follows: | | | | necessary pick them up and carry them. Do this as |
| - Meal-Activity-Bath-Clean teeth-Toilet-Bed time | | | | many times as needed. Do not take a child into your |
| This timetable could be placed somewhere that is | | | | bed as this is likely to perpetuate the behaviour. |
| easily accessed. | | | | |
| Each step could have a symbol which can removed | | | | - If your child comes into your room at night because |
| as each task is finished. (perhaps put it in an | | | | they are worried about whether you are there, take |
| envelope). | | | | them back to their room and reassure them briefly |
| A speech and language therapist or teacher could | | | | that you will be there and will see them in the morning |
| help parents/carers to access the symbols or go to | | | | and leave the room. Be calm and firm. Do not be |
| the local library and access ‘Boardmaker' software | | | | angry with your child or provide too much attention e.g. |
| on the computer. | | | | cuddles. Any positive or negative attention is likely to |
| Communication-Social Stories | | | | reinforce the behaviour pattern. |
| This is an approach that can help people with AS/LD | | | | |
| to understand the ‘social rules' regarding sleep, for | | | | - If your child has nightmares, turn on the light briefly |
| example, that everyone needs to sleep, where to | | | | and show them how familiar their room is. Reasssure |
| sleep, when to get up. Some people with AS/LD | | | | them that everyone has dreams sometimes and that |
| who have all consuming interests may want to stay up | | | | they are not real. Do not take them into your room to |
| all night engaging in them. | | | | comfort them so that they learn to handle their fears in |
| A speech and language therapist or teacher may help | | | | their own bed. |
| you develop a social story. | | | | Early Waking |
| Communication-Objects of Reference | | | | By 5am a person will have completed most of his |
| These are everyday objects that can help people | | | | her nights sleep. |
| with a learning disability communicate their needs | | | | At this early hour the desire to sleep is less strong |
| choices, particularly if they are non verbal. | | | | than at bedtime or earlier in the night. Some children, |
| For example a photo of their bed/bedroom, a certain | | | | now sleeping more lightly, will wake if there is a mild |
| blanket or cuddly toy could be introduced. Whenever | | | | disturbance e.g. light entering the room, early rising |
| you are prompting a person to go to bed, show them | | | | family member, traffic noise etc If interruptions are |
| the object as you say the word/make the sign. Over | | | | frequent enough your child will learn to anticipate them |
| time they will use that object to indicate that they want | | | | and may start to wake spontaneously or as a habit |
| to go to bed, or realise that this object indicates what | | | | before dawn. The problems are best solved by |
| is happening next. | | | | reducing disturbing factors. |
| Continence | | | | If early waking continues then delay your response |
| If someone has continence difficulties either being | | | | to your childs awakening. If your child is crying and |
| incontinent at night or being constipated this will effect | | | | unhappy then he/she is still likely to be in a night time |
| sleep. | | | | sleeping rhythm and needs to learn the habit of |
| Advice- | | | | going back to sleep. Go into their room, tuck him up |
| Try to encourage the person to use the toilet during | | | | and say, "Go to sleep" and leave the room. Return at |
| the evening before bed. Assess their bowel | | | | 10-15 minute intervals and repeat the same message. If |
| movements for constipation. You may need further | | | | you are consistent in doing this, after a week or so, |
| advice when there is waking due to being wet or | | | | your child should start to sleep a little longer. |
| soiled. | | | | Do not reward early waking with milk/bottle/drink, |
| Environmental and sensory needs | | | | food. play, attention or coming into your bed. This will |
| Many people with AS/LD are sensitive to their | | | | then become a long term early waking habit. |
| environments. It worth doing an environmental and | | | | Early waking can be tricky. Some children are early |
| sensory needs assessment when considering sleep, to | | | | wakers despite all efforts to modify their sleep pattern |
| find out what preferences are. | | | | but most can learn to sleep a little longer. If your child is |
| A Learning Disability Nurse or Occupational Therapist | | | | already getting an adequate number of hours of sleep, |
| could help you | | | | then consider delaying bedtime by thirty to sixty |
| Overstimulation | | | | minutes. For some parents it may be you will have be |
| Around an hour before bed begin to ‘wind down'. | | | | up earlier than you might like for a few months until |
| Turn off the T.V./music (that is stimulating), avoid lively | | | | your child extends his/her sleep pattern. |
| play, and dim the lights. | | | | - Once you have reassured your child, leave their |
| Hearing/noise sensitivity | | | | room. Ignore crying and protests. Return them to their |
| Consider using thick carpets that deaden noises. Shut | | | | bed without speaking if they continue to get out of |
| their bedroom door and have their bedroom in a | | | | bed. You might want to calmly close their door and to |
| quieter part of the house. Consider noises from the | | | | open it once they are in bed and quiet for two minutes. |
| bathroom and the position of a bed in the room can be | | | | |
| important, avoid it being near pipes, the bathroom or | | | | - Consider a reward programme. Give your child a |
| looking out over a busy, noisy street. | | | | sticker for each night that they stay in their own bed. |
| A ‘white noise'; for example humming or a radio | | | | Stickers could be traded in for a small treat at the end |
| tuned out can help others to settle. | | | | of the week. |
| Vision sensitivity | | | | |
| Use neutral colours that are not too intense or loud. | | | | - During the day, help your child to feel secure and |
| Plain or pastel coloured walls and carpets, avoid | | | | loved through praise and encouragement. They might |
| patterns, stripes. Avoid visual displays on the walls. | | | | want to draw a picture of a scary dream or to come |
| Keep the room clutter free; remove toys/TV/play | | | | up with an alternative happy ending. You might want to |
| station/Wii etc. The bedroom should be for sleep | | | | repeat that dreams are not real and to talk about |
| only not for play. | | | | what to do to get back to sleep if a dream wakes |
| Use black out blinds/curtains/shutters to block out the | | | | them up. For example teach them to think of a place |
| light if a child has hypersensitivity to light. If a child is | | | | where they feel happy and safe when they are going |
| frightened of the dark introduce a night light. If | | | | back to sleep. Try to have these conversations in the |
| ‘switch flicking' is a problem remove the light bulb or | | | | daytime and keep interaction down to a minimum at |
| consider having the switch moved to outside the | | | | night so they are not rewarded with your attention. |
| bedroom door. | | | | |
| Smell sensitivity | | | | 'Sleep deprivation is used as effective torture in some |
| Consider using odourless non toxic paints/wall paper | | | | parts of the world' |
| paste. Avoid strong smelling air fresheners and | | | | Good luck |
| cleaning materials. | | | | References: |
| Touch sensitivity | | | | Andrews.C-(2009) - Sleep Problems with Children with |
| Think about whether your child prefers deep pressure | | | | ASC , NHS Leeds (unpublished) |
| when being touched. If so they may need heavy | | | | Bogdashina. O- (2003) -Sensory Perceptual Issues in |
| weighted blankets tightly tucked in to feel secure. | | | | Autism: Different Sensory Experiences - Different |
| Others may need lighter bed clothing if they are | | | | Perceptual Worlds, London. Jessica Kingsley Publishers. |
| hypersensitive to touch. Looking at bedding materials | | | | Gray.C (2000) The New Social Story Book, Illustrated |
| that may irritate. | | | | Guide, Future Horizons, USA |
| Temperature | | | | National Autistic Society (2004), Helping your child with |
| Try to keep the bedroom at a constant temperature | | | | autism to sleep better. (This leaflet can be downloaded |
| that is comfortable for your child. Perhaps use a | | | | from their website |
| thermostat. | | | | Nguyen.A (2006), Creating an autism-friendly |
| Spacial sensitivity | | | | environment,London. The National Autistic Society. |
| Keep furniture to a minimum and have it placed around | | | | Sussman. F, (2004), More Than Words-helping |
| the edges of the room in smooth lines. Avoid objects | | | | parents promote communication and social skills in |
| in the centre or in walkways. If furniture needs to be | | | | children with autism spectrum disorder. The Hannan |
| moved do it gradually. Don't change too many things at | | | | Centre, Canada. |