Parents Q&A: Sleep Problems in Children with Autism

Parent’s Questions: My son is 7 years old with ASD. He is not willing to sleep on his own and needs to sleep with me every night. If I am not back from work, he will sleep with his helper. How can we make him to be an independent sleeper?
Autism Partnership advices: Sleeping problems are very common in children with ASD and can be very hard to manage. Very often, parents co-sleep with their child so to keep a closer eye on them during the night. Parents often worry that their child may get up in the nighttime and be more prone to something happening to them due to their possible unawareness of danger. Other parents enjoy the closeness when they sleep with their child. However, it comes a day when the child is now getting too big and it seems inappropriate to continue with this situation. Parents will often experience big resistance to change from their child who is also used to sleeping in this way. So here are some tips to consider when training your kids to be an independent sleeper.

Firstly, sleeping is skill that has to be learned. It is critical that we teach our children how to go to sleep without the need for other external things to be present. Examples might be:
  1. Child needs parent to lie next to them before they fall asleep
  2. Child needs to be patted to sleep
  3. Child needs to be rocked gently to sleep
In all these examples, the child relies upon others to help them to sleep. This is not good as without these things, they will not be able to sleep on their own. If they wake up in the nighttime, they will not be able to go back to sleep on their own.

So the first step is to examine your child’s sleep behavior and train them to sleep without the help. This can be done by doing the followings:
  1. Setting up a bedtime routine that eases the child to sleep. (E.g. taking a hot bath, reading a book together or listening to soothing music)Bedtime-Story
  2. Putting the child to bed a bit later so they are more tired and less likely to resist the changes and fall asleep quicker.
  3. Gradually fade the accommodations over time. For example, if you have to ease your child to sleep, then don’t lie down, but instead, sit in the bed and be insistent. Do that for a few days and then move to sit on the bed with your legs over the side. If you child is fine with that, then sit in a chair next to the bed. If that works perfect as well, then put the chair outside the room, etc. With time, these gradual changes will help your child to sleep by themselves.
  4. If your child is now able to sleep by themselves without any help, they are much more ready to sleep in another room by themselves. One possible start is that you can tell them that you are sleeping in another room so that they can still sleep in their current bed (your bed) but it means they are sleeping by themselves all night. If that is going well then move them to their own bedroom. To help the process, there should be a great reinforcer the next day if the child can manage an evening successfully.
My best advice is to really look at how your child sleeps. For a good model, you should be able to kiss them goodnight and walk out and turn off the light and they can sleep soundly. I hope the articles are useful and we look forward to more questions.
Advices provided by Toby Mountjoy (Associate Director of AP).
Mr. Toby Mountjoy is a Board Certified Behavior Analyst and holds a Master of Science in Applied Behavior Analysis. With over 20 years of experience working with individuals with ASD, he has been extensively trained by Dr. Ronald Leaf, Dr. Mitchell Taubman and Dr. John McEachin. Besides overseeing the Autism Partnership operation in Hong Kong, Korea, Philippines and Singapore with over 100 staff, including psychologists, consultants and therapists, he has also provided consultations to school districts, agencies, and families worldwide. Mr. Mountjoy has also contributed chapters to publications such as “Sense & Nonsense” and “It’s Time for School”. In 2007, he founded the charitable Autism Partnership Foundation and Aoi Pui School to offer more services for children with Autism.