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Sleep and the ASD Child By Bill Nason

sleepless_child_150sqBill Nason is Moderator of the excellent  “Autism Discussion Page” on Facebook.

Excerpted from The Autism Discussion Page on the Core Challenges of Autism: A toolbox for helping children with autism feel safe, accepted, and competent

Difficulty sleeping is a very common problem with children on the spectrum. As many as 50% of children on the spectrum experience some difficulty sleeping. This can be a real problem for both the child and parents getting their needed rest. For the children, who already have fragile nervous systems, lack of sleep will compound any other difficulties (sensory, emotional, behavioral, etc.) they are experiencing. Steady sleep patterns are essential to keep the nervous system calm and organized. Listed below are several of the common strategies used to stabilize sleep patterns.

  1. Consistent bedtime routine: The body needs to calm down and relax in order to sleep effectively. One of the best ways to stabilize sleep is to establish a consistent, relaxing routine before going to bed. The child should go to bed and rise at the same time every day. This helps establish a consistent sleep cycle for the body. The bedtime routine should consist of a sequence of relaxing events that lowers the child’s arousal level. This means avoiding video games and high stimulating activity for the last 45-60 minutes of the evening. Common activities in bedtime routines are taking a bath, brushing teeth, toileting, getting out clothes for tomorrow, getting a drink of water, reading a story, snuggling in bed, saying prayers, etc. Keep the same sequence of tasks each evening to build a consistent routine. This helps prepare the body for sleep.
  1. Lessen any environmental distractions: If the child is a light sleeper, noise and activity going on in the house can disturb his sleep. Also, common noises occurring outside can be distracting for them. If needed, try using a consistent background noise (environmental tapes, soft music, white noise machine, fan, etc.) that will mask any other noises. Next, lighting can be an issue. If the child is scared of the dark, then a night light may be needed. Or, are there outside light sources that are disturbing your child’s sleep (street lights, house lights, etc.)? If so, make sure they are blocked out. Another factor that could disrupt sleep is temperature. If the room is too cold or too hot, the child’s nervous system will stay on high alert and not be able to sleep. Lastly, be aware of any tactile sensitivity that may present problems for your child. Are the pajamas a material that he feels comfortable in? How about the sheets and blankets? If any of these are too scratchy for the child, the nervous system will not relax.
  1. Favorite video or song: Although you want to limit electronics that actively engage the child, for some children, having the same favorite video playing in their room each night often calms and soothes them. They typically do not watch it, just having the familiar scripts in the background relaxes them. These favorite videos or music can represent security in something they love, block out other noise, and give them a familiar sensory pattern that calms and regulate them.
  1. Deep pressure and snuggables: Deep pressure calms the nervous system and can promote sound sleeping. Provide large pillows, stuffed animals, or a body pillow to snuggle with. Lots of heavy blankets or a weighted blanket can assist with sleeping. Also, some children love the feeling of being wrapped up in a sleeping bag. Snuggling with a pet, or simply having one sleeping in the same bed, will often soothe and relax the child.
  1. Diet and exercise: The three basic components to an organized nervous (sleep, diet, and exercise) all affect each other. A good diet and lots of physical activity will help stabilize the nervous system so it will sleep better. However, try to avoid arousing physical activity for the last hour before bedtime.
  1. Avoid frequent napping during the day: If your child is having difficulty sleeping at night, try to avoid a lot of napping throughout the day. If naps are needed mid-day, try to keep it short (30 minutes or less) and occurring at the same time every day.
  1. Medical concerns: If the child has gastrointestinal problems, upper respiratory problems, or any other acute medical concerns, these can keep the nervous system on “high alert,” thus keeping it from falling asleep. Sleep apnea could also be a factor. If your child has any of these difficulties, seek medical help to lessen their impact.
  2. Sensory integration problems: If the child has sensory processing issues, they often have problems modulating their arousal level, making it difficult to fall or stay asleep. Their nervous system may be too “wound up” to fall asleep. A good sensory diet throughout the day can help calm and organize the nervous system.
  3. Sleep aids: Melatonin has been an effective sleep aid for many children on the spectrum. It is used very frequently with minimal, if any, side effects. There are a host of other sleep inducing supplements and medications that can be prescribed, but should be used as a last resort. Seek out your doctor’s advice when using these.


bill_nasonBILL NASON has been a mental health professional working in the field of developmental disabilities for the past 35 years.   He received his Masters Degree in Clinical Psychology from Eastern Michigan University and has worked as a Limited License Psychologist in a variety of residential and community mental health settings in Michigan servicing developmental disabilities and individuals with Autism Spectrum Disorders. Bill spent fifteen years of his early career working closely with very severely impaired individuals, with multiple behavior challenges, living in an institutional setting.   In this setting, he learned how to touch the hearts of those with severe neurological vulnerabilities. Bill has learned to blend together his knowledge of applied behavior analysis, sensory processing, and social/emotional development into comprehensive strategies for helping children on the spectrum feel safe, accepted and competent.

Bill has spent the past 18 years consulting with community residential settings, schools, and families helping them design and implement comprehensive treatment strategies. Bill has extensive experience in coaching sports programs for children on the spectrum, and currently runs the soccer and basketball programs for Oakland University Center for Autism Research, Education, and Supports (OUCARES). He also has a long history of volunteering presentations and coaching sports programs for his local autism support group.

Over the past four years, Bill has developed and moderates the Facebook Page, “Autism Discussion Page,”presenting daily posts, slide presentations and discussions centering on helping children on the spectrum feel “safe, accepted, and competent.” He has also authored two books based on the content of his Facebook page, The Autism Discussion Page on the Core Challenges of Autism, and The Autism Discussion Page on Anxiety, Behavior, School, and Parenting Strategies published by Jessica Kingsley publishers (