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Sleep and SEND- a guide for parents

 

SEND and sleep

As any parent knows having a child who has difficulties with their sleep is exhausting! But as a parent of a child with SEND your child is more likely to be struggling with their sleep, in fact research shows about 80% of children with autism have problems sleeping.

Why your child is struggling with their sleep

  • Children with autism often have difficulties winding down and going to sleep. They may repeatedly get out of bed and refuse to go to sleep unless you are close by.
  • They may also have problems staying asleep and be awake for many hours during the night, perhaps coming into your room or going to other parts of your home.
  • They often find it hard to relax and can have high levels of anxiety, meaning emotional upsets at bedtime and taking a long time to go to sleep.
  • Social cueing difficulties can mean your child finds it hard to make connections in terms of pre bedtime activities and understanding that it’s bedtime. They may have developed a series of nightly rituals and routines that potentially delay bedtime.
  • They can have a poor concept of time and not realise it’s bedtime or recognise tired signs.
  • Research shows many children with autism have irregular secretion of the sleep hormone melatonin, impacting their ability to go to sleep.
  • Your child may have sensory difficulties such as sensitivities to smells, sounds, touch and light that could prevent them both falling asleep and staying asleep.
  • They may have medical conditions affecting their sleep such as sleep apnoea, epilepsy, restless leg syndrome, allergies and gastrointestinal problems such as reflux.

 What can you do to help your child sleep?

  • As most child sleep problems are multifaceted it will help you get a good understanding of your child’s sleeping pattern by filling in a sleep diary for a week or two. This information could also be invaluable when discussing your child’s sleep with health professionals.
  • A visit to your GP may be needed to explore underlying medical concerns, as well as a possible referral to a dietician.
  • Review your child’s sugar and food to ensure they are having sleep inducing foods rather than high sugar snacks in the evening.
  • To help your child understand sleep and the steps of their bedtime routine, visual aids showing their bedtime routine in picture form can really help. You may like to make a booklet or laminate cards and create a Velcro wall chart that you go through with them on the lead up to bedtime each evening.
  • You may also wish to create a social story for your child that you read to them each evening that describes their bedtime routine and makes them the centre of the story. Social stories were created by Carol Gray in 1991 and are meaningful short descriptions of activities and specific actions to help children understand and know what to expect.

Children love routine. You may wish to revisit your child’s bedtime routine:

  • Time your child’s bedtime routine so you have a consistent start time each evening and even more importantly, a consistent wake time in the morning.
  • Aim to avoid all screens an hour before bed. Light from screens can suppress the sleep hormone melatonin.
  • Start their bedtime routine with about 10 to 15 minutes of quiet fine motor such as colouring-in, fuzzy felts, sticking or puzzles.  Or your child may just like a relaxing story at this time.
  • To help your child unwind, from this point on it’s best not to chat too much. Instead use simple sentences or their visual aid booklet to guide and instruct them.
  • Then go for a short relaxing bath in warm water.
  • Go straight into the room they sleep in to get dressed for bed. To stop your child becoming distracted or loosing focus with the routine it’s best to keep everything around the bedroom and bathroom area.
  • Once they are tucked up in bed, read then a bedtime story, at this time of night its best to be to too lively or stimulating.
  • Some children find a massage and or soothing music will help them to go sleep. Do whatever you feel is right for your child’s sensory needs.

Check their bedroom environment.

  • Your child may have their own specific sensory differences that you need to consider. Is their bedroom dark, cool and quiet? Do they find it more relaxing to have gentle sleep sounds playing and a small amber night light? Are there smells that they find upsetting, can you minimise smells from the kitchen and would scented oils help them relax.

 

If you would like help with your child’s sleep please call us to discuss how we can help you.

 

 

Standing up or climbing out of their cot!

standing up in the cot

What if… my baby keeps stands up in their cot?

This tends to happen towards the end of your baby’s first year as they become more mobile and are excited to try out their new-found skill….how amazing for your baby to go from sitting to standing!

But problems arise if your little one cannot lower themselves back down or if your baby quickly learns that each time they stand you appear by their side. Once resettled by you, they may get up again numerous times and this can become a game and a battle of wills that lasts until your child eventually falls asleep exhausted.

What to do:

  • Ensure your baby has plenty of floor time in the day.
  • Teach them to lower themselves back down from a standing position by practising pulling-up and sitting-back-down games. When you are confident they can lower themselves safely, leave them standing for a short while you sit or lie by the cot. Occasionally tap the mattress and simply say ‘It’s sleepy time, lie down’. When they start to tire, quickly lay them down and say “well done for lying down” and then offer some positive feedback with some gentle stroking or patting. However if they spring straight back up continue to “ignore” this behaviour and to lie low by the cot patting the mattress. You may be doing this numerous times especially the first few nights. But with perseverance the habit of standing will gradually stop.
  • If your baby is happily standing and is content for you to leave them for a minute or two, you can come and go from the room, laying them down each time you return. You may have to repeat this numerous times, especially the first few nights.

What if… my toddler climbs out of their cot?

What to do:

  • Start by lowering the mattress if you have not already done so.
  • Remove objects such as teddy bears from the cot that your child could climb on and gain leverage to push themselves out.
  • Try not to inadvertently reward them for climbing out, for example, by taking them into your bed. Be calm and firm. Try to catch them early. Quickly go into their room and firmly tell them not to climb out. If you do this consistently, they will probably get the idea and stay put. However if your child continues to climb out, it will be best and safest to transfer them to a bed.
  • You may also decide to put a stair gate across their door to keep them safe if they decide to test out their new freedom and wander in the night and to childproof their bedroom, almost turning it into a large cot.

How to prepare your child’s sleep for when the clocks go back Sunday 31st October 2021

When the clocks go back 31st October, how will this affect my child’s sleep?

If your child loves to wake up early and you’ve finally managed to persuade them to sleep in past 6.00am, you may be dreading the clock change on Sunday 31st October. Overnight you are back to having an early riser and facing the day at 5.30am again.

But worry not….help is at hand, Mandy Gurney, Founder of Millpond Children’s Sleep Clinic, shares her top tips to minimise the disruption to sleep in your household. With a little advanced planning you can proactively prepare your child for the clock change.

Here’s how….

Tip 1:
Prepare your child’s body clock
About 10 to 12 days before the clock change start putting your child to bed 15 minutes later than usual. For example if their usual bedtime is 7.30pm, move this to 7.45pm.

After three nights of the new time, shift bedtime by another 15 minutes, so it is now 8.00pm.

Continue repeating this process until the bedtime has moved an hour later.

Initially your child may still wake at the same time in the morning, but by shifting their body clock slowly this way, you will find the morning will soon catch up.

Remember to shift naps, meal and milk times as well.

Tip 2:
Let the light in
Light has the biggest influence on our body clocks.

Encourage your child to play outside in the afternoon light, as this will help to keep them up that little bit later at bedtime.

Tip 3:
Wind down before bed
An hour before sleep, encourage your child to have a wind down time. Do something relaxing such as reading a book together before you start their bedtime routine.

However make sure you avoid any screens at this time, research has shown that bright light from these screens can interfere with the production of melatonin the sleep hormone.

Tip 4:
Your bedtime routine
About 30 minutes before your child goes to bed carry out the same series of steps every night. Having a regular routine that you follow each night will enable your child’s body to prepare for sleep as soon as you start this.

A warm bath-
Have a warm, relaxing bath lasting no longer than 10 minutes. A bath before bed should not be playtime as this could over stimulate your tired child. Go straight into the bedroom and get your child ready for bed.

Bedroom lights-
Dim the lights in the bedroom ready for your return from the bath, as this will help with the production of the sleep hormone melatonin.

Story time-
Read one or two quiet stories or sing a gentle lullaby. Have a cuddle and kiss goodnight and tuck them in with their favourite soft toy.

Time to sleep-
Once they’re drowsy, leave the bedroom so that they learn to fall asleep independently. Your child should be asleep about 15 minutes later.

Tip 5:
Morning feeds and meals
It is best to delay your child’s milk and breakfast by 15 minutes every few days too, so they don’t wake early for food.

Tip 6:
Is it time to get up?
To help your child know when they can get up in the morning set up a lamp with a low watt bulb and plug this into a timer switch in their room.

Set the light to come on 15 minutes later than they would normally get up.

Explain that they must stay in bed until the light comes on in the morning, even if initially this means you have to stay in the room with them to enable this to happen.

If your child stays in bed until the light changes give them kisses and cuddles to show how pleased you are.

As you shift bedtime later, move the time on the switch later.

Don’t be tempted to move any quicker than this as your child may struggle to wait and it won’t work.

Contact
e: sleep@millpondsleepclinic.com
t: 020 8444 0040