Strategies to Support Your Child’s Sleep

Sleep problems can be considered a skill deficit that is common, especially in children and youth with developmental disabilities. Sleep problems (difficulty falling asleep, staying asleep or getting enough sleep) are associated with higher levels of severe problem behaviour (meltdowns, aggression, self-injury), stereotypic self-stimulatory behaviour and lack of cooperation with daily tasks.

Sleep problems also interfere with learning. Although there is a notion that children eventually grow out of their sleep problems, these problems tend to persist and do not simply subside as children get older. Persistent sleep problems in childhood are associated with childhood and adult obesity, adolescent behavioural and emotional problems, anxiety in adulthood, and sleep problems through adulthood. Children’s sleep problems also negatively affect parents and are often associated with parental stress, depression and marital challenges.

The good news is that all children can learn to be great, or at least better sleepers. Below are some tips and strategies to support and improve your child’s sleep. When addressing sleep concerns, start on a Friday or when our child has 2 or 3 days off from early commitments. If you require more comprehensive support addressing your child’s sleep, please reach out to ACT’s intake department at and request a consultation with a BCBA.

During the day:

  1. Ensure that your child engages in physical activity at least every other day and at least four hours before going to bed.
  2. Avoid all caffeinated beverages, especially after 4:00 PM or at least six hours prior to your scheduled bedtime.
  3. If over four years of age, try to avoid any napping, especially after 3 pm. If a nap does occur, put the child to bed later that night (e.g., if your child napped for one hour, put them to bed an hour later that night).
  4. Reserve your child’s bed for sleeping to the greatest extent possible (do not let the bed become a play or social zone).

The hour prior to putting your child to bed:

  1. Provide your child with a snack that is high in complex carbohydrates and protein, and avoid foods with a high glycemic index as part of the nighttime snack:
    1. Foods that are high in complex carbohydrates: Fruit, Whole grains, beans and starchy veggies
    2. Foods that are high in protein: Eggs, Almonds, Chicken, Cottage Cheese, Greek Yogurt, Milk, Fish, Quinoa, Peanuts and Peanut Butter
    3. Foods with a high glycemic index: Watermelon, Vegetables, Bread and Cereals, Tofu, foods with high levels of Corn Syrup or Glucose (ie., sweets, candies and “greasy” foods)
  2. Eliminate all medication prescribed to improve sleep or reschedule medication that has a high sedation profile to be delivered in the morning. Sedating medications interfere with the learning that is required for your child to learn to fall asleep and often only allow for low-quality sleep (e.g., less than optimal REM sleep). If you feel compelled to provide medication to help your child sleep, consider 1.5 to 4mg of melatonin taken 30 to 45 minutes prior to going to bed while the ambient lighting is reduced.
  3. To minimize the activity that often occurs once a child is put to bed, allow them access to that activity for an extended amount of time before the child is put to bed. If the child engages in callouts for more parental attention or to have a parent cuddle with them, provide the child with lots of parental attention and cuddle time on a couch outside of the bedroom prior to putting the child in bed. If the child engages in high levels of self-stimulatory behaviour in bed (e.g., hand flapping), make sure the child has a place and opportunity to engage in these behaviours (if they are non-injurious) before they go to bed.
  4. Begin transitioning to “mellow” activities one to two hours before beginning the nighttime routine (e.g., read some books, do a puzzle, play cards or a low-energy board game, etc.) Avoid screen time or technology in the hour before bedtime. Additionally, avoid baths or hot showers in the hour before bedtime as increased body temperatures will make it more difficult for your child to sleep. If you do have to bathe your child, consider lukewarm or cool water to do so.
  5. Establish a nighttime routine that involves dimming of ambient lighting, decreased resilience on screen time, cooler ambient temperature, and a consistent pattern of actions during the 15 to 30 minutes prior to going to bed (e.g., change into pyjamas, have a book read to them outside of the bedroom, the sound machine is turned on, the child is bid goodnight).

When to go to and get out of bed:

  1. To enhance the value of sleep at the start of your sleep treatment, put the child to bed one hour later than when the child fell asleep the night before. If the child falls asleep quickly (within 15 minutes) on the first and subsequent nights, put the child to bed 15 to 30 minutes earlier the next night until the child is going to bed at a time that allows him or her to get an age-appropriate amount of sleep (generally about 11 hours for very young children up to age four; up to 10 hours for children ages five to 11; and between eight and nine hours for youth ages 12 and older).

Considerations while in bed:

  1. Optimize sleep dependencies (those events without which the child cannot fall asleep) by making sure they are present throughout the entire night, do not require any resetting during the night and are transportable.
    1. Healthy sleep dependencies: White noise machine (ie., The Hatch ), stuffed animals or blankets that are guaranteed to stay in place.
    2. Unhealthy sleep dependencies: TV, radio, presence of another person, lights, fallen stuffed animals, “full belly” or being rocked or patted.
  2. Do not allow the child to fall asleep outside of their bed (e.g., on the couch) or with a radio or television on that automatically shuts off during the night.
  3. Optimize their sleep context by making it dark (consider room darkening/blackout curtains) and relatively cool, by masking ambient noise that may alert or awake the child by using a white noise machine at a conversational volume and by removing any objects that may encourage behaviour that is incompatible with sleeping (e.g., remove all electronic gadgets and preferred toys from sight).

Adapted from Prevention and Treatment of Children’s Insomnia (difficulty falling asleep, staying asleep, or getting enough sleep) (Hanley, 2013)

Written by: Mackenzie Quain, MpEd., BCBA