Sleep is essential for us to live healthy lives. Yet, did you know that up to 80 percent of Autistic children experience sleep difficulties, compared to 50 percent of their neurotypical peers?1,2 Behavioural sleep intervention is an effective and evidence-based support for children experiencing behavioural sleep challenges, such as the symptoms of insomnia.3 However, the research on how to best customise an intervention to a child’s likes and dislikes is limited.4
So how can we best learn about a child’s preferences and include these in a behavioural sleep intervention to support better sleep? The idea of ‘happy, relaxed and engaged’ (HRE)5 can help guide us to individualise children’s sleep routines to their preferences and, ultimately, improve quality of life with better sleep.
What is Behavioural Sleep Intervention?
Behavioural sleep interventions have been consistently shown as effective in improving children’s symptoms of insomnia.6,7 A commonly used behavioural intervention is ‘sleep hygiene’ or ‘sleep optimisation’, which is designing daytime and nighttime routines to support healthy sleep.8 This may include:
To learn more about Behavioural Sleep Intervention, check out our previous blog here!
What does the research say?
Currently, the research on sleep often recommends individualising a child’s sleep routines to their needs. However, few research articles explain how to do so. In 2020, Phillips and colleagues analysed the current research on behavioural sleep intervention for neurodivergent children and found that the specifications on how to modify behavioural interventions for neurodivergent children were limited.9 Other studies have added Functional Behaviour Assessment to their sleep interventions, and found that the individualisation of behavioural sleep intervention to children’s needs leads to successful outcomes.10,11,12 Further research is needed to identify effective strategies for individualising behavioural sleep intervention to children’s specific needs and preferences.
What is Happy, Relaxed and Engaged?
The concept of HRE refers to a person’s positive affect and engagement with activities.13 When teaching new skills, ensuring a child is enjoying a rich, fun playtime is critical for future teaching to be successful.13
“A meaningful reinforcement context is a useful tool for teaching important skills.”
– Gover, Staubitz & Juarez, 2022, p. 74
Critically, HRE is individualised to the person’s needs and preferences. We must consider which factors will result in the client’s happiness and relaxation and engagement in their preferred activities.
How can we design customised sleep routines?
1. Identify the child’s HRE
The first step is to learn what supports the child to be happy, relaxed and engaged! This could be through observing how the child enjoys spending their free time, asking those closest to the child or asking the child what they like. Some questions to consider include:
2. Create sleep routines which support sleep
Optimise sleep by ensuring that the child’s sleep signals are conducive to sleep. Consider each of the sleep signals, including:
Create a behavioural sleep intervention and sleep routines which are both supportive of a good night’s sleep and which include the child’s individual preferences. This might include, for example:
By considering both the child’s needs and preferences and general sleep guidelines, this can support the child to have a joyful bedtime each night.
Disclaimer: The advice in this article is general in nature. If your child experiences sleep difficulties, reach out to a trusted professional for further individualised advice and support.
Super Kids acknowledges each individual’s personal preference to use identity-first or person-first language to describe themselves or their loved one. We interchangeably use both language conventions and therefore refer to both autistic children and children with autism.