Practical Strategies and Support for Night-Time Wakefulness and High Activity Levels

Understanding the Situation

Sleep issues and increased movement are common among children on the autism spectrum. Parenting an autistic child who has difficulty sleeping through the night and tends to be highly active can be challenging, both emotionally and physically. The following advice is designed to offer practical strategies, support, and reassurance to families facing these challenges.

Establishing a Consistent Bedtime Routine

• Predictable Schedule: Try to keep bedtime and wake-up times consistent, even on weekends. Routines help autistic children feel secure.
• Wind-Down Activities: Engage in calming activities before bed, such as reading a story, listening to gentle music, or taking a warm bath.
• Visual Schedules: Use visual aids, like a chart or picture cards, to outline the bedtime routine step-by-step.

Creating a Sleep-Friendly Environment

• Minimize Distractions: Reduce noise, use low toned voices, dim lights, and lessen other sensory distractions in the child’s bedroom. Consider blackout curtains, white noise machines, or using a fan.
• Comfort Objects: Allow your child to have a favourite blanket or stuffed animal to help them feel safe.
• Use of weighted blankets and calming scents, like lavender.
• Temperature and Clothing: Ensure the room is a comfortable temperature and your child’s pyjamas are soft and non-irritating.

Managing Daytime Activity

• Physical Exercise: Encourage regular physical activity during the day to help use up energy. Activities could include playing outside, swimming, or dancing.
• Use of visual structure, with pictures of running, jumping and other high energy activities timed for 15-30 minutes, every couple of hours, depending upon the child’s energy.
• Structured Play: Provide opportunities for structured play, building toys like blocks, lego, and sensory toys that allows your child to move but in a safe and controlled way.
• Sensory Needs: Offer sensory-friendly activities, such as jumping on a trampoline, playing with kinetic sand, or using a weighted blanket.

Supporting Emotional Well-Being

• Stay Calm: When your child is active at night, try to remain calm and patient. Reacting with frustration may increase anxiety or make sleep more difficult.
• Positive Reinforcement: Praise and reward your child for staying in bed or following the bedtime routine, even if for short periods.
• Communication: If your child is verbal, talk about why sleep is important and how everyone in the family benefits from rest.
• If the child is nonverbal, connect with the child and explore the best way he/she is showing the potential for building a visual way of communication.
• Most nonverbal children have the ability to learn to type and read when guided gently and gradually with positive reinforcement.

Seeking Professional Support

• Consult Your Health Care Provider: a prescription of melatonin would be helpful, but without the structured day and night activities, not very helpful.
• Other sleep medications not recommended.
• Occupational Therapy: Occupational therapists can help address sensory needs and suggest activities that may promote better sleep.
• Communication Therapy: Speech language or Communication Device use learning.

Self-Care for Parents and Families

• Primary caregiver should take advantage of the time when the child sleeps, to catch up on their sleep.
• Short power naps during the day when the child is busy with indoor play.
• Connecting with other families who have a child with autism, as a support group.