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Make Bedtime Easier for Your Child with Special Needs

Bedtime is often a word that makes children – and parents – cringe with anxiety. Whether it’s crying, tantrums, refusals, waking up at all hours of the night or all out brawls, the obstacles that lead to bedtime drama are vast. Many children will struggle with bedtime at some point, but children with special needs often have a particular difficulty in this area.

The following strategies may help your child fall fast into dreamland; but if sleeping is a major effort for you and your little one, assistance from a licensed occupational therapist could be beneficial.

Scenario One: The Energized Bunny

Bobby is a 2-year-old who hates bedtime. When the TV is shut off at night, he knows it’s time for bed and will scream and run through the house. He never seems to be tired, is always on the go and seems to get ramped up at night instead of settling down. His parents have to practically drag him to bed, where he kicks and screams until he crashes and falls asleep.

Some children crave movement and lack the ability to settle themselves. This can be particularly hard at bedtime. Providing calming strategies throughout the day and routine at nighttime can help ease their transition and give them the support they need to fall asleep.

  • Providing a routine – Routine is key for children who avoid, or all out refuse, bedtime. This way they know exactly what is going to happen and when. After the initial adjustment phase, children should begin to decrease their resistance, as long as consistency is present. Providing a visible schedule for the bedtime routine can also help some children. Here are a few suggestions:
    • A written list with checkboxes for an older child to check off after each step is accomplished.
    • A list of pictures for a younger child to follow.
    • Stickers are also a great motivator. Have your child put a sticker next to each finished step.
    • Have the child help put the list together so they have a choice in what step happens when.
    • Use a “Time Timer” (this can be purchased through Amazon or other retailers). This is a timer that highlights the amount of time left in red and the child can watch the red disappear. This is especially helpful for small children.
  • Providing heavy work (calming input to their muscles) – Heavy work provides proprioceptive input, which is a sensory processing term referring to deep pressure provided to the body’s muscles and joints.  Proprioceptive input helps calm and regulate an individual’s sensory system. Early in the evening, prior to settling down time, try wheel barrowing walking, rough and tumble play, jumping and crashing into pillows, or walking like animals (crabs, bears, tigers, etc).  This heavy work to their muscles will help provide support to the child’s nervous system for them to calm down enough to fall asleep.

Other calming strategies to try:

  • Use lavender during bath time
  • Towel off the child after a bath with heavy downward strokes
  • Massage with lotion after bath or before bed
  • Use a heavy quilt to sleep with
  • Turn the TV off one to two hours before bedtime. Television actually stimulates the brain. Even through the child’s body may seem calm, this can hinder their ability to fall asleep.
Scenario Two: The Negotiator

Sally is four-years-old and loves to negotiate during her bedtime routine. She is always requesting things to get mom or dad back in the room. Eventually, mom will lay down with her so she will settle down. Some nights, mom will sleep with her in her bed all night or Sally will end up in bed with her parents.

Breaking a habit is hard for anyone, but for a child it seems even harder. Children don’t understand the importance of sleeping on their own or allowing mom to have a break and get a good night’s sleep. Some children can easily adapt to a sudden change from mom lying with them to fall asleep to nothing at all, but others can’t.

“Explore."

Try this step down method to help ease the transition.

  • For a night or two parent can sit next to the child to comfort and soothe them until they fall asleep.
  • Next, the parent can sit at the end of the bed with only comforting words.
  • Then try having the parent sit next to the bed or in a nearby chair
  • Then try standing at the door
  • Then try waiting outside the door
Scenario Three: The Wiggle Worm

Joey is three-years-old and hates bedtime. He doesn’t enjoy bath time and consistently squirms away when his mother tries to bathe him. Once out of the tub, he runs off and hides to avoid getting dressed. He cries when putting on his pajamas, unless they are his old ones, which he is now outgrowing. He seems to consistently tug and pull at his clothing. He tosses and turns in bed for hours until he finally falls asleep.

Some children have difficulty tolerating the feel of certain textures, clothing, or materials. The behaviors associated with this discomfort can often appear as defiance.

Watching how your child responds to certain clothing or textures can clue you in to whether this is an area of concern.  Joey doesn’t like bath time when his mother washes him with a wash cloth (which he feels is rough and scratchy). He likes to play in the water, but only if he doesn’t splash. The pajamas mom wants him to put on are new and scratchy, while he loves his old comfortable ones that are soft and worn. He doesn’t like the feel of the comforter on his bed and tosses consistently to get comfortable.

Here are some strategies that might help ease the situation.

  • Look at your child’s sheets, blankets and pajamas. Try having your child pick out ones that he likes.
  • Wash pajamas a few times with fabric softeners to break them in prior to putting them on your child.
  • Use a soft sponge or baby washcloth in the bath.
  • Give your child a massage after bath time. The deep pressure will help calm their system.
  • Try using a heavy quilt at bedtime.
  • There are many weighted products commercially available, such as blankets, stuffed animals and lap pads. This is an option to help provide deep pressure, which may help calm your child’s system in order to help him fall asleep.

 

About the author

Brooke Thomas

Brooke has 5 years of clinical experience in occupational therapy include pediatrics, adult rehabilitation and inpatient care. Her interests as a therapist are Sensory Processing Disorder, developmental delay and visual motor difficulties.

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Make Bedtime Easier for Your Child with Special Needs