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Tips For Parents: Sleep Deprived?

sleepSLEEP DEPRIVED? 
This is the first in a montly series of "Tips For Parents" that will cover a wide range of topics. 

This month we tackle the issue of sleep deprivation. A simple intervention to get your family back to sleep FAST!
 


”THE BEDTIME PASS"

The Bedtime Pass intervention utilizes a physical object to represent a limit on bedtime requests including but not limited to the ever popular, "one more story," "can I have more water?" "more kisses," "extra hugs please," "turn the light on," "turn the light off," or the most comprehensive yet simple, "MOMMY MOMMY MOMMY!"  Though initially these requests and cries for attention may be endearing and sweet, they quickly become sleep thieves which can take a toll on the entire family. In addition to chronic sleep deprivation negatively affecting a child’s everyday functioning, it may also disrupt parents’ sleep, valued alone time, work performance, and overall energy.

Establishing successful sleeping habits at an early age will set the stage for happy and healthy sleep for the entire family. By using the Bedtime Pass intervention, you can keep the sweetness of a fun bedtime ritual AND ensure everyone in the family gets the zzz's you need!


BEFORE BEGINNING ANY NEW TEACHING INTERVENTION, IT IS IMPORTANT TO ASSESS IF IT IS RIGHT FOR YOU AND YOUR CHILD. DO THIS BY ANSWERING:

Is this strategy for your child?
Does your child get up multiple times after being put to bed?  If so, how many and what does that behavior look like?  Does your child cry, shout, calmly request, find you in the house, get out of bed and start playing with toys, etc?  What is your current strategy for addressing his requests and resistance to sleeping?

Is this strategy for you?
Learning new things takes time. Before introducing The Bedtime Pass intervention, you should look at your family's schedule and select a date range during which you can consistently implement the Bedtime Pass intervention. If your typical routine cannot be followed (e.g. if staying in hotel, must stay up later than typical for events, must get up earlier than typical, etc), do not start the intervention. You will need to commit to keeping your child's sleep schedule as typical as possible (e.g. bedtime routine, time to sleep, time to wake) throughout the teaching of the new Bedtime Pass intervention. Though requires some initial patience and and lots of consistency, with your steadfast application, your child will quickly learn to fall asleep and stay asleep each night!

 

ONCE YOU DETERMINE THAT THIS IS THE RIGHT INTERVENTION AND YOU HAVE THE TIME AND COMMITMENT TO DEVOTE TO TEACHING, IT IS TIME TO START!  FOLLOW THESE STEPS TO TEACH YOUR CHILD TO USE THE BEDTIME PASS EFFECTIVELY:

STEP 1: CREATE OR SELECT A "BEDTIME PASS" WITH YOUR CHILD

The pass can be anything, it just needs to be an item your child can exchange. This is a great opportunity to give your child choices and incorporate his preferences. Examples of a pass range from a simple card to a decorated key. To increase your child's excitement of the new program, you can also make this an art activity to do together. If you child loves rainbow fish, decorate a fish card with tissue paper and name it "sleepy fish."  If you child prefers superheroes, make or dress a doll and name it "Super Zzzz."  If your child gets up more than three times per night, you should make three passes. If your child gets up 1-2 times per night, make two passes.
 

STEP 2: ESTABLISH THE RULES OF THE NEW SYSTEM

Tell your child that she may exchange a pass ("Sleepy Fish") one time for a reasonable request (such as a quick hug or a sip of water). Once the pass is exchanged and request granted, he must return to and remain in bed. If your child does not exchange the pass on a given night, be sure to praise him for going right to sleep. For children who wake multiple times each night, start with three passes. Once they successfully use 3 or fewer passes for three consecutive nights, drop down to two passes. Once the child is successfully using two or fewer passes for three consecutive nights, drop down to one pass per night. Any unused passes can be cashed in for a prize at the end of the week! 
 
 
STEP 3: BUILD THE ROUTINE

Develop a simple script for your child to review each night at bedtime. For example, “Remember, you can use Super-Zzzz each night for a quick hug or if you need me. After you give it to me, you need to stay in bed and go to sleep.” Remember that the goal of the intervention is for your child to simply go to sleep without the additional request. Be sure to make that goal clear and reinforce going right to sleep the next morning with lots of social praise and congratulations to your child (and Sleepy Fish).

 

TROUBLESHOOTING 101
Any new learning will have its challenges. Your child has likely developed a solid habit that has effectively resulted in delaying going to sleep. The crucial component of behavior change is consistency of the intervention. As you run into hiccups along the way, here are some simple suggestions:

What if?: What do I do if my child calls out or gets out of bed after the pass has been exchanged?
Answer: This will likely happen at the start of your intervention. Given that you are working to break a well established habit, it is very important that you do your best to resist giving your child any attention; Avoid responding to him and simply guide your child back to bed with as little physical interaction as possible and no talking. Be consistent and calm and your child will quickly learn that the social interaction and reinforcement once available now has to wait until morning.

What if?: What if my child has a nightmare or gets sick?
Answer:  We recommend taking care of your child’s immediate needs and providing comfort first and foremost. Consult a medical professional if you suspect there to be underlying medical issues impeding your child’s sleep.

What if?:  What if it does not seem to be working?
Answer: If you have consistently implemented the Bedtime Pass and followed through when needed, and your child is continuing to demonstrate challenging bedtime behavior by resisting bedtime, you may want to consider the addition of another strategy (such as, bedtime fading).

 
To Conclude:

The Bedtime Pass is a simple and effective strategy that can help your child remain in bed and get to sleep, likely avoiding power struggles and extinction bursts that often accompany other methods. The pass works! We have seen the Bedtime Pass successfully used with young children of different abilities. In fact, we often see that children independently start to save their pass and not use it each night, perhaps saving it “just in case” as a sense of security or falling asleep before they deem it necessary to use their one-time pass.

Up to 50% of all young children demonstrate sleep problems, with up to 80% of children with autism exhibiting sleep dysfunction. Research suggests that sleep problems adversely affect cognitive functioning and daytime behavior. Because of this, it is crucial to address behavioral challenges accompanying sleep with young children as soon as possible.

Get back to sleep! Shake things up with a novel approach to bedtime resistance and let us know if the Bedtime Pass worked for you and your child.

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