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Tools to Address Sleep Troubles in New Bedroom
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Situation
What would be the best way to help an 8 year old boy with Autism Spectrum Disorder to adjust to moving to another home? He seems to do fine until it is time to go to bed and then he gets terribly upset, crying and hitting himself. This behavior does not occur when he is able to sleep in his old bedroom. His grandmother lives in his previous home so he has access to his old room.
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Summary
Moving to a new home or a new city can be stressful for anyone. For children with autism, change can be particularly anxiety-provoking. However, preparing them ahead of time with visual support strategies, involving them in small decisions and using a transition object may help manage their anxiety. In this situation, it seems your child is struggling most with the bedtime routine in their new home. Additional layers of support surrounding this home routine could include a bedtime mini-schedule and assessing the bedroom for environmental factors (size, smells, fabrics) that are very different from what they are used to in their previous bedroom. Then, try to mimic their previous routine and arrange the new room in a more familiar way.
Here are a few other tips to reduce the stress of moving into a new home or bedroom to help your child with autism spectrum disorder sleep well.
- Use a behavior story to explain the upcoming change and what your child can expect in the new bedroom.
- Create a visual bedtime routine schedule that ends with a comforting activity before bedtime.
- Give directions at bedtime followed by a structured choice such as: “It’s time to brush your teeth. Would you like to use your yellow toothbrush or your green toothbrush?”
- Provide a familiar object from the child’s previous bedroom such as a pillow, stuffed animal or blanket.
- Check the new bedroom for sensory-based triggers such as noises, smells or bright lighting that may disrupt your child’s sleep.
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Definition
A behavior or social story is a simple description of an everyday social situation, written from a child’s perspective. The situation is described in detail and focuses on the important social cues, events, expectations and ways for the child to react in the situation. Behavior stories are intended to be used with a child prior to an event. It is rehearsed with an adult so that when the event actually occurs, the child can use the story as a guide for behavior. Visual supports are tools that support a child’s understanding of events throughout their day and to assist in decreasing anxiety. Visual supports may include pictures, words, objects, arrangement of the environment, visual cues within the environment, schedules, timelines, and scripts.
A mini-schedule is a visual schedule or the visual sequencing of events for a short period of time. It is NOT a day schedule. It can be in picture, object, word or numeral format. A mini-schedule can give a sense of time and when an activity will end. Knowing what and when things happen can prevent many behavioral issues.
A comfort object (or transitional object) is an item used to provide psychological comfort, especially in unusual or unique situations. These objects may take the form of a blanket, a stuffed animal, or a favorite toy.
A structured choice option is an intervention that gives a child a sense of control over a situation by providing choices. Structured choice interventions are used to prevent or de-escalate interfering behaviors and to increase appropriate behaviors.
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Quick Facts
- Child's Age: 3-5, 6-10, 11-13, 14-17, 18+
- Planning Effort: Moderate
- Difficulty Level: Moderate
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Pre-requisites
Ability to attend to pictures/written stimuli.
Ability to understand basic language.
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Process
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Write or edit the attached Social Story and have someone read this with your child daily. (Please see the resource section for additional information on the use of Carol Gray’s Social Story strategy.) These are short stories, often with pictures and text describing different situations and activities that will help children with ASD attain positive outcomes through gaining a better understanding of what to expect and how to respond in given situations.
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Include coping strategies your child may already know or explicitly teach new techniques within the behavior story itself. This could be something your child’s counselor or therapist may assist with as well.
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List the 3-4 steps in his bedtime routine and make the last step a comforting activity such as a story, saying prayers or a gentle back rub. Use pictures (and/or words) to represent each step. When bedtime is approaching, give your child a transitional warning (5 minutes, then bedtime) and set a timer. When the timer goes off, point to the first picture in the mini-schedule.
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Avoid asking “Do you want to go to bed?” but rather say something like “It is time to go upstairs and brush your teeth.” Then follow with a “Structured Choice” such as “Do you want to use your red or green toothbrush, hop or walk upstairs, go with me or Daddy?” This can help divert his attention from the directive or task.
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Try to obtain a familiar object from Grandma’s house such as a comforter, pillow or blanket to comfort your child in his new room.
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Take note as to what may be so different about his past bedtime routine and environment. Maybe it is not the bedroom, but the steps leading up to bedtime that are creating stress in your child at this time. Think about “What is his behavior trying to tell me?” Try to maintain consistency from his bedtime routine at Grandma’s to his new home.
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Be observant for “sensory based” triggers in his new room for example: noise outside the window, feel of sheets/comforter, lighting or strong smells from candles or potpourri. Children with autism often struggle with changes in their routine or environment.
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Documents and Related Resources
Mini-Schedules: Getting Ready for Bed (related answer on this site)
Sound Sleep Strategies (related answer on this site)
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