Sleep disturbances in children with neurodevelopmental disabilities and Autism are common and persistent. They have a profound effect on the quality of life of the child, as well as the entire family. Here we explore what sleep hygiene is and how an Occupational Therapist can help.
Sleep difficulties are associated with negative outcomes for the child or young person. Including challenging behaviour and impaired educational or work performance. The family often experience increased stress and relationship difficulties.
Although interventions for sleep difficulties often involve a combination of behavioural strategies and medication. An essential first intervention for behavioural sleep problems is sleep hygiene education. This advises parents and carers on creating optimal sleeping conditions for their child and exposes them to activities and cues that prepare them for and promote appropriately timed and effective sleep.
We teach the families to be able to unpick and problem solve the sleep issues so that they can manage them more effectively.
Despite the importance of sleep-hygiene principles, many clinicians often lack appropriate knowledge and skills to implement them, particularly within the SEND and Disabilities community.
How Occupational Therapists can support sleep hygiene
Restful and adequate sleep provides the foundation for optimal occupational performance, participation, and engagement in daily life. The impact of sleep on function and participation is incorporated into the repertoire of occupational therapists and addressed across the lifespan. Prevention and intervention strategies to address individual and family needs lie within the scope of practice for occupational therapy and represent another way in which the profession approaches clients from a holistic perspective to help them live life to its fullest.
Occupational Therapists use knowledge of sleep physiology, sleep disorders, and evidence-based sleep promotion practices to evaluate and address sleep disorders on occupational performance and participation. Sleep difficulties are addressed with all clients and framed from the perspective of health maintenance and health promotion. Here is a case study of how occupational therapists may address sleep difficulties with a child with Autism.
Case Study: Children with Autism Spectrum Disorder
Occupational Therapists working with families of children with an autism spectrum disorder or another developmental disorder explore the impact of sleep deprivation on the family unit and the child’s and caregivers’ ability to function effectively during the day. We support families to systematically trial changes in bedtime routines, habits, and patterns. Cognitive or behavioral therapy interventions, or strategies to address sensory avoiding or sensory seeking behaviours are used.
James is a 14-year-old with Autism, he is minimally verbal, has high sensory needs and can present with challenging behaviour. James has been taking Melatonin in increasing doses since he was 6 and at the time of initial assessment was taking 3-4 hours to settle for bed and waking multiple times per night. When awake James was at risk of absconding, risky behaviour and usually woke the rest of the house.