Saturday 18 November 2017

Dear David Coleman: Can you help me teach my six-year-old son who has autism how to sleep alone in his own room?

Photo by Thinkstock
Photo by Thinkstock
David Coleman

David Coleman

Clinical psychologist David Coleman offers parenting advice in his weekly column.

Q. My son, who is six, has autism, and I would love for him to sleep in his own room by himself. This has always been a problem from when he was a baby. He has always been in our bed or needed me in his bed. At the moment when he goes to bed at about 9pm or 9.30pm I have to lie in beside him. He likes to hook his arm around me to ensure I am there! It might take him up to two hours to fall asleep. I sneak out then, but he might wake within the next two hours and I have to go back in to him. It's like he needs to hold on to me in order to sleep.

David replies: Sleep issues are so common for many families. I think the level of co-sleeping (where a parent shares a room or a bed with their child) is massively under-reported. Very many families have one or more children who rarely either fall asleep, or stay asleep, on their own.

In this respect, then, you and your son are certainly not alone. Indeed, in situations where co-sleeping leads to a good night's sleep for both the parent and the child, I think there is a lot to recommend it.

Parents gain the comfort of knowing their child is close by, safe and sleeping soundly. Children gain real comfort and security from the presence of their parent and can afford to relax deeply into their sleep.

Even though you seem determined to help your son to transition to sleeping in his own room, alone, it might be worth considering why this transition is necessary just now? Perhaps he needs you, rather than just simply wanting you. On the flip side, however, maybe you have had enough of the discomfort, or perhaps you have other reasons.

That your son has an Autistic Spectrum Disorder (ASD) possibly plays a big role in the dynamic of what is happening currently. You don't say what his level of communication is, but, if it is limited, then that might add to his insecurity and also your ability to reason with him about the difference between what he might want and what he might need.

It may be clear to you, for example, that the closeness and security he appears to seek, with you, at night is not necessary for him. If you are determined to change it, then look at creating a very gradual withdrawal from the high level of physical comfort you currently offer him.

This is achieved by taking small incremental steps from lying beside him, to sitting in the bed with him, to sitting beside the bed (but still touching him), to sitting beside the bed without touching him, to sitting apart from the bed in the room, to sitting by the door, to sitting outside the door and then to just visiting on a regular basis.

You can expect your son to protest at the changes, but on each occasion his protest might only last a few days or a week or so, before he realises that you are willing to stick by whatever stage you are at.

You can respond to the protests by being warm, caring and firm. Try to avoid getting into big discussions with him (if he communicates at this level) and use lots of empathy to let him know that you do understand that the new stage might be challenging, but that you have confidence he can cope.

He, in turn, needs to be confident that you will be reliably available to him, even if the level of physical closeness is reduced.

It is your reliability that gives him enough security and comfort that he might be able to fall asleep.

Try, then, not to rush ahead with moving to the next stage, or the next step, in the withdrawal process.

Give him plenty of time to get used to the new way of doing things after each stage. Backtrack to an earlier stage if he seems overwhelmed and upset and not settling into a new stage.

As a consequence, this kind of approach to gradually weaning your son off your physical presence in the bed with him, can take several months of investment of time and energy every night.

If you are in receipt of services for your son, then talk, too, with his occupational therapist, who may have some guidance for you in relation to helping him settle from a sensori-motor perspective.

However you choose to proceed, be patient.

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