How can I help my child with autism settle down and get ready for bed?
Many children with autism and other developmental conditions have difficulty calming down and preparing for sleep. The first goal is to help them understand the elements of the bedtime routine. A visual schedule and consistent routines are important for this. You can take photographs, use drawings, cut out pictures from magazines or the internet, or use Picture Exchange Communication System (PECS) cards to visually communicate the steps of the routine (for example, show pictures of a bathtub, toothbrush, potty, pjs, book, and bed). One idea is to have two columns of velcro on a laminated piece of paper or on the wall, with the left column being elements of the routine and the right one being the “all done” column. As your child completes each activity, they can move the card from the left to the right –the “all done” side.
Additionally, using a visual timer (either analog or on your phone or iPad/tablet) can be helpful. If your child completes the routine before the timer goes off, they get to do something that they like (such as an extra book or other activity your child finds calming). It often works best to put the favorite part (s) of the routine at the end. Your child’s behavior therapist, occupational therapist, or speech therapist can help you communicate about bedtime and provide reinforcement that is specific to your child. Your developmental pediatrician may have suggestions for medical approaches to helping your child settle as well.About Dr. Melisa Moore