Sensible Sleep Strategies Easing Bedtime Battles

Torri Smith Tejral, MS, BCBA Author

01/02/2018 Added

24 Plays

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This presentation will provide an overview of good sleep behaviors. It will provide a review of effective supports to put in place to ensure good sleep routines and behaviors.

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[00:00:01.882]Welcome to Sensible Sleep Strategies
[00:00:04.119]for Easing Bedtime Battles.
[00:00:06.250]My name Torri Smith Tejral
[00:00:07.715]and I will be presenting today's webinar.
[00:00:14.237]We often don't realize how important sleep is
[00:00:17.084]until we are not getting enough of it.
[00:00:19.217]This is true for us as adults,
[00:00:20.922]this is also true for our children.
[00:00:23.809]Sleep concerns can be very challenging to treat
[00:00:26.297]and are often reported as a concern
[00:00:28.758]for children who are on the autism spectrum.
[00:00:31.733]Today's session is gonna focus
[00:00:33.185]on evidence-based interventions
[00:00:35.706]that address the difficulties that lead to bedtime battles.
[00:00:40.237]It is the intention of today's presentation,
[00:00:42.246]that when you leave,
[00:00:43.486]you will have a host of strategies
[00:00:46.025]that you can pick from to try with your child tonight.
[00:00:50.982]A lack of sleep can affect the child
[00:00:53.198]by leading to increased problem behaviors.
[00:00:56.111]In addition to that,
[00:00:57.162]a lack of sleep can also impact the child's ability
[00:01:00.056]to be an effective learner at school.
[00:01:02.565]If the child's struggling to stay awake during the day,
[00:01:05.196]it's going to be a struggle for them to pay attention
[00:01:07.291]to the instruction that's happening
[00:01:08.929]and engage in that in the best way possible.
[00:01:12.017]In addition, it can affect more than just the child
[00:01:15.032]who's not getting enough sleep.
[00:01:17.056]This can lead to an increase in parental stress
[00:01:19.807]and can also lead to a disruption in family life
[00:01:22.245]as you are dealing with a child
[00:01:24.295]that is not going to bed on time
[00:01:26.281]and is potentially interrupting the sleep and the routines
[00:01:29.106]that you have established for your other children.
[00:01:34.845]Sleep difficulties can be impacted for two general reasons.
[00:01:38.687]The first one is biological,
[00:01:40.403]and the second one is a behavior concern is present.
[00:01:44.367]Before we get started today about strategies
[00:01:46.489]that you could try in order to address
[00:01:48.492]some of the sleep concerns at home,
[00:01:50.461]we first must rule out if there is a biological reason
[00:01:52.909]why the child is having difficulty sleeping.
[00:01:56.099]This often means that we need a physician
[00:01:57.845]to help address any of those issues that are present.
[00:02:00.967]If your child is struggling with sleep issues,
[00:02:03.648]I encourage you to bring up this concern with your physician
[00:02:05.922]to ensure that there are no medical reasons
[00:02:07.902]why the child is having difficulty sleeping.
[00:02:13.591]Once we have ruled out any medical concerns
[00:02:16.489]that may lead to sleep difficulties,
[00:02:18.225]we can start to focus on all of the behaviors
[00:02:20.968]that go into being a good sleeper.
[00:02:23.599]So when we think about good sleep behavior,
[00:02:26.128]we really think about all of those required skills
[00:02:29.234]kiddos need to consistently exhibit
[00:02:31.112]in order to get a good night sleep.
[00:02:33.976]Some of those behaviors are following good instructions.
[00:02:37.552]That means when mom and dad say it's time to head up to bed,
[00:02:40.530]the child follows that instruction to go to their room
[00:02:43.360]and get in their bed.
[00:02:45.244]There's also the instruction of staying in bed
[00:02:47.058]until they're asleep.
[00:02:48.442]In order for children to fall asleep,
[00:02:50.248]they have to exhibit certain physical behaviors,
[00:02:53.603]lying still,
[00:02:55.553]laying quietly, so that way they can fall asleep.
[00:03:00.158]The next one is calm behavior,
[00:03:01.999]is that once they are laying down in their beds,
[00:03:04.069]now we need them to exhibit calm behavior
[00:03:06.083]so that way they can actually initiate sleep.
[00:03:09.889]That moves us to our next behavior, is sleep initiation,
[00:03:13.194]which means we want them to have the skill
[00:03:14.767]of falling asleep independently,
[00:03:16.952]and what we mean independently,
[00:03:18.151]we mean with the absence of mom and dad
[00:03:19.968]being there to rub their back or to rock them.
[00:03:22.700]Any of those behaviors that you may do
[00:03:24.651]that help your child fall asleep,
[00:03:26.715]we want our children to get to a place
[00:03:28.094]where they can initiate sleep on their own.
[00:03:30.839]And finally, we think about sleep maintenance
[00:03:32.798]which means that then once they fall asleep,
[00:03:34.810]they're able to stay asleep
[00:03:36.162]and stay in their beds all night.
[00:03:39.107]So when we look at all of the behaviors
[00:03:41.221]that are encompassed in being a good sleeper,
[00:03:43.993]we wanna start to look at each one of these
[00:03:45.942]and see if there's some skills
[00:03:47.225]that we can support in teaching
[00:03:49.350]so that way your child could do a better job
[00:03:51.501]of being a good sleeper.
[00:03:56.043]So where do we start?
[00:03:57.443]Now that we know about the behaviors
[00:03:59.181]that support being a good sleeper,
[00:04:01.528]we wanna start thinking about
[00:04:02.698]what kind of changes could we make to the environment
[00:04:05.258]and to our behavior, how we respond,
[00:04:08.222]to support them in being a good sleeper.
[00:04:10.488]Today we're gonna talk about five different changes
[00:04:12.733]or modifications that you could make
[00:04:14.929]that will support those specific sleep behaviors.
[00:04:18.045]We're gonna talk a little bit about
[00:04:19.016]the physical sleeping environment,
[00:04:21.027]we're gonna talk about the use of a regular bedtime,
[00:04:23.892]we're gonna talk about a consistent routine,
[00:04:26.594]the use of adult attention, and finally,
[00:04:28.960]how the use of reinforcement about how we respond
[00:04:31.978]to good sleep behaviors can really lead
[00:04:34.233]to better sleep behavior on a nightly basis.
[00:04:38.976]Today we're gonna discuss the most
[00:04:40.227]common issues that arise with sleep.
[00:04:42.259]These are general strategies for you to use
[00:04:44.383]if you see these behaviors present in your child.
[00:04:47.146]However, if you try these strategies
[00:04:49.158]and your behavior persists,
[00:04:51.190]I would encourage you to reach out for
[00:04:53.181]some more individualized support.
[00:04:58.247]The sleep environment.
[00:04:59.642]This is where we're gonna focus on the room
[00:05:01.430]that you want your child to sleep in.
[00:05:03.490]We wanna think about the changes that we can make
[00:05:05.479]to that environment that will serve as a signal
[00:05:08.073]that now is time for us to go to sleep.
[00:05:11.365]One of the ways that we signal that
[00:05:12.836]is by making sure that their sleeping environment is dark.
[00:05:16.363]Now, it doesn't have to be pitch black,
[00:05:18.374]but we wanna make sure that
[00:05:19.410]there is a significant difference
[00:05:21.013]between the dark that it is at night
[00:05:23.400]and the bright that it'll be first thing in the morning.
[00:05:26.165]That's one of the ways that we start
[00:05:27.567]to signal to our children that when it's dark,
[00:05:30.614]maybe the room is mostly dark with a small night light,
[00:05:33.816]that's gonna signal to them that
[00:05:35.125]this is the time for sleeping.
[00:05:38.564]When it's the morning,
[00:05:39.813]we want that room to be very bright,
[00:05:41.328]so we're gonna turn on all the lights
[00:05:42.515]and open the shades so that way that serves as a cue
[00:05:45.026]that sleep time is now over.
[00:05:47.606]We also wanna make sure that it's a comfortable environment,
[00:05:50.126]meaning that they have a comfortable bed
[00:05:52.128]with comfortable blankets.
[00:05:53.986]We wanna make sure that their environment
[00:05:55.623]is cool but not cold.
[00:05:57.594]We know that a dark environment is great
[00:06:00.731]but we know a hot environment
[00:06:02.084]doesn't necessarily support good sleep.
[00:06:04.949]We also wanna make sure that the room is relatively quiet.
[00:06:08.159]It doesn't have to be silent,
[00:06:10.177]but we do want the room to be relatively quiet.
[00:06:12.466]We often talk about sometimes the use of a white noise,
[00:06:14.562]like a fan running in the background,
[00:06:16.765]can help because it tends to block out
[00:06:18.187]other noises that they may hear in the home.
[00:06:20.503]So if there are siblings in the home
[00:06:21.876]or you're up doing dishes before you go to bed,
[00:06:24.944]we wanna make sure that those sounds and noises
[00:06:27.159]don't disrupt them from being able to fall asleep.
[00:06:33.010]Another one of the strategies that you can use
[00:06:35.407]that's gonna help support good sleep behavior
[00:06:37.519]is having a regular bedtime.
[00:06:39.775]We know that when we're teaching the children
[00:06:41.900]about how to use good sleep behavior,
[00:06:44.326]one of the ways that we can help teach them
[00:06:46.013]is making sure that we have a lot of consistency,
[00:06:48.654]meaning that we want you to find a bedtime
[00:06:50.990]that works for the child,
[00:06:52.776]and then we want you to use that bedtime every night,
[00:06:55.967]even on the weekends.
[00:06:57.312]I know it's tempting to let them stay up late
[00:07:00.553]on the weekends or when we don't have to be up for school
[00:07:02.746]or for work in the morning,
[00:07:04.850]however, what we find is that then that leads to difficulty
[00:07:07.848]then on Sunday night when we wanna
[00:07:09.148]get them back on their routine,
[00:07:11.209]and it may take us several days to get
[00:07:12.848]them back on that consistent bedtime,
[00:07:15.162]and then it's Wednesday, Thursday.
[00:07:17.344]Then Friday they have a lot of success
[00:07:18.939]and then we're back to Saturday
[00:07:20.595]where then we let them stay up late again.
[00:07:23.571]This is especially gonna be important at the beginning
[00:07:26.365]when you are trying to teach consistent sleep behaviors.
[00:07:30.743]I would encourage you to set that consistent bedtime
[00:07:33.427]and then implement that every night
[00:07:35.996]as they are learning to be good sleepers.
[00:07:41.614]In addition to using a consistent bedtime every night,
[00:07:44.987]we would also encourage you to think about
[00:07:46.523]implementing a consistent bedtime routine.
[00:07:49.375]This routine would consist of one to three or four steps
[00:07:53.674]that you're gonna do each night
[00:07:55.105]before placing the child in bed.
[00:07:57.583]We want this routine to be consistent but manageable.
[00:08:01.009]The reason we encourage it to be manageable
[00:08:02.887]is that it's a routine we want you to start to do
[00:08:04.910]every single night with your child.
[00:08:07.230]If our routines get too long and have too many steps,
[00:08:10.013]we tend to wanna skip the routine,
[00:08:12.371]and what we know is by setting up a consistent routine,
[00:08:15.154]kids will actually start to connect
[00:08:16.680]those activities with bedtime.
[00:08:19.504]They're gonna start to connect those activities
[00:08:21.353]with getting ready to sleep.
[00:08:23.550]An example of a good sleep routine may be
[00:08:25.784]to brush your teeth, read a book, and go to bed.
[00:08:29.703]You may also use a sleep routine that involves
[00:08:32.356]snuggles with mom and dad, singing a song,
[00:08:35.180]reading a book, those are really gonna be set by you
[00:08:38.216]and what's important in your house at bedtime.
[00:08:41.152]I'm gonna encourage you to not think about
[00:08:42.698]more than two or three steps to be done every night.
[00:08:46.721]If we do too many, again, we have a tendency
[00:08:48.902]to wanna skip the routine
[00:08:50.296]and then that could negatively affect
[00:08:51.565]their willingness to wanna go to bed.
[00:08:54.287]The warning I would give you is that
[00:08:55.394]once you establish this routine,
[00:08:57.245]the kiddos can kinda come to depend on it
[00:08:59.146]as their transition into sleep behavior.
[00:09:02.040]So when you think about that nighttime routine,
[00:09:04.171]you wanna make sure it's something that really supports,
[00:09:06.947]that can be supported in your family every night
[00:09:09.273]and that allows your child to really
[00:09:11.426]have more predictability when they're getting
[00:09:13.436]ready to go to sleep every night.
[00:09:21.118]As you are establishing your routine to be used every night,
[00:09:24.096]I would encourage you to think about
[00:09:25.091]the use of a visual schedule.
[00:09:27.204]A visual schedule can make the steps
[00:09:29.033]of that routine very clear to the child.
[00:09:31.836]We can also refer to this visual schedule during the routine
[00:09:35.259]so they know what step comes next.
[00:09:38.176]The use of a visual schedule can also help
[00:09:39.972]to support predictability for the child.
[00:09:42.727]Now there's lots of ways to do
[00:09:44.443]a bedtime routine visual schedule.
[00:09:46.971]For some children, you could write out the words
[00:09:49.113]and that could serve as a good support for them.
[00:09:52.132]For our younger children,
[00:09:53.339]we need to think about using pictures
[00:09:54.976]or symbols to indicate the step in the process.
[00:09:58.755]If this is a strategy you think
[00:09:59.913]would be beneficial for your child,
[00:10:01.669]I would encourage you to keep it simple.
[00:10:03.855]Google Images has a lot of really great resources
[00:10:06.423]that are available for free.
[00:10:08.415]As you're thinking about setting this up,
[00:10:09.828]I would encourage you to browse around on Google Images
[00:10:12.917]for images that represent the steps of your routine
[00:10:15.271]that you feel like are important.
[00:10:17.439]If you need additional support,
[00:10:18.603]you could sure reach out to other professionals
[00:10:20.271]that are working with your child.
[00:10:21.753]However, in order for this to be really successful,
[00:10:23.929]I would encourage you to make it simple
[00:10:26.041]for you and the child to use consistently.
[00:10:32.084]The use of our attention and our reactions
[00:10:35.041]can also be a valuable tool
[00:10:36.768]in teaching kids appropriate sleep behavior.
[00:10:39.622]When we think about the nighttime routine
[00:10:41.804]and getting kiddos to go to sleep,
[00:10:44.764]we often see that what happens
[00:10:46.500]is when the child exhibits behavior
[00:10:48.245]that we don't like at bedtime,
[00:10:50.006]like getting out of bed, refusing to stay in their bed,
[00:10:53.216]that tends to result in a lot of re-attention
[00:10:55.539]and reaction from us because we are
[00:10:57.805]often redirecting and trying to get
[00:10:59.627]them to stay in their beds.
[00:11:01.481]However, if they're doing the behavior that we wanna see,
[00:11:03.875]which is laying quietly in their beds,
[00:11:06.047]we tend to remove all of our attention
[00:11:08.631]because we want them to fall asleep.
[00:11:11.852]When using our adult attention,
[00:11:13.185]I would encourage to think about
[00:11:14.144]when we're giving attention and when we're not.
[00:11:17.460]So, a strategy to use is to give
[00:11:19.271]lots of attention during that bedtime routine.
[00:11:22.252]You're gonna provide lots of praise
[00:11:23.430]for following the routine,
[00:11:25.017]you're going to do your snuggles in bed
[00:11:26.666]or reading your books in bed,
[00:11:29.012]and then you are going to provide
[00:11:31.070]a goodnight signal, if that's a kiss or lights out,
[00:11:34.061]or whatever is natural in your home.
[00:11:36.384]After that time,
[00:11:37.482]I would encourage you to think
[00:11:38.315]about providing limited attention,
[00:11:40.453]which means if they leave their bedroom or leave their bed,
[00:11:43.173]you would return them with no talking,
[00:11:45.099]there wouldn't be a big reaction from the environment.
[00:11:48.862]We also wanna make sure that
[00:11:49.806]if they're laying in bed quietly,
[00:11:51.615]that we give them little bits of attention for doing that.
[00:11:55.141]That may mean you pop your head in and give 'em a high five,
[00:11:58.040]that may mean that you reach your arm
[00:11:59.148]and then you rub their leg.
[00:12:02.880]The attention that you will give during that
[00:12:05.004]would need to be appropriate to your child
[00:12:07.186]and what they find reinforcing from you.
[00:12:11.166]What we wanna make sure is that if they exhibit
[00:12:13.077]the behavior that we don't wanna see,
[00:12:15.165]that our reactions are limited and matter-of-fact,
[00:12:18.274]meaning that if they leave bed,
[00:12:20.026]we take them and return them back to bed
[00:12:22.573]with not a lot of talking or arguing
[00:12:25.437]or rationalizing about why they have to stay in bed.
[00:12:28.389]I always think about it, like,
[00:12:29.559]after you go to bed at night,
[00:12:31.441]after you say your goodnights
[00:12:32.900]and you do your sleep routine,
[00:12:34.666]we wanna make sure any attention that they get from us
[00:12:36.942]is really for exhibiting those behaviors we wanna see,
[00:12:39.946]like staying in bed and laying quietly.
[00:12:43.391]If they exhibit behaviors we don't wanna see,
[00:12:45.634]we wanna make sure that our attention
[00:12:47.960]is not available for that.
[00:12:49.652]I'm not saying we ignore the fact
[00:12:50.927]that they're now in the living room playing with their toys,
[00:12:53.754]we wanna make sure that we return them to their beds
[00:12:56.311]so they can go to sleep
[00:12:57.750]but we wanna make sure that our attention
[00:12:59.512]in the form of verbal interactions is very limited
[00:13:03.391]so they start to understand that those behaviors
[00:13:05.833]aren't gonna get a big reaction out of mom and dad.
[00:13:12.091]When we think about all these behaviors that we want to see
[00:13:15.275]that lead to the child being able
[00:13:17.039]to fall asleep and stay asleep,
[00:13:19.902]the next tool that we're gonna talk about
[00:13:21.524]is the use of reinforcements.
[00:13:24.191]Reinforcement is the reaction that we give,
[00:13:27.378]so that would be our attention or our praise,
[00:13:30.440]or access to a candy or a special item or activity,
[00:13:34.866]based upon them exhibiting the behavior that we wanna see.
[00:13:39.399]Now when I say behavior,
[00:13:40.639]I'm really referring to the good behavior,
[00:13:42.549]like staying in bed and falling asleep,
[00:13:45.045]and the behavior that we don't like to see.
[00:13:48.327]When we use reinforcement as a teaching tool,
[00:13:50.798]we wanna make sure that we give powerful reinforcement
[00:13:53.734]when they exhibit the behavior that we wanna see again.
[00:13:57.209]What reinforcement does is it actually increases
[00:14:00.140]the likelihood that they'll do that same thing again.
[00:14:03.684]For example, if we were working with a child
[00:14:06.286]and we wanted them to stay in bed all night
[00:14:08.878]and we set the goal for them that
[00:14:10.567]if they stayed in bed all night,
[00:14:11.864]they could have a Hershey's kiss on their way to school,
[00:14:15.047]getting that Hershey's kiss would be
[00:14:16.915]reinforcement for staying in bed all night.
[00:14:19.897]Now, that reinforcement only works
[00:14:21.886]if they exhibit the behavior we wanna see.
[00:14:24.625]If the child were to leave the bed a lot at night,
[00:14:27.987]they would not be able to access
[00:14:30.222]the reward of having a Hershey's kiss.
[00:14:33.520]When we think about reinforcement,
[00:14:35.719]we can really use anything that's motivating
[00:14:37.866]and valuable to the child.
[00:14:39.865]So that may be a Hershey's kiss
[00:14:41.697]but it may be getting to do an extra
[00:14:43.216]activity with mom in the morning.
[00:14:45.351]Or maybe it's that they get to be the first one
[00:14:48.794]to pick the breakfast,
[00:14:50.358]or maybe if they have a great nighttime sleep,
[00:14:53.474]they could access their most favorite
[00:14:55.754]show in the morning before school.
[00:14:58.191]In addition to it being candy or items or television shows,
[00:15:02.430]or anything tangible,
[00:15:04.106]often what we can do is really use
[00:15:05.423]our attention as a reinforcer
[00:15:07.613]meaning that if we identify that there are
[00:15:09.961]certain behaviors we wanna see our kids do at night,
[00:15:12.429]and then they do those behaviors,
[00:15:13.850]we wanna make sure that our response
[00:15:15.837]in the form of our attention,
[00:15:17.614]praise, enthusiasm,
[00:15:20.253]is given based upon them doing
[00:15:22.163]those things the night before.
[00:15:24.341]Now, often when we think about this,
[00:15:25.962]we wanna just be thinking about what's
[00:15:27.201]powerful and motivating to your child.
[00:15:29.528]You know that better than anyone,
[00:15:31.406]about what they're motivated to earn,
[00:15:33.402]but we wanna think about how could we use reinforcement
[00:15:36.153]to support the behaviors at night that we wanna see.
[00:15:42.691]So to get started using reinforcement,
[00:15:44.930]I'd like you to think about the behaviors
[00:15:46.159]you want your child to exhibit at night.
[00:15:48.302]So what would happen if they stay in bed all night?
[00:15:50.690]Or what would happen if they fall asleep on their own?
[00:15:53.382]What would happen if they stay in bed
[00:15:55.862]when you are trying to get them to sleep at night?
[00:15:58.727]We wanna make sure that we have a plan for reinforcement
[00:16:01.377]if they would exhibit these really great behaviors at night.
[00:16:04.660]Now again, we talked about
[00:16:06.001]a lot of those options previously,
[00:16:08.369]but your plan doesn't have to be elaborate.
[00:16:10.907]We wanna think about things that are powerful for them
[00:16:13.123]that could potentially
[00:16:15.013]happen right away in the morning.
[00:16:16.992]So, it could actually become part
[00:16:18.150]of your morning routine of school.
[00:16:19.861]If they stay in bed all night,
[00:16:20.958]they get to have their most preferred Pop Tarts.
[00:16:23.505]And if they don't stay in bed all night,
[00:16:25.446]they get to have the cereal that is nutritious and healthy,
[00:16:28.454]but it's not as fun for them as the Pop Tarts are.
[00:16:36.653]Now I'd like to focus on some specific what ifs.
[00:16:39.940]What if we'd done all of those strategies
[00:16:42.208]and you notice that they're not exactly fixing the problem?
[00:16:45.673]I'd like to go through some common sleep troubles
[00:16:48.275]and the first steps that you would use
[00:16:50.398]in order to try and to turn those problems around.
[00:16:56.223]Here are some common sleep troubles
[00:16:58.247]that we're gonna try to tackle today.
[00:17:00.191]What if my child will not go to bed?
[00:17:02.337]What happens if they won't go to sleep on their own?
[00:17:04.760]What happens if they won't stay
[00:17:05.765]in bed until they fall asleep?
[00:17:07.744]What happens if they don't go to bed until really late?
[00:17:10.427]And what happens if I can't get
[00:17:11.510]them to stay in bed all night?
[00:17:13.389]These are some of the most commonly reported
[00:17:15.924]concerns that we see at bedtime.
[00:17:17.993]We're gonna talk about some general strategies
[00:17:19.779]that you can use if your child
[00:17:20.930]presents with one of these areas of difficulty
[00:17:23.713]and get you started on addressing that problem tonight.
[00:17:30.262]So what if your child refuses to go to bed?
[00:17:33.287]When you say, it's time to go to bed,
[00:17:34.774]and you try to initiate that bedtime routine,
[00:17:36.941]you see lots of refusal and problem behavior
[00:17:39.872]with getting the bedtime routine started.
[00:17:42.487]Well, it's kind of understandable
[00:17:43.904]that we sometimes see this when
[00:17:44.999]we first implement a new routine,
[00:17:47.078]bedtime can be pretty un-fun.
[00:17:49.156]There's not a lot of toys that we let you play with,
[00:17:51.334]mom and dad aren't hanging out with you,
[00:17:52.835]there's not much to look at,
[00:17:54.355]and you kinda just have to lay there quietly to fall asleep.
[00:17:57.551]Sometimes that's difficult to get kids to start doing
[00:18:00.576]because it is pretty un-fun.
[00:18:02.856]Here's a couple of strategies that
[00:18:04.412]I would recommend that you use to get started.
[00:18:07.284]The first one is going to be,
[00:18:08.925]start by putting them to bed when they are very tired.
[00:18:12.310]This sounds very counterintuitive
[00:18:14.513]given that I just told you you needed a consistent bedtime,
[00:18:17.440]but if you're seeing a lot of bedtime refusal,
[00:18:19.206]one of the things we want you to do
[00:18:20.748]is to push bedtime back until they're really tired,
[00:18:23.362]so that way when you lay them in their beds,
[00:18:25.319]they're more quickly able to fall asleep
[00:18:27.866]because they're very tired.
[00:18:29.801]This may mean that your bedtime that
[00:18:31.700]you're shooting for may be 8 p.m.,
[00:18:33.990]but when you start to implement their routine,
[00:18:36.135]you may start with them laying down at nine.
[00:18:39.698]Once they are consistently falling asleep at nine o'clock,
[00:18:43.028]and your bedtime is going smoothly,
[00:18:44.919]then we would encourage you to gradually push that back
[00:18:47.021]to that eight o'clock bedtime
[00:18:48.260]to ensure they're getting enough sleep.
[00:18:51.938]We wanna make sure that we think about
[00:18:53.009]the use of reinforcement during this time, too,
[00:18:55.378]which may mean that during your bedtime routine,
[00:18:57.491]we wanna make sure that every time they follow
[00:18:59.727]one of those instructions that you give,
[00:19:02.912]that they get access to a lot
[00:19:04.118]of reinforcement during the bedtime routine.
[00:19:07.404]This may look like our first step as brushing our teeth.
[00:19:10.555]So the child starts brushing their teeth
[00:19:12.522]and you may be providing a ton of reinforcement attention
[00:19:15.561]because they're following the routine.
[00:19:17.573]So that may be, let's go brush your teeth,
[00:19:20.219]and the child starts brushing even with your help,
[00:19:22.790]and you would say, oh my goodness,
[00:19:24.153]I love how good you're doing.
[00:19:26.042]You're giving back rubs, you're saying, that's amazing,
[00:19:29.206]because what we want them to see
[00:19:30.510]is that following the routines at bedtime
[00:19:32.847]equal big, positive reaction from mom and dad.
[00:19:36.867]The next thing that we want you to think about
[00:19:38.978]is the use of follow thru
[00:19:41.483]which means that when you're giving
[00:19:43.035]those instructions during bedtime,
[00:19:45.404]if you give the instruction that
[00:19:46.468]it's time to brush their teeth,
[00:19:47.952]we do wanna make sure that we follow thru
[00:19:49.863]with that instruction and have them brush their teeth.
[00:19:52.961]That may mean that we have to provide
[00:19:54.234]a lot of support initially
[00:19:55.943]for them to complete these skills independently.
[00:19:59.867]Given the age of your child
[00:20:01.913]and their ability to follow those independently,
[00:20:04.573]we may provide a lot of support
[00:20:06.539]like helping with the steps of that,
[00:20:08.012]like putting the toothpaste on the toothbrush,
[00:20:10.885]or running the water.
[00:20:12.574]Those may be ways that we can support them
[00:20:14.199]in following those instructions,
[00:20:16.025]but we also wanna make sure that once we start the routine,
[00:20:18.273]that we are gonna follow that routine.
[00:20:20.261]If they get upset and do a lot of refusal,
[00:20:23.198]it doesn't mean that we're gonna stop the routine
[00:20:25.155]and let them do something else that they want to do.
[00:20:27.667]We wanna make sure that it's clear to the child
[00:20:29.604]that once we start the routine,
[00:20:31.188]we are gonna follow thru that routine
[00:20:32.631]and then we are gonna lay in bed.
[00:20:35.336]Once they become successful with this bedtime routine,
[00:20:38.017]then you can start pushing it earlier
[00:20:39.659]so you can get them in bed at your target bedtime.
[00:20:42.778]In order for this to really
[00:20:44.734]support good sleep time behavior,
[00:20:47.260]the most important thing that you wanna think about
[00:20:49.083]is consistency and the use of reinforcement.
[00:20:52.346]That may mean at the beginning
[00:20:53.674]you're providing a lot of attention and support
[00:20:56.368]for those behaviors at bedtime
[00:20:58.850]and that your reaction to those behaviors,
[00:21:01.063]when they do what they're supposed to do,
[00:21:02.906]is gonna be over the top.
[00:21:05.048]Once they get good at those behaviors,
[00:21:07.433]we do wanna start to fade you out
[00:21:09.310]so they can be more independent with the routine.
[00:21:12.246]At first, it's gonna be important
[00:21:13.518]that you make a really big deal about each steps
[00:21:16.136]so we can start to build their independence
[00:21:18.764]and compliance with that bedtime routine.
[00:21:26.273]What do you do if your child
[00:21:27.142]will not go to sleep on their own?
[00:21:29.424]Let's say that your child is very
[00:21:30.609]compliant with the bedtime routine,
[00:21:32.541]they'll complete all steps of that
[00:21:33.946]and they'll lay in their bed compliantly,
[00:21:36.261]but when it comes to falling asleep,
[00:21:38.061]your child can't do that without your support.
[00:21:40.642]This often means that parents have
[00:21:41.994]to stay in the bedroom or provide physical support
[00:21:45.181]and interaction in the form of rubbing
[00:21:47.214]their back or rocking them.
[00:21:50.054]So if we wanna support independent sleep initiation,
[00:21:53.806]so falling asleep on their own,
[00:21:55.328]what are some things we can try?
[00:21:57.183]The first thing that we can start to think about
[00:21:58.636]is providing a transitional object that's not you.
[00:22:03.136]So this is often where we start to think about
[00:22:04.943]preferred items that the child likes,
[00:22:06.575]whether that's a blankie or a stuffed animal,
[00:22:09.122]something that the child prefers
[00:22:10.331]that can start to provide that support as they fall asleep.
[00:22:14.678]At the beginning,
[00:22:15.714]it may be good to think about using that item
[00:22:17.861]when you help them fall asleep.
[00:22:19.683]So we start to support them falling asleep
[00:22:21.525]with the stuffed animal and you present,
[00:22:23.692]and then we work on fading you out,
[00:22:25.794]and then they're able to continue to fall asleep
[00:22:27.960]with just the stuffed animal.
[00:22:30.321]We also want to think about the use of reinforcement.
[00:22:33.125]I know I keep coming back to this
[00:22:34.846]but it's gonna be really important to think about
[00:22:36.656]as they're starting to fall asleep on their own
[00:22:39.205]or showing independence with falling asleep on their own
[00:22:41.744]and just using the stuffed animal
[00:22:43.810]that they get access to reinforcement
[00:22:45.709]that is meaningful and powerful for them.
[00:22:49.595]Sometimes this means that we provide adult attention
[00:22:52.208]when they're laying quietly
[00:22:53.236]and mom's not rubbing their back,
[00:22:55.159]sometimes this means that they may get access
[00:22:57.037]to a really preferred item in the morning
[00:22:59.161]when they're able to lay quietly
[00:23:00.523]with just their stuffed animal.
[00:23:02.846]What happens if you've tried those two things
[00:23:04.534]and it's not quite enough?
[00:23:06.356]Then, I'd like to talk a little bit more
[00:23:07.700]about what we call the Excuse Me Routine.
[00:23:13.087]If your child struggles to fall asleep independently,
[00:23:16.213]you can also try the Excuse Me Routine.
[00:23:20.305]To use this, you would use your regular bedtime routine
[00:23:23.488]and your consistent bedtime.
[00:23:25.723]Once your child is laying in bed
[00:23:28.672]and exhibiting what we consider sleep compatible behavior,
[00:23:31.412]meaning that they're laying quietly,
[00:23:33.254]potentially with their transitional
[00:23:35.131]item like a stuffed animal,
[00:23:37.356]you would say, oh, excuse me, I have to go,
[00:23:40.852]and you'd give a reason, you can make one up.
[00:23:42.772]So you could say, excuse me,
[00:23:44.080]I have to go start the dishwasher,
[00:23:46.506]or excuse me, I gotta go shut off the light in the bathroom,
[00:23:49.311]or excuse me, I gotta go let the dog out,
[00:23:51.511]but I'll come right back to check on you.
[00:23:54.014]The first time you do this,
[00:23:55.131]you want your break from the room to be extremely brief,
[00:23:58.941]so you may pop right out in the hallway
[00:24:00.615]and come back in while they are still
[00:24:02.976]laying quietly in their bed.
[00:24:05.511]Then you can say, oh my goodness,
[00:24:06.942]you laid so quietly the whole time I was gone.
[00:24:10.933]Gradually, you're gonna start doing more excuse me's,
[00:24:13.734]so you may say, I have to shut off the light,
[00:24:16.023]you'd go back in, the child laid quietly,
[00:24:19.017]after a brief period of time,
[00:24:20.190]you may say, oh, excuse me,
[00:24:21.511]I gotta go start the dishwasher,
[00:24:23.456]so you pop out, you'd be gone for a little bit more time
[00:24:27.846]than you were the first time,
[00:24:29.267]and you'd come back in, and again,
[00:24:30.809]praise the child if they are laying quietly in bed.
[00:24:35.231]As you continue to repeat this,
[00:24:37.333]you're slowly gonna increase
[00:24:39.257]the amount of time you're gone from the bedroom
[00:24:41.889]before you pop back in.
[00:24:44.169]As we think about working on this night after night,
[00:24:47.421]the first night you may only be gone
[00:24:49.589]two or three times for really brief periods of time,
[00:24:52.706]but as we move into the next night,
[00:24:54.640]night three, night four, night five,
[00:24:56.785]you may start to be gone from the bedroom
[00:24:58.506]for longer periods of time
[00:25:00.339]and you may start to leave more often.
[00:25:03.020]We wanna make sure that when you come back in
[00:25:05.536]and they are exhibiting that sleep compatible behavior,
[00:25:08.688]that we provide that positive attention and reinforcement
[00:25:11.727]so they know that that behavior pays off.
[00:25:14.821]As you continue to work on this,
[00:25:16.644]our ultimate goal is that the child
[00:25:18.576]actually falls asleep when you're outside of the room,
[00:25:22.187]and then they start to exhibit the skill
[00:25:24.119]of falling asleep on their own
[00:25:25.839]and then they can continue to do that
[00:25:28.044]in the subsequent nights.
[00:25:30.221]As you do this,
[00:25:31.054]the only thing that I would encourage you to remember
[00:25:33.185]is that this may be a slow process,
[00:25:35.228]meaning this may take a couple of weeks
[00:25:36.984]for you to be able to fade yourself out completely.
[00:25:40.270]At the end of using this routine,
[00:25:42.316]it may look like that you do your bedtime routine,
[00:25:44.806]you give your kisses and say goodnight,
[00:25:46.773]and then you say, excuse me,
[00:25:47.814]I have to go downstairs and work on the dishes.
[00:25:50.541]You may be gone for a long period of time,
[00:25:52.539]popping back in to see if the child's still awake.
[00:25:55.065]If they're awake, you could
[00:25:55.898]provide praise for laying quietly,
[00:25:57.855]and if they're asleep, then you can go about your night.
[00:26:00.872]This is a great strategy to use
[00:26:02.884]when we have children that have become dependent
[00:26:05.288]upon us being present so they can fall asleep.
[00:26:12.796]What do you do if your child won't stay in bed?
[00:26:15.164]So this is a child who may be compliant with the bedtime
[00:26:17.456]routine and they can fall asleep on their own
[00:26:20.463]but they don't remain in bed long enough for that to happen.
[00:26:24.340]I often think about these as the one more, right?
[00:26:27.235]I need one more kiss, one more love,
[00:26:29.604]one more book, one more drink of water,
[00:26:32.634]one more trip to the bathroom, one more blanket.
[00:26:36.039]It's amazing how many excuses kiddos
[00:26:38.855]can come up with at bedtime to have
[00:26:41.282]a reason to get out of their bed.
[00:26:44.375]If this is happening in your home,
[00:26:46.979]a couple of things that we give you to think about
[00:26:48.534]is how we use attention to teach
[00:26:50.354]the kiddos what we wanna see and what we don't wanna see.
[00:26:53.507]So this may look like a lot of attention
[00:26:55.359]during the bedtime routine, a lot of praise,
[00:26:58.549]and a lot of attention when you're
[00:26:59.530]tucking them into bed at night,
[00:27:00.873]so whatever the final step of your routine is.
[00:27:04.503]Then I would make sure,
[00:27:07.736]when you leave the bedroom for the final time,
[00:27:10.125]that we say goodnight,
[00:27:11.535]that you have some sort of cue
[00:27:12.662]that the bedtime routine is over
[00:27:14.349]and now they need to remain in their bed.
[00:27:17.054]If they get out of their bed,
[00:27:18.495]I would develop a consistent and pretty boring phrase
[00:27:22.706]that we would then return them to bed.
[00:27:25.677]Meaning that if they come downstairs
[00:27:27.031]or come to your room to find you,
[00:27:29.143]I would say, it's time for bed,
[00:27:31.097]and I would return them back to bed
[00:27:32.674]with limited talking, limited interaction.
[00:27:36.124]If they leave the bed,
[00:27:37.130]we wanna make sure that we return
[00:27:38.403]them as quickly as possible so they don't start
[00:27:41.243]to sneak out of bed to get to play with toys
[00:27:43.923]or read a book or sneak the iPad,
[00:27:47.478]we wanna make sure that we monitor that pretty closely
[00:27:50.603]so that getting out of bed
[00:27:51.867]doesn't really get them anything
[00:27:53.486]that's worth getting out of bed for.
[00:27:55.907]They're not gonna get more time with their toys,
[00:27:58.006]they're not gonna get more time with mom and dad,
[00:28:00.208]if they leave their bed,
[00:28:01.081]we just return them in a pretty boring way.
[00:28:04.778]Having said that,
[00:28:06.018]it's also important that when we think
[00:28:07.291]about what their curtain calls are,
[00:28:09.261]their one mores at night,
[00:28:11.205]that we try to address those as part of our bedtime routine.
[00:28:14.420]So if you know your child often says
[00:28:16.199]he wants another drink of water,
[00:28:18.132]I would make sure getting a drink of water
[00:28:19.707]is part of their bedtime routine.
[00:28:21.697]That way we make sure that they get their drink of water
[00:28:24.391]but it happens before they lay down in bed
[00:28:27.252]so they don't have a reason to get up.
[00:28:29.599]I would also include going to the bathroom
[00:28:32.258]and hugs and kisses from mom and dad
[00:28:34.680]as part of that bedtime routine.
[00:28:37.250]Now, if your child tends to exhibit a specific one more,
[00:28:40.817]one more blanket or one more book,
[00:28:42.848]I would make sure that we try to
[00:28:44.303]put those as part of their bedtime routine,
[00:28:46.739]and then, if they happen after your bedtime routine,
[00:28:49.667]their not allowed to get those.
[00:28:51.276]So you do a book as part of your bedtime routine,
[00:28:53.623]but once you say goodnight, we don't read any more books.
[00:28:58.437]Finally we wanna think about,
[00:29:00.069]could we use a visual in order to support that?
[00:29:02.898]Which means that if you have a picture of them
[00:29:04.359]laying in their bed or you use a visual
[00:29:06.480]as part of your nighttime routine,
[00:29:08.517]that you can reference that when you return them to bed.
[00:29:11.009]It's time for bed, and you point at that picture.
[00:29:15.196]The use of reinforcement is the final part of this
[00:29:17.946]that's gonna make it really effective,
[00:29:20.247]meaning that if your child stays in bed all night,
[00:29:22.391]we wanna make sure that in the morning,
[00:29:24.635]something meaningful and powerful happens for them
[00:29:28.629]because they stayed in their bed all night.
[00:29:31.132]This may mean that, again,
[00:29:32.808]they have a preferred breakfast item
[00:29:34.641]or you do a fun activity with them
[00:29:36.751]or you have a little singing party going down the stairs
[00:29:40.025]because they stayed in their bed all night.
[00:29:42.317]We wanna make sure that if they're not
[00:29:44.285]getting your attention when they leave the bed
[00:29:46.207]when they're not supposed to,
[00:29:47.736]that they get a ton of your attention when they stay in bed,
[00:29:50.888]even if that attention comes in the morning.
[00:29:53.356]That way, we really motivate them
[00:29:55.557]to continue to exhibit that positive sleep behavior.
[00:30:03.761]What if your child is a night owl,
[00:30:05.839]meaning that they tend to fall asleep really late at night?
[00:30:09.706]We would first start by thinking about
[00:30:11.460]when do they consistently fall asleep.
[00:30:13.840]So maybe your goal is that your child
[00:30:15.529]has that consistent 8:30 bedtime,
[00:30:17.795]but that child doesn't usually fall asleep until 10:30,
[00:30:21.474]which means that you spend two hours of your evening
[00:30:24.490]fighting that bedtime routine and staying in bed.
[00:30:28.111]The first place we would have you start
[00:30:29.653]is to push back your bedtime routine
[00:30:31.822]to happen right before the time
[00:30:33.552]when they're usually falling asleep.
[00:30:35.600]Now I know this sounds a little backwards,
[00:30:37.605]but let me walk you through
[00:30:38.554]why it's such an important step
[00:30:40.063]when trying to change that behavior.
[00:30:42.418]What we want to have happen
[00:30:43.849]is that they connect that bedtime routine,
[00:30:46.999]for example, brushing your teeth,
[00:30:48.595]reading a book, and laying bed,
[00:30:50.418]with the skill of being able to fall asleep, right?
[00:30:54.384]That we want those things to come
[00:30:55.984]very, very close together in time.
[00:30:58.611]So if you do that bedtime routine at eight o'clock
[00:31:00.822]and then between 8:30 and 10:30,
[00:31:04.152]you return them to their bed
[00:31:05.404]and engage in a lot of struggles
[00:31:06.892]to get them to staying in bed,
[00:31:09.149]the child's not necessarily making that connection
[00:31:11.795]that that routine then signals me falling asleep.
[00:31:14.791]So the first place we would have you start
[00:31:16.234]is to then push your routine back
[00:31:18.546]to occur right before the time
[00:31:19.979]that they're usually falling asleep.
[00:31:22.012]So if this child doesn't fall asleep till 10:30,
[00:31:24.100]I would start your bedtime routine at 10:25.
[00:31:26.862]I would do the bedtime routine
[00:31:28.300]and have them lay down in their beds,
[00:31:30.560]and then hopefully, they would fall asleep
[00:31:32.305]very quickly following that routine.
[00:31:35.255]After they are consistently exhibiting success
[00:31:39.501]with the bedtime routine and then falling asleep,
[00:31:42.194]we can consider what changes we could make
[00:31:44.172]to push that earlier in the evening
[00:31:47.027]so you're able to establish more sleep for the child.
[00:31:50.207]Before you're able to address that, again,
[00:31:52.284]I'm gonna talk about the use of reinforcement
[00:31:54.522]in supporting that behavior.
[00:31:56.635]So if we say we're gonna do the bedtime routine
[00:31:58.945]and then we're gonna lay down in our beds
[00:32:00.846]and you're gonna stay in your bed until you fall asleep,
[00:32:03.407]we wanna make sure that the reinforcement
[00:32:05.218]that we provide for staying in bed
[00:32:07.552]and falling asleep right away
[00:32:09.218]is really powerful for them,
[00:32:11.138]whether that's in the form of our attention
[00:32:13.554]or in the form of, like, a special activity
[00:32:15.834]or a special breakfast,
[00:32:17.541]we wanna make sure that they
[00:32:19.419]understand that those behaviors,
[00:32:21.801]laying in bed and falling asleep right away,
[00:32:24.169]are really powerful and pay off for you in a big way.
[00:32:27.912]Once you have that established,
[00:32:29.901]where you have your later bedtime routine
[00:32:32.428]and then the child's consistently falling asleep,
[00:32:34.752]and their accessing that reinforcement,
[00:32:37.246]that reward that's really positive for them
[00:32:40.742]and we're seeing them do that consistently,
[00:32:43.126]then you can start to push your bedtime routine back,
[00:32:46.277]maybe in 10 or 15-minute intervals,
[00:32:49.013]so you start to get your bedtime to a more reasonable time.
[00:32:53.103]So to go back to our example,
[00:32:54.824]if you're doing your bedtime routine at 10:25
[00:32:58.052]and the child is laying down in bed at 10:30,
[00:33:01.335]and let's say in the morning
[00:33:02.239]they're earning a reinforcer that's powerful for them
[00:33:04.787]and we see a week period of that being successful,
[00:33:07.581]then I may start to push the bedtime routine
[00:33:11.067]to starting at 10:15 with the child
[00:33:12.896]falling asleep immediately after.
[00:33:15.132]After a period of time where they're successful,
[00:33:16.888]I could push it back till 10.
[00:33:18.540]And I could continue to push it back
[00:33:19.882]after several days of success
[00:33:21.992]where I'm continuing to connect
[00:33:23.512]that the routine comes immediately before the bedtime,
[00:33:26.796]we start to create that sense
[00:33:27.926]of predictability and consistency.
[00:33:30.930]If we're able to do that consistently,
[00:33:32.731]we should be able to gradually move the bedtime earlier
[00:33:36.114]so the child is getting enough sleep.
[00:33:39.145]At the beginning when I recommend this,
[00:33:41.053]this sounds very counterintuitive to what we would say,
[00:33:44.040]if the child's very tired, they need more sleep.
[00:33:46.431]And while I agree with you,
[00:33:47.951]we often have to start with where the child is,
[00:33:50.519]support success, teach the skills that we want them to have,
[00:33:53.948]and then gradually, we can move that bedtime back.
[00:34:00.320]So what if your child tends to get
[00:34:02.210]out of bed in the middle of the night?
[00:34:04.668]So they do a good job with your bedtime routine
[00:34:07.618]and they fall asleep pretty quickly,
[00:34:10.287]but you find that at two, or three, or four in the morning,
[00:34:12.914]your child sneaks out of bed
[00:34:14.746]and comes into your room to get you up
[00:34:16.424]or comes to go snuggle in with their brother or sister.
[00:34:21.106]If that's a concern,
[00:34:22.527]we wanna think how we can respond
[00:34:24.481]to them getting out of bed in the middle of the night.
[00:34:27.533]If that's happening,
[00:34:28.695]I'm going to encourage you to return
[00:34:30.292]your child to their own bed, or to wherever they sleep,
[00:34:34.216]every time they leave.
[00:34:36.080]Now I know at the beginning
[00:34:36.964]that sounds a little overwhelming,
[00:34:38.361]when it's two o'clock in the morning
[00:34:40.262]and your child leaves their bed two or three times,
[00:34:42.889]because that means mom and dad are up two or three times.
[00:34:47.101]When we return them to their beds,
[00:34:48.632]we wanna make sure that we're not providing
[00:34:50.409]a lot of attention to them, not a lot of talking,
[00:34:53.349]not a lot of rocking or rubbing their back
[00:34:56.443]or any sort of interaction that would lead them
[00:34:59.661]to wanna continue to get out of their bed.
[00:35:02.579]If we do this consistently,
[00:35:04.837]what we'll see if the first couple of nights
[00:35:06.522]will be pretty rough,
[00:35:08.234]they will wanna get out of bed a lot
[00:35:10.759]and are looking to see if they can
[00:35:13.529]get a reaction out of mom and dad,
[00:35:15.472]or get mom and dad to lay with them
[00:35:17.393]or engage in some of those behaviors that they really like.
[00:35:21.161]If we're really consistent about returning them
[00:35:23.665]and providing limited attention during this time,
[00:35:26.512]we will see that this behavior will stop pretty quickly.
[00:35:30.190]However, in order to support it
[00:35:32.279]and stopping as fast as possible,
[00:35:34.728]we wanna make sure that we are providing reinforcement
[00:35:37.655]for when they don't leave their bed at night.
[00:35:41.060]This reinforcement has come up multiple times.
[00:35:44.144]In every instance of addressing a problem at bedtime,
[00:35:48.806]we are gonna use reinforcement to make sure
[00:35:51.050]that if they do the behavior we like,
[00:35:53.342]the response is so powerful and meaningful
[00:35:56.570]that we tend to see more of the behavior that we wanna see,
[00:35:59.958]like staying in bed and laying quietly,
[00:36:02.707]and less of the behavior that we don't wanna see.
[00:36:10.295]In today's presentation,
[00:36:11.805]we've been able to cover quite a bit of information
[00:36:14.250]about supporting good sleep behavior.
[00:36:16.508]We first talked a little bit about
[00:36:18.004]the reasons why we see sleep difficulties
[00:36:21.010]and that these could be from a biological reason
[00:36:23.256]or a behavioral concern.
[00:36:25.334]I would encourage you to bring up
[00:36:27.100]your sleep concerns to your physician
[00:36:29.379]in order to rule out any medical cause
[00:36:31.112]as to why sleep may be difficult for your child.
[00:36:34.161]Once you've done that,
[00:36:35.333]we can start to look at strategies
[00:36:37.102]that we can use to support good sleep behaviors.
[00:36:40.531]Then we went into a lot of what ifs.
[00:36:42.587]When you look at those what ifs,
[00:36:43.883]I would encourage you to think about your child
[00:36:46.565]and the concerns that you see present at bedtime
[00:36:49.594]that lead to a disruptive evening
[00:36:51.281]for your child and for yourself.
[00:36:54.255]In this presentation,
[00:36:55.227]we covered lots of strategies and techniques
[00:36:57.930]that you can use to address those concerns.
[00:37:01.217]I would encourage you to pick one area
[00:37:02.992]that you'd like to focus on with your child
[00:37:05.351]and implement that one area consistently.
[00:37:08.624]Once you're able to address that one area
[00:37:10.827]and you see your child being successful,
[00:37:13.049]then you can move on to adding more things,
[00:37:16.155]more techniques and strategies,
[00:37:17.733]to support good sleep behavior.
[00:37:20.260]As a reminder, regardless of the strategy that you pick,
[00:37:23.788]the use of reinforcement will be important
[00:37:26.878]in order to support good sleep behaviors.
[00:37:29.894]Good luck as you tackle those bedtime battles.

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Sensible Sleep Strategies Easing Bedtime Battles

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