Just Go to Sleep: Strategies for Improving Sleep Habits in Your Family

We all know sleep is important for maintaining a healthy, happy lifestyle. Unfortunately, sleep doesn’t always come easy, even to children. Some children, especially those with sensory processing issues and other difficulties, struggle to get to sleep and remain asleep through the night. What’s more, chances are, if your child isn’t sleeping, you aren’t either. The result is a cranky, sleep-deprived child and a cranky, sleep-deprived adult. Here are some strategies for improving your child’s “sleep hygiene,” or habits that promote healthy sleep.

Importance of a bedtime routine:

The first piece of advice that most people get about improving their sleep hygiene is to have a consistent bedtime routine. Maintaining a consistent bedtime routine is one of the best ways to help your child’s body know when it’s time to sleep. They will start to associate a particular time and set of actions with sleeping, which prepares their body for sleep before they even get into bed.

Establishing a routine goes beyond just having a set bedtime and wakeup time (although these should be as consistent as possible as well). A bedtime routine could start as early as a few hours before bed. Before bed, your child will need to brush their teeth, change into their pajamas, potentially take a bath or shower, and partake in whatever calming activities your family chooses. All of these activities should, ideally, be as consistent as possible from night to night. Try to make sure that all of these activities occur in the same order, at the same time, every night to help your child’s body recognize that bedtime is coming up.

Many experts recommend that beds not be used for for any activities other than sleep. If the bed is the place where your child sleeps, but also where they watch YouTube videos, play board games, hear a bedtime story, and do homework, then their body might be confused about what’s happening when it’s time to sleep. Consider moving those activities to a different location to help your child’s body understand that when it’s in bed, it’s time to sleep.

While it may be difficult to establish a highly structured bedtime routine every single night, establishing a routine and sticking to it as much as possible is one of the best ways to decrease sleeplessness for your child.

Using sensory regulation strategies to make a routine effective:

To make your bedtime routine as effective as possible, you might want to consider adding sensory regulation strategies into your normal routine! Sensory regulation refers to the body’s ability to take in information in the form of sight, sound, smell, taste, touch, proprioception (the feeling of where the body is in space) and vestibular awareness (a sense of balance and motion). When your body receives sensory information from the environment, that information can wake them up or calm them down.

Everyone’s response to sensory input is different, but generally, children find fast movement activities, like running or jumping jacks, exciting, while “deep pressure” activities, like being wrapped up in blankets, calming. Again, everyone’s different, so for some kids the opposite is true! However, this rule of thumb might be a good place to start: Try getting all of your exciting movement activities out of the way earlier in the day and stop them after dinner time, then, engage in some calming touch activities like a warm bath or massage as you start to get ready for bedtime.

It can be helpful to get a baseline idea of what calms or excites your child, so consider experimenting! Over the course of a few days, you can try out different activities and see how your child reacts to them. Is your child more active when you sing to them, or does it calm them down? Do they get energized by drinking a cool glass of water, or less? Here are some activities you could try to get a handle on your child’s personal preferences and responses.

Generally calming activities:
-Massage
-Being “squished” under pillows, or a weighted blanket, or having blankets wrapped tightly around them
-Taking a warm bath
-Slow rocking
-Chewing chew toys or gum

Generally energizing activities:
-Fast moving like running, jumping, or swinging
-Chewing something crunchy
-Drinking a cold glass of water
-Seeing bright lights, like a computer or television screen
-Hearing loud noises, including loud music

Once you know how your child responds to input, try to build a schedule that comprises of more energizing activities earlier in the day, then transitions to calming activities before bed. You can also try to incorporate these types of sensory input into activities you’re already doing; for example, if you usually read a book before bed, try having your child chew a chewy while you’re reading! This will help ensure you can develop a routine that’s effective for your individual child.

Other strategies for improving sleep hygiene:

If you’ve already implemented a sleep routine that incorporates calming input and your child is still having difficulties getting to sleep there are some other basic sleep hygiene techniques to try. Here are just some strategies you can use with your child to encourage appropriate sleeping habits:

-Make sure your child’s room is conducive to sleep. In general, people sleep better in environments that don’t have a lot of alerting light, aren’t too warm, are quiet and don’t have a lot of toys and objects to be distracted by. Your child’s room should be dark, cool, quiet, and uncluttered.

-Turn off screens before bed. TVs, cell phones, tablets, and computer screens produce blue light that tricks the brain into thinking it’s daytime. Try to limit your child’s screen time in the evening and stop all screen access for about an hour before bed. Once your child is in bed, take all screens out of their room to remove the temptation to get out of bed and start playing.

-Get enough exercise during the day. Children need a lot of movement to remain healthy and in control of their bodies! Make sure they have a lot of time outside, and a lot of time moving and playing before you start your calming routine after dinner.

Questions or concerns

If you have questions or concerns about your child’s sleep or sensory regulation, please contact us at info@playworkschicago.com or 773-332-9439.

Corrine Pratt, OT Student
Occupational Therapy Fieldwork Student

Photo credit: Simon Berger on Upsplash

Blankets, Vests, and Lap Pads…Oh My! A Guide to Weighted Objects

What are weighted objects, and how do they work?

In the context of pediatric therapy, a “weighted object” refers to any object or item that is worn, placed on, or carried by the body to elicit a desired sensory response. These objects work by providing deep pressure, or distributed weight over parts of the body through cuddling, hugging, squeezing, and holding, to regulate the nervous system and calm the body. Additional input is processed by the proprioceptive system, which provides information about the position and movements of our muscles and joints, to increase understanding and awareness of where our body is in space.

What are some potential benefits of using weighted objects?
Potential benefits of using weighted objects include:

1. Better attention and focus: weighted objects are often calming for children that seek opportunities for movement and deep pressure and for those that have a difficult time sitting still and attending to structured activities. As weighted objects provide the input these children are seeking, their bodies become more calm and organized, and they are better able to focus and stay on-task, especially in the classroom environment.

2. Less anxiety and improved sleep: the calming effects of weighted objects on the nervous system help to reduce sympathetic arousal, or the fight-or-flight response, and promote feelings of comfort and relaxation. For these reasons, use of weighted blankets at night has also been found to help individuals fall asleep more easily as well as improve overall quality of sleep throughout the night.

3. Smoother transitions between daily routines and activities: when children experience increased regulation and sensory organization due to the effects of weighted objects, they often feel more “in control” of their bodies and are better equipped to handle transitions and changes in their routines, leading to fewer or less intense tantrums and emotional outbursts.

What are examples of weighted objects and where can I find them?

Common examples of weighted objects include:
• Vests
• Blankets
• Lap pads
• Backpacks
• Stuffed animals

Depending on your child’s needs, weighted objects come in a variety of shapes and sizes and can be worn or held during specific activities (vest; lap pad; stuffed animal) to improve attention, carried between environments (backpack, stuffed animal) to improve smooth transitions, and placed on the body (blanket) during quiet activities, such as reading books, riding in the car, and when going to sleep, to provide comfort, reduce anxiety, and promote a calm, organized state of arousal.

Many weighted objects are available for purchase from online and in-store retailers. Weighted objects may also be created by adding weight to items already found in your home. For example, filling a long tube sock with dry rice or beans and tying off the end securely or adding these materials to one of your child’s favorite stuffed toys may work well for use as a lap pad or weighted stuffed animal. Similarly, adding books or bottles of water to your child’s backpack makes for an easy weighted adjustment during transitions to and from school. Research suggests that each object should be about 10% of the user’s body weight plus one pound to promote optimal effects, so be sure to consult with a trained therapist or doctor before trialing weighted objects with your child at home.

Do weighted objects work for every child?
While research suggests that weighted objects have several positive benefits, they may not be appropriate or suitable for every child. Objects are often most effective when implemented with other sensory strategies and should be used only as directed by your child’s occupational therapist or doctor to best target their individualized needs and ensure safe and appropriate application.

Questions or concerns?
If you have questions or concerns about whether your child may benefit from using a weighted object, please contact us at info@playworkschicago.com or 773-332-9439.

Caitlin Chociej, MS, OTR/L
Occupational Therapist

References:

Chen, H., Yang, H., Chi, H., Chen, H. (2013). Physiological Effects of Deep Touch Pressure on Anxiety Alleviation: The Weighted Blanket Approach. Journal of Medical and Biological Engineering, 33(5), 463-470. doi:10.5405/jmbe.1043

Vandenberg, N. L. (2001). The Use of a Weighted Vest to Increase On-Task Behavior in Children with Attention Difficulties. American Journal of Occupational Therapy, 55(6), 621–628. doi: 10.5014/ajot.55.6.621

Photo Credit: Naomi Shi via Pexels

Feeding our Senses: What is a Sensory Diet?

Does your child love to run, swing, and jump? Engage in messy play with finger paint and shaving cream or seek out hugs and cuddles? Or perhaps they prefer to watch other children navigate the rock wall at the playground or quickly wipe their hands clean when dirty? Our sensory systems are responsible for how we take in sensory stimuli from our environment, process and interpret the information internally, and produce appropriate responses. We rely on proper functioning of eight senses (yes, eight!) to maintain a regulated state, in which we are better able to understand, interact with, and grow within our environments.

What are the eight sensory systems?

  1. Sight: helps us process what we see
  2. Hearing: helps us detect and process sounds, beats, and frequencies
  3. Smell: helps us detect and process scents and odors
  4. Taste: helps us process and distinguish between different tastes
  5. Touch: helps us process and understand how things feel on our skin, such as soft or hard, hot or cold
  6. Vestibular: provides us with a sense of balance, movement, and an awareness of orientation in space
  7. Proprioception: provides information about position and movements of our muscles and joints, including pushing, pulling, and deep pressure sensations
  8. Interoception: provides an internal sense of how our organs feel, such as hungry or thirsty, our sense of temperature, our feelings of pain, and when we need to use the bathroom

What happens if our sensory systems do not process stimuli correctly or efficiently?

When our brains are unable to make sense of the information our bodies receive, we often respond to the environment in inappropriate or unexpected ways. While the reactions formed in this disorganized state, often referred to as deregulation, present differently for every child and depend on both the type and number of sensory systems affected, responses often aim to find more of (seek) or stay away from (avoid) input. Examples include but are not limited to:

  • Sight: excessively looking at moving, spinning, or shiny objects; appearing bothered by bright lights
  • Hearing: appearing to ignore people when spoken to; becoming distracted in noisy settings; covering ears in response to loud noises
  • Smell: showing heightened sensitivity or aversion to scents and odors; may impact feeding routines
  • Taste/oral: preferring a limited variety of foods; difficulty trying new foods; excessive drooling
  • Touch: difficulty tolerating having nails trimmed or wearing certain clothing textures; refusing to touch or play with various textures, such as grass, sand, finger paint, or Play-Doh; wiping hands clean immediately after getting dirty
  • Vestibular: appearing to excessively enjoy or look for movement opportunities (running, jumping, rocking, etc.); seeming clumsy; appearing fearful of ordinary movement, such as when both feet are off the ground (e.g. swinging)
  • Proprioception: biting or chewing on non-food items; excessive bumping into, pushing, or hitting peers or objects in the environment
  • Interoception: not feeling full after eating; missing the urge to use the bathroom at the appropriate time

These sensory responses may lead to overarching difficulties with a child’s ability to attend to academic activities in the classroom, maintain balance and coordination, plan and sequence novel tasks, build social relationships, perform self-care activities, such as dressing and feeding tasks, and participate in family routines and schedules.

Sensory diet: what is it and how can it help?

A sensory diet is a carefully designed series of sensory-based activities in which a child is encouraged to participate to increase regulation and attention throughout the day. Much like we eat healthy foods to give our bodies the nutrients they need, sensory diets are made to meet the specific sensory needs of each child. While sensory diets typically incorporate touch, movement, and proprioceptive input, strategies targeting any sensory system can be included to promote optimal regulation. Sensory diets are often organized into schedules based on a child’s daily routines, activities, and family plans to maximize participation and success and can be easily modified as the child’s needs change over time. See below for an example of a sensory diet:

If implemented correctly, sensory diets provide consistent access to specific amounts of sensory input needed throughout the day and result in more appropriate responses to environmental stimuli over time. When successful, children are better able to participate in meaningful activities and daily routines, develop important foundational skills, and more effectively understand and engage in the world around them.

Questions or concerns?

If you have questions or concerns about whether your child may benefit from a sensory diet, please contact us at info@playworkschicago.com or 773-332-9439.

Caitlin Chociej, MS, OTR/L
Occupational Therapist

References:

Bodison, S., Watling, R., Kuhaneck, H.M., & Henry, D. (2008). Frequently Asked Questions About Ayres Sensory Integration. American Occupational Therapy Association. Retrieved April 14, 2019 from http://www.aota.org/Consumers/WhatisOT/FactSheets.aspx.

Smith Roley, S., Mailloux, Z., Miller-Kuhaneck, H. & Glennon, T. (2007). Understanding Ayres’ Sensory Integration. OT Practice 12(7).

STAR Institute for Sensory Processing Disorder. (2018). Your 8 Senses. Retrieved April 14, 2019, from https://www.spdstar.org/basic/your-8-senses.

Photo Credit: Sharon McCutcheon via Pexels