Sleep Problems and Kids on the Spectrum

            A common report of parents, teachers, and therapists dealing with students on the autistic spectrum is a complaint about kids’ unwillingness to go to bed at a reasonable time and, consequently, chronic fatigue.

            Sleep difficulties have been attributed to factors like anxiety, circadian rhythm disturbances, and the attraction of a stimulus free (i.e. parent free) environment to socialize online. With regard to the latter, many students have told me that they enjoy the late hours of night (and early morning hours) as they can search the web unencumbered by parental demands. It is almost as if these students have a reverse wake-sleep cycle. That is, they often complain of fatigue at school, but come alive at night.              

            Some kids are the victims of their obsessive preoccupations and once they begin an activity-whether it is doing homework or a school project or simply indulging in computer games, socialization online, or an idiosyncratic interest, they are unable (or unwilling) to stop.

            Parents and professionals alike find it difficult to manage kids’ own problems with self-regulation at bedtime. Parents have tried to be reasonable by setting agreed upon bedtimes; however, this is often fraught with problems because kids may agree but cheat while parents go to bed or they may refuse to agree at all. Others remove all forms of technology from kids’ reach. Yet, this often exacerbates the problem. This is because for some of these kids socializing occurs solely online. Taking this away is often met by strong resistance. Parents are faced with trying to be an external source of regulation without eliminating the only channel for socializing that some kids have.

            It is not hard to recognize that it is a very slippery slope between chronic staying up late patterns, fatigue and school failure. A vicious cycle may evolve where students are constantly tired and unable to perform, falling behind on assignments and projects and earning low test grades. Paradoxically, even this result does not necessarily move some students to reverse this sleep pattern. They are compulsively drawn to the nighttime and its’ delights.   

            Avoiding the power struggles that ensue that make matters worse is essential. Taking the time (and having the patience) to attempt to analyze (understand) kids’ resistance to going to bed at a reasonable time is an arduous, but necessary task. Sometimes, in the process, they may need to burn and crash before they are motivated to consider a different course. Overpowering them, however, is usually not successful. Parents who are overwhelmed should seek professional help for their student and themselves as the process of reversing this phenomenon is a difficult, but not impossible one to accomplish.

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Kids Who Think Too Much

            Many parents have reported that their children worry much of the time. The worries may be specific involving concerns about school performance or peer acceptance or they may vague in nature, taking the form of a repetitive preoccupation with something bad that may happen.  Very often kids are unable to articulate the source of the latter worry; yet, it is unmistakably strong, persistent, and may appear at points of separation like bedtime that make it difficult to go to sleep.

Parents who have attempted to field these worries by reassurance have frequently reported that while this may sometimes be effective, it is just as often ineffective or temporary. For example, a parent may try to reassure a child that there is nothing to worry about and that nothing bad is going to happen to the child or to them (the parents). Nevertheless, one bright youngster replied, “How do you know?” In fact, we do not know for certain about many things and just as kids at around age seven discover that their belief that their parents are all-powerful and all-knowing is not accurate, kids are often not convinced in their parents ability to predict the future. Kids know that parents are not endowed with super powers and they do not know all.

For kids who need a high degree of certainty in order to feel comfortable and safe, this is a devastating discovery as is the fact that uncertainty is more common than certainty in this complex world. Kids who think too much paradoxically find comfort in their worries at the same time that they are tortured by them. This is because repetitive or obsessive worrying performs an adaptive function by binding powerful impulses that drive the worry. For example, some kids who worry about something bad happening are really struggling with their taking action on their own angry emotions. Worrying holds these emotions in check and the price to pay is that these feelings are directed inward as anxiety.

This is why parents’ attempts to dismiss worries via reassurance often fall short. Dealing with worries is made more difficult because kids who worry induce worry in their parents and often feelings of frustration and anger as they tire of hearing the same anxious thoughts over and over. In order to constructively address kids’ worries, adults must first be willing to tolerate hearing them-sometimes repeatedly. Worries signal that something is amiss and adults need to take the time to try to understand their meaning.

Rather than solely giving reassurance, parents need to consult with their anxious children to understand their worries and to collaborate together and how to address them. Consulting communicates a genuine interest and an invitation to kids to be a partner in figuring out what to do. While concrete strategies like isolating worries in a worry box that contains them may prove to be useful adjuncts, they need to be accompanied by a willing ear. Worries may need to persist for awhile before kids are able to give them up. However, something first must be put in their place. Moreover, even when a worry is extinguished, kids who worry tend to generate additional worries, making the task of regulating worry an ongoing task necessitating patient consultation to understand before a strategy is created and implemented.