Children who have mental health disorders or are in foster care often have more problems in sleeping. Sleeping in a strange bed and strange home contributes to this, but in many cases, a child in foster care who has sleep problems may be having intrusive or bad dreams. Or, they have had a pattern of bad dreams in the past, and they resist and fear going to sleep. In some cases, their medication may be interfering with sleep. If you suspect this, check with the child’s doctor. While there are medications available to help children to sleep, but even these are not always 100% effective.
In most cases, the child’s sleep difficulties are behaviorally based. The child has gotten into a successful habit of avoiding going to bed, or getting up in the middle of the night to play. As such, the child needs to have a strong adult who can be self-disciplined in using a set sleep protocol with the child. Caregivers need to work hard at helping children with sleep disorders to get to sleep and stay asleep. The key, of course, is consistency. I’m not talking just the usual consistency, but super consistency, 99.9% consistency and adherence in following the sleep protocol.
* Be ready to use this protocol for at least one year, or until the child has had a positive sleep pattern for three months before easing any of the steps.
* Establish the bedtime and always, always keep the bedtime the same. This means NO changes, even for “special events” or summertime. Due to summer daylight issues, set the time at whatever nightfall is in the summertime. Really. Same bedtime every night.
* Establish a set bedtime routine: bath, snack, quiet time, potty time, story, prayer, and tuck in.
* Be sure to have a nightlight on in the child’s room.
* After following the bedtime routine, LEAVE the room. If the child comes out of the room, take their hand, walk them back to bed, and say this (and only this) in a calm voice: “It is time for you to go to sleep.” Turn and leave the room as you did the first time. DO THIS THE EXACT SAME WAY EVERY TIME THE CHILD COMES OUT OF THEIR ROOM. (Yes, it might be well over 300 times.) Over time, you will have to do this less and less. You might track how many times you do this nightly in order to get encouragement in seeing the progress.
* With older children, you can have them go to their room at bedtime and have 30 minutes of lights on quiet activity before lights out. You can also tell an older child that if they do not cooperate with staying in their room and going to sleep, bedtime will be 30 minutes later for each infraction tomorrow night.
* If you hear the child awake, or up playing in their room, don’t intrude. Only act if they come out of the room.
* Limit the toys in the child’s bedroom, especially the more complex and interesting toys. One or two cuddle toys, or a few story books are o.k., but put the construction toys, battery operated toys, and action figures in some other place.
* DO NOT allow the child to sleep in any bed other than their own, unless you are not really serious about curing their sleep problem. While some families have a tradition of children sleeping in the same bed, or children sleeping with adults in the ‘family bed’, this is bad practice for foster children, due to liability issues, health issues, and from a behavioral standpoint. It creates secondary behavior problems unnecessarily.
* Do not be discouraged by the child’s resistance. The child may cry, scream, tantrum, or have a stress episode. Other than a stress episode, all else is manipulation to get you to give in and alter the routine. If you do, even in a little way, and just once, you will have to start all over again. I hate to sound smug, but if this is not working, it’s because YOU are not following the protocol EXACTLY as you see here.