Sleeping Issues & Early Intervention

Trouble getting your child to sleep?

Sleep is essential for everyone – adults and children alike. Without the necessary rest, we can all become irritable and not think clearly. For a child, specifically in their first 3 years of life, getting restful sleep is that much more important as they build the cognitive skills that serve as the foundation for a lifetime of learning.  But for parents, sometimes, getting your child ready for a nap or a night’s sleep can be challenging. At teli, our Pediatric Occupational Therapists have extensive experience with parents worried about their children’s sleep habits and can provide some helpful suggestions to help.  Our staff has identified some of the most common questions that parents ask and have provided answers.

Q:  Bedtime is such a battle at our house. Do you have any calming suggestions?

A: There are plenty of techniques that all parents are can use to help bedtime be less of a battle.  Preparing your child for bed by establishing a routine so they can begin to anticipate bedtime and engaging them in calming activities are important strategies. Here are a few suggestions that can help:

  • Quiet playtime activities to prepare for bedtime can send the right bedtime signals to your child. Preparing their stuffed animals for bedtime, saying “Good Night” and tucking in their stuffed animals for the night can help to begin the transition to bedtime.
  • Consistent bedtime rituals or routines are essential to prepare your child for sleep. Create a calming environment in the bedroom by dimming the lights and snuggling up with your child to read two books of their choice. A gentle back or foot massage can help continue to relax and calm your child.
  • Banish the electronics for at least 90 minutes prior to bedtime. The blue light emitted by the TV, iPad or even your phone provides stimulation that simulated daylight and sends the wrong message to your child. Turning off or dimming the lights in the house to signal the end of the day is helpful as well.
  • A comfortable room environment can play a large role in helping children with sleep problems.  A dark room with a non-blue night light at a cool temperature of 68 degrees is recommended

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Q: How much sleep do children really need?

A: A child’s brain develops at such an accelerated rate in the early years and sleep is essential to be sure that foundational learning can occur. While every child is different, sleep requirements are significant in the early years for infants and toddlers. For some children with developmental delays, the need is even greater, as they are working hard to grasp concepts and new behaviors particularly if they have Early Intervention services. By insuring that they are getting the rest they need, you are helping children with developmental delays maximize their learning and setting them up for success. The following are estimates based on a combination of naps and nighttime sleep time, for reaching the totals, which are essential for recharging and igniting their learning capacity, dependent upon your child’s age.

Category Age Recommended Hours of Sleep
Newborn 0-3 months 14-17
Infant 4-11 months 12-15
Toddlers 1-2 years 11-14
Preschoolers 3-5 years 10-13


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Q: Are there certain activities that make it easier for children to transition to bedtime?

A: The activities that will help your child transition to bed and fall asleep more easily are those with calming qualities. The single most important tool in getting your child to sleep is to establish a consistent calming nighttime routine. Children respond to a routine, and with practice begin to accept and almost expect that routine going forward.  This helps children realize that the day is over and it’s time for bed. Some popular suggestions for parents of children experiencing sleep problems include:

  • Stick to a Schedule – A consistent routine bedtime is important to help a child prepare to wind down and get ready for bed.
  • Activity During the Day – Keep your child active physically throughout the day so their body is ready for sleep
  • Comfort – Be sure their bed and PJ’s are comfortable
  • Tech Free Zone – Your child should not use iPads, watch TV or use other electronics within 90 minutes of bedtime
  • Reduce Clutter– Involve your child in a quick clean up in their bedroom to signal an end to a day and a preparation for a new day in the morning.
  • Calming Activities – A gentle massage to a child’s back and feet, quiet play and a bedtime story or two to begin the transition to relaxation. Tucking in their stuffed animals for the night can also help.
  • Calming Environment – Cool room temperature, soft music and lighting from a small night light if your child is not comfortable in a dark environment can “set the mood”. Blue light from electronic screens should be avoided.
  • Light Nighttime Snack- Light snacks such as milk or fruit that is easily digested is perfect. Be sure to avoid foods that contain caffeine, chocolate for example, or significant amounts of refined sugar.  A glass of water in reach may also be a good idea.

Q: Should I use rewards for my child to help them establish a good sleeping routine?

A: You can use rewards to help your child establish their bedtime routines but be sure that the reward is appropriate.  A good reward system is to use stickers with a bedtime chart.   You easily create a bedtime chart by listing 4-5 bedtime routines such as take a bath, read a book, use the potty, brush your teeth and turn off the lights.  Kids love them, and they are inexpensive.

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Q:  Can massage be helpful in calming a child before bedtime?

A:  Studies have shown infants who are massaged before bedtime can be very beneficial to help relax a child and can be a great addition to a bedtime routine.  A gentle touch can do wonders to help anyone feel loved and cared for. 

For an infant that may be going through a fussy period or may be experiencing colic, a gentle touch can help to quiet them in the moment as well as nurture their growth and development, communication and learning.

When a parent massages their child, it promotes the release of the neurotransmitter oxytocin, which is known as the bonding and attachment hormone. Increasing this at bedtime, enables a child to feel safe and nurtured, helping a child feel relaxed and secure to fall asleep.

The foundation of infant massage is gentle motion in a particular area of an infant’s body, be it the arm, leg, neck, or belly.  A massage has other physical benefits such as help with gas elimination, muscle tension and any growing pains a child may be having.

The repetitive motion over a short period of time can help to loosen muscle tightness, relieve soreness and increase blood flow. Two naturally occurring chemicals dopamine and serotonin are released through massage and can have a big impact on your child’s bedtime.

Dopamine helps increase our coordination and ability to focus and serotonin helps regulate behavior in terms of emotions. Increasing these hormones help decrease irritability, which promotes relaxation for bedtime.

It is also known that low serotonin can also interrupt sleep patterns and cause difficulty sleeping, so promoting the release of serotonin can help support healthy sleep patterns.

Long, deep massage strokes can also help decrease naturally occurring stress hormones, cortisol and epinephrine therefore, promoting relaxation and facilitating deep sleep.

Healthy sleep patterns are so important to support our children’s growth and development. Adding a gentle massage to your infant’s bedtime ritual can not only provide a calming influence but enable you to have some valuable together time!

Resource: Vanessa Doherty, teli Pediatric Occupational Therapist

If you continue to experience challenges in with your child’s sleep routine, you may want to  talk to your health care provider.  Importantly, Early Intervention Services are available at no cost to you!  Get connected to our early intervention experts today.