Tag Archives: consistency

Bedtime Blues or Bliss–II

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My last post provided guidelines for establishing bedtime routines for your children, with an emphasis on consistency. Consistency is the key to helping ensure that everyone gets a good night’s sleep. When your child gets into a consistent sleep routine, he or she will be at less risk for emotional, behavioral, and learning problems. Additionally, you – the parent – will feel more refreshed during the day and enjoy a better overall family life.

What if my child has more serious sleep problems? Some children and teenagers suffer from sleep disruptions and have difficulty following a good sleep diet. These disorders may include:

  • Insomnia
  • Nightmares
  • Sleepwalking
  • Night Terrors
  • Other sleep disturbances caused by hormonal changes and stress in adolescence

Let’s explore these more serious sleep problems in greater detail.

Primary insomnia occurs when your child has difficulty falling or staying asleep without any known underlying medical condition. This may be due to poor sleep patterns or erratic sleep schedules. Usually the establishment of a good sleep routine is sufficient to reduce or eliminate primary insomnia. Emphasize calming activities in the hour or so before bedtime, avoid giving your child caffeinated food or drinks before bedtime, and provide for plenty of exercise during the day. If these techniques do not help, consult your child’s pediatrician to rule out any underlying medical conditions that my interfere with sleep. A mental health professional may be sought out as well.

Nightmares are disturbing and/or frightening dreams. As many as half of all children may suffer from nightmares; however, they are most common in preschool and elementary grade children and tend to lessen over time. Nightmares may begin around age 2, peak in the 4 to 6-age range, and then slowly diminish, although they can occur in all ages. What causes nightmares? Stress, traumatic events, scary TV programs, violent video games or movies, vivid imaginations, fear (such as fear of the dark), and even some medications can all trigger nightmares. When your child experiences a nightmare, calm her down and repeat a shortened version of her bedtime routine to help her back to sleep. A nightlight in the bedroom may help a frightened child, or a shared storybook for those who have frequent nightmares.

Sleepwalking occurs during deep sleep, often 1 to 2 hours after initially falling asleep. Episodes can range from simply sitting up in bed to actually getting up and walking around the house, down stairs, or even outside. It can be very difficult to wake a sleepwalking child. When awakened, he may seem confused and usually will have no memory of the event. Comfort your child after an episode of sleepwalking and then return him to his bed. Sleepwalking usually stops in late childhood, although a few continue to sleepwalk into adulthood.

Night Terrors are episodes during which the child screams, seems disoriented and anxious, does not recognize parents, but at the same time appears wide awake. They usually occur between ages 3 and 8, and often 3 hours into the sleep period. Night terrors typically end by age 12. I often refer to them as “Parent Terrors” because it can be very scary to be awakened by a screaming, anxious child who may not recognize you. While children who have night terrors seem to be awake, they are not consciously awake, and may fight the parent who is trying to calm them. When the night terror eventually ends, often after 10-15 minutes, the child will return to sleep and have no memory of this terrifying event. Although parents are usually frightened (and I have personally experienced this!), there is little or no impact on the child. Hold your child gently until the episode ends and then return him/her to bed. Night terrors are NOT a sign that your child is troubled or emotionally disturbed.

Teenagers usually outgrow nightmares, sleepwalking, and night terrors; however, other sleep disturbances caused by hormonal changes and stress in adolescence may crop up.  Changes in sleep cycles can be triggered by puberty, hormonal fluctuations typical to adolescents, and the stresses of growing up in a complex society. Most teens do NOT get enough sleep at night, nor do they fall asleep quickly when they lie down for the night. Teens begin their days with school early in the morning. Extracurricular activities, such as jobs, homework, athletics and other social events often work against teens, preventing them from getting an adequate number of hours of sleep. Parents can intervene by reducing stress, encouraging adequate exercise, eliminating caffeine and energy drinks in the evening and removing distractions from their bedrooms.

If you believe your child has any of these serious sleep issues, a sleep diary may be helpful. Record the number of hours your child sleeps, how many times he/she wakes during the night, what happened before the child fell asleep, and any parental intervention taken during the disruption. Your child’s pediatrician should be consulted for serious sleep problems. The sleep diary information will be a useful tool to determine if your child has a sleep disorder.

Does your child or teen have sleep disturbances?  Please share your interventions or frustrations. I’d love to hear from you.

Bedtime Blues or Bliss?

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One of the most frequent inquiries I get from parents involves children and bedtime issues. Even the best sleepers can go through a period of resistance to going to sleep. Why does this happen and what can you as a parent do to set up healthy sleep routines, or what I like to call a “sleep diet.”

Set bedtimes so your child gets the appropriate amount of sleep. Preschoolers generally require 11-13 hours/night, while school-aged children typically need about 10-11 hours.  Most children respond best to bedtime if a routine consisting of a set of activities that are the same EVERY night, including the weekends, is set up early in their lives. Activities may include a signal or warning that it is time to get ready for bed, readying for the next day (for older children), taking a bath, reading a book, conversing or maybe even singing a soothing song.

Still, some children refuse to go to sleep. Very young children may become fearful and experience separation anxiety (a general fear of something happening to their parent(s) while they are asleep). Children ages 4-6 may experience more specific fears, such as fear of monsters, darkness or fear of having a bad dream—all normal for this age group. In the 3-10 age range, disturbing dreams may occur, peaking at about age 10. And teenagers may suffer from disturbances in their sleep cycles due to puberty, hormonal imbalances or stressors such as growing up, college or career plans, relationships or other social concerns.

How parents handle the reasons for their child’s resistance or difficulty getting to bed will play an important part in outcomes. When the child’s resistance persists and becomes a learned behavior and parents give in to the child due to their own fatigue or other reasons, rules are relaxed and new behaviors pop up. The child learns that nagging, whining, crying, stalling, one more drink of water, etc. will put off going to bed.

You may be noticing a common theme in my posts—CONSISTENCY! As with time-out and grounding, consistency is the key. Inconsistency can turn good behaviors bad and make bad behaviors worse. When parents try to buckle down after rules have been loosened for a time, the child learns to push back harder to get what he/she wants. Riding this roller coaster may cause you and your child to lock horns in a battle over bedtime that nobody wants to endure.

So, as a parent, what can I do to attain bedtime bliss? Here are several suggestions:

  • Establish effective bedtime routines that include—the same bedtime each night, quiet time for one hour before bedtime, providing time cues for bedtime, story time, etc.  You set the routine however it works for your household, but once you’ve set it, keep it consistent!
  • Provide healthy daily routines for your child including good nutrition, physical activity during the day to promote sleep at night, and no violent video games or TV shows before bed.
  • One “get out of bed free” pass.  The child receives a ticket to be used ONCE per night to get a drink or ask a question of the parent. This ticket may not be used more than once per night. This technique may work for some as it feels like fun to your child and gives them a little leeway for any problem they may have getting to bed.
  • Planned ignoring is a technique in which the parent makes it clear that once the child is in bed and the routine is complete, no more interactions will occur.  If the child objects, then the parent ignores the child and provides no further attention.  That means NOT responding to questions, comments or statements from the child. If he gets out of bed, escort him back to bed with minimal interaction.  Expect an increase in negative behaviors for several nights, but the child will eventually learn to go to sleep without protest. This usually takes about three nights. Planned ignoring is often most difficult for parents; hence, set the routine early.

Next week, I will continue with this topic and focus on more serious sleep issues. Stay tuned, and as usual, send me a note and let me know what you think.  Any topics you want explored?

 

 

Beyond Time-Out: Challenges of the Older Child, Tween and Teen

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Several readers of this blog have commented to me that time-out is a useful tool with younger children, but what are they to do with their older children, tweens, or teens?

Remember, the idea of time-out is to withhold (i.e. take time-out from) positive reinforcement with the goal of reducing undesirable behavior. Sometimes traditional time-out (see blog posts 3 and 4) doesn’t work with an older child, tween or teen, and other negative consequences for reducing inappropriate behavior must be implemented.

For example, your 11-year-old is talking back to you and it’s becoming a problem within the house. She thinks time-out is for babies. You explain to Sally that talking back is an inappropriate behavior and will not be tolerated. You make it clear to Sally that every time she talks back to you, a privilege will be removed. Examples are: TV, telephone or cell phone use, staying up late, outside play time, electronic games, trip to the mall, etc. Construct a privilege list alone or together with Sally PRIOR to implementation of this technique. For each new day, when Sally talks back, an item is crossed off the list for that day. The procedure starts anew daily, allowing Sally to begin each day with a clean slate. Do not choose too MANY behaviors at first. Like time-out for younger children, concentrate on a few of the most troublesome behaviors that your child exhibits and focus on those, ignoring the less serious ones. Consistency is the key.

What if my teen misbehaves? Grounding is a technique that can be used for disciplining teens. Of course, grounding is effective with older children and tweens as well, but for now, let’s concentrate on your teenager. Grounding is like time-out in that your child is removed from a desirable activity for a period of time—things like borrowing the car, watching TV, computer time, telephone privileges, going out with friends, electronic gaming, etc.

When you utilize grounding with your teen, consider the following:

  • Discuss with your teen what grounding means. Make your expectations and rules clear; write them down and post if necessary.
  • Set an appropriate time limit on the grounding relative to the age of your child.  For a teen to lose the car for one week is not unreasonable, but a month may be too long. Remember that the grounding loses its effectiveness if the period of time of grounding is too long. Your child’s incentive for good behavior during the grounding may be lost.
  • When you are angry is NOT a good time to set a grounding limit. Calm down first and make a decision based on what you feel is reasonable for a specific unwanted behavior.
  • When you set the grounding limit based on thoughtfulness, do not change your mind. When parents give in and reduce the time of grounding your child will quickly learn that you won’t follow through.
  • So that the entire family is not punished for your teen’s misbehavior, make arrangements for that child if the family goes out. A sitter should be used so that the grounded child remains in the house while the family can still enjoy their outing.

As always, parents should not disagree with each other about discipline in front of their children. Be consistent by rewarding or punishing the same behavior in the same way as much as you can. Parents should agree with what is acceptable or unacceptable behavior and how to respond to both. When speaking to your child about unacceptable behavior, be very specific. Displeasure over a “messy kitchen” isn’t clear enough. Instead, be specific about what “messy” means. For example, the dishes are not in the dishwasher; the books are spread across the table; there are crumbs on the floor; etc. Reward desirable behavior as much as possible throughout the day, and remember that your children are modeling your behavior.

What behaviors exhibited by your teens are challenging to you?  Let me know by leaving a response or sending me feedback. As always, I’d love to hear from you.