“Please go to sleep, please go to sleep, please go to sleep.” “Please stay asleep, please stay asleep, please stay asleep.” Have either of these become your mantra, during your child’s bedtime, or later when you’re trying to wind down and go to sleep yourself?
Teaching sleep routines is hard for many parents. Maintaining those routines during sleep regressions can be even harder. If you have a child with autism, you may have found that traditional sleep training methods don’t work for you, at least at face value.
In this article, we’ll discuss a sleep training method for young children that often flies under the radar: the bedtime pass. We’ll go over what the bedtime pass system is, how it works, and how to modify it for children on the spectrum.
What Is Bedtime Pass?
The bedtime pass system was first developed by Dr. Pat Friman, a practitioner and researcher specializing in behavioral health research and clinical practice. In 1999, Dr. Friman and a research partner, Connie Schnoes, published the results of a study they conducted using the bedtime pass. The system was successful, and the method was then tested in various research studies over the following decade.
Bedtime pass has been disseminated to families through the suggestion of pediatricians, parent coaches, behavioral therapists, and other health and wellness influencers like Dr. Alan Greene. Today, bedtime pass remains one of the lesser known strategies for sleep training, because it is not for use with infants, or toddlers under around three years of age. However, it continues to steadily gain in popularity as parents discover it when their child is a little older and find success.
The bedtime pass system provides an alternative to letting your child cry and waiting it out while they have a tantrum in their room before falling asleep. It is also a good strategy to use when transitioning from a crib to a bed. This is because the bedtime pass provides structure around when it is allowable to get out of bed, instead of figuring this out with your child by trial and error once the crib rails are gone.
How Does The Bedtime Pass Work?
Here’s how the traditional bedtime pass system works:
1. Create the bedtime pass with your child. You can draw on the card with your child, or decorate with stickers, et cetera. You don’t have to write “bedtime pass” on the card, but you can if this is motivating for your child. This also may help others who are involved in the bedtime routine such as your spouse or babysitter.
2. Talk about the plan. Give your child instructions on how the bedtime pass works, before you start. Identify what day you’ll begin the program and keep the bedtime pass stored away until it’s time to start. This will help increase excitement and positive feelings about the system, since the pass you and your child decorated together is specially reserved for starting bedtime pass.
3. Implement the pass. Do your child’s bedtime routine as normal. This could include a sequence like bath time, pajamas, brushing teeth, reading a story, and singing a song. Tuck your child in to their bed. Place the pass on their bedside table. Remind them that the pass is there if they need to get out of bed, for a hug, or a drink of water, or anything like that. They can use it once each night. If they use it, you’ll keep it for them until the following night. Then say goodnight and leave the room.
4. If your child uses the pass, provide them with what they are seeking, whether it be water, a hug, or perhaps another short song. Give your attention freely, this first time they use the pass. Then, lead them back to bed and tuck them in again. This time, keep the pass. You can let them know they’ll be able to use it again the next night. Say goodnight and leave the room.
5. If your child gets out of bed again, give minimal attention. Lead them back to their bed. Repeat this as many times as necessary. Research has shown that this method results in far less crying at nighttime, and quick results. Children who use bedtime pass begin falling asleep more quickly, and even begin to keep their pass with them all night, not needing to use it at all.
How Can I Make Bedtime Pass Work For My Child With Autism?
You may be thinking: “there is no way this would work with my child! They will tantrum all night long, and I’ll be just as exhausted as ever.” Here are some tips and tricks to adjust bedtime pass specifically for kiddos on the spectrum.
1. Use more than one pass, at first. You should identify how many times your child is getting out of bed at night, and start with that many passes. For example, if it takes a max of 5 trips before they fall asleep, plus 1 midnight wake-up where they need help to go back to sleep, you could start with 7 passes. Start with the absolute maximum you think you will need in order for the bedtime pass system to work. At first, you won’t see a difference in the amount of time and energy you’re dedicating to getting your child to sleep, of course. The idea is that once they’re using the pass system successfully, you’ll be able to gradually decrease the amount of passes you leave with them at bedtime.
2. Use a visual guide, or a social story. Using pictures to illustrate bedtime pass and what your child will do as well as what you will do at every step of the process can help them catch on to what’s expected. When each step is presented in a sequence, it also helps you stick to the plan when you’re tired or overwhelmed. This will also help you establish additional guidelines for the system, like what happens when your child gets up without the pass, what kinds of things they can trade the pass in for, and if the pass functions differently at bedtime vs. during middle of the night wake-ups.
3. Add in additional reinforcement. This could take any number of forms. You might provide your child with an additional reinforcer each time they use the pass, like a star on a chart toward earning a new LEGO set, or a finger puppet for their collection, or a special sticker. You could allow cash-in of unused bedtime passes for reinforcers the following morning. You can time your child’s total minutes out of bed, and do a special reinforcer each day following nights when those total minutes decrease.
4. Troubleshoot. If the bedtime pass doesn’t work at first, what are some things you can adjust? Do you need to talk about the pass at night more, or perhaps less? Do you need to adjust your number of passes? Do you need to change your methods so that the times your child uses the pass are clearly reinforced, while times they get out of bed after all passes have been used up are clearly neutral?
Sources & Additional Resources:
https://www.ncbi.nlm.nih.gov/pubmed/10520609/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1702334/
https://www.drgreene.com/bedtime-pass-program
https://www.autismspeaks.org/sites/default/files/2018-09/Sleep%20Quick%20Tips.pdf
https://vkc.mc.vanderbilt.edu/assets/files/resources/sleepasd.pdf
Courtney Gutierrez, M.Ed., BCBA, LBA Courtney is a behavior analyst, educator, and writer in the Pacific Northwest. She has over fifteen years of experience in the field of autism services, and over ten years of master’s level experience in classroom teaching and ABA therapy. Her areas of expertise include infant and toddler development, parent coaching, ABA clinical leadership and training, P-12 special education, and case consultation for children and young adults with autism and other special needs. Courtney lives in Seattle with her husband and two children.