Teaching Babies to Self-Regulate Themselves to Sleep

When you're this little, even a toy cubby makes a good space to curl up for a nap.

When you're this little, even a toy cubby makes a good space to curl up for a nap.

;By Shari Karmen, TLC Therapeutic Services Manager & Occupational Therapist

Sleep is so important to our everyday wellbeing. Babies, children, and adults all need sleep, along with food, to be self-regulated. Self-regulation is the ability to manage emotions and control body functions as well as maintain focus and attention. Self-regulation happens differently over the many stages of our lifespan. Self-regulation in an infant encompasses how an infant deals with a disruption (for example, a loud television) and regains control of their behavior so they can focus on what they're doing (nursing, eating, playing, etc.). In a preschooler self-regulation looks at how a child plays with others, learns to share and take turns.

If a child doesn’t have a healthy sleep and waking pattern, it makes it hard for them to learn. In babies we tend to see two issues with sleep that can cause problems with self-regulation:

1.    Fragmented sleep – many short periods of sleep, but not good long sleep cycles and

2.    Too much sleep, especially during the day. This frequently suggests a developmental issue. Daytime is when sensory stimulation occurs and the sleeping baby is not stimulated.

Parents and caregivers play a vital role in how babies learn to sleep. The amount of support given in the beginning impacts how much caregiver involvement is needed later on. This means if we teach babies early how to fall asleep in a healthy, self-regulating manner, the better off they are for sleep learning. It’s important for the caregiver to recognize:

–   Their decreased role in helping a baby to sleep;

–   Recognizing sleep cues and conditioning;

–   The infant's ability to self-regulate.

Having a consistent place to sleep is another important key to sleeping. Young infants have few self-regulatory behaviors, but as we teach them self-soothing techniques – pacifier, lovey – they become more competent self-soothers. Crying it out doesn’t work because babies don’t have the skills to self-regulate, calm, and then fall asleep on their own.

In the first few months of life babies show clear signs of sleepiness:

–   Yawning

–   Glazed eyes

–   Rubbing eyes

–   Heavy eyelids

–   Decreased sucking during feeding

–   No, or less, interest in interacting

–   Turning away from stimulation in the environment

–   Body movements become less organized

–   Fussy behavior

It’s important to recognize these cues and respond to them while the “sleep gate” is open. If you don’t catch the sleep cues within 15 minutes, “tired is wired.”

Place a drowsy baby in the crib and stay close by without touching the baby. A self-regulating baby will suck fingers, look around and then fall asleep. If the baby cries, wait for a time and then approach with a comforting voice.

If your baby continues to cry, approach and pat, but don’t pick up. Provide reassurance with your voice. If crying persists, re-enter the sleeping area with a “boring” visit. Stand close by, but don’t interact with the baby.

Encourage naps when babies are full. It’s easier to fall asleep with a full belly rather than after a baby has been stimulated with play. Between 6-8 months separation anxiety is heightened so parents are encouraged to move baby out of their room before this period if they are sharing a room.

Routines create predictable patterns. Babies with bedtime routines develop into toddlers and preschoolers with predictable bedtime routines. Sleep in the same location every night. Start to power down an hour before bedtime. Read books, play soft music, have a small snack, and other calming activities are pieces you can add to a bedtime routine.  Developing a consistent bedtime routine is key!

Happy sleeping!

Read more about cultivating healthy sleep habits in children:

Schedules & Routines for Children

by Zoe Read, TLC Teaching Assistant

Schedules and routines play an important role both at home and in the classroom, helping children prepare and feel comfortable with transitions throughout the day.  At TLC, we follow the Pyramid Plus teaching model, which utilizes different methods to communicate and engage children in smooth transitions from activity to activity.

One tool TLC teachers use to aid transitions is visual cards. Visual cards have pictures depicting what the class will be doing throughout the day. The cards help children be aware of and prepare for what is going to happen next in their classroom schedule. Children also have the opportunity to make decisions regarding what activities will be part of the routine, and when the activities will happen. Cards are often Velcroed to a yard stick, and children can rearrange them with the teacher's help and consent.  Each class has a daily Schedule Helper. When having group time, the day's Schedule Helper communicates to the other children what has happened, and what is going to happen next, preparing his or her fellow classmates for successful transitions through out the day while working on verbal skills and public speaking.

Using these same techniques can be helpful with home routines, too. Routines like getting ready for school, getting ready for bed, or trips to the grocery store can all be pre-planned using visual cards or similar tools, so a child is better prepared to transition from activity to activity and place to place.

The following links and resources can be helpful to parents and caretakers looking for other ideas to create smooth transitions and routines at home:

Teaching Your Child to be Successful with Routines (from Vanderbilt University)

Morning and bedtime printable routine lists

Create a Morning Schedule with Your Child:

Things you need

Universal File Folder Visual cards (search schedule cards on Pinterest or create your own) Velcro Laminating is a plus (but not a must)

My daughter, Shea, decorated the file folder on the outside and helped plan and create her schedule, which allowed her to engage in the process and have buy-in to the routine.  Having your child help can give him or her a sense of ownership, and can build excitement about schedule.

To make the schedule, place the Velcro on the back of the visual cards and then in the file on the left side. Then, take one side of the Velcro and place it on the other side of the envelope so when your child finishes that part of the schedule they take the card and move it to the other side.

When using this tool, the child is part of the process of choosing and completing tasks, and can feel a sense of accomplishment at seeing what tasks they have completed. To further break down the routine into manageable parts for younger children or children with developmental delays, you can also take pictures of the different stages of the routine (for example, squeezing toothpaste onto the toothbrush as a step). The schedule is fully personalizable to your child's needs.

Allowing your child to know and see what is going to be happening throughout their day helps them prepare and feel comfortable through transitions.

Zoe and her daughter Shea on the TLC playground

Are you a TLC parent who wants to learn more about positive behavior reinforcement at home? Come to TLC's Parent Toolkit Night on October 20th!

Kids & Transitions

By Kathy Keith, TLC Occupational Therapist

Transitions can be hard… for all of us. This is something I am acutely aware of during this current season we like to call “back to school.” As a mom and an Occupational Therapist, I regularly see the challenges associated with transition periods in kids (and sometimes, grown-ups too).  These can range from the transition of going from kindergarten into 1st grade, to transitioning between play activities, to transitioning from just getting out of the house and into the car. Personally, I see the flurry of disorganization and dole out hundreds of reminders trying to get my own crew out the door in the morning (do I really need to remind a 12 year old to brush her teeth?). Professionally, I often see families with children who are unable to seamlessly transition from activity to activity. 

The following strategies are a few ways that may help with difficult transition times, and will hopefully help with increasing independence as well!

  • Create a routine

Children crave routine and structure! It helps them feel safe and understand what will be happening next, or what to expect. For example, a bedtime routine could be: jammies on, brush teeth, one book, then bed.

If bedtime always looks the same, it can increase the child’s independence in completing the steps themselves, and decrease struggles with caretakers.

A schedule to help make transitions run smoothly

  • Make a schedule

Kiddos also respond well to visual schedules. At TLC, we use pictures to show the kids what the day will look like. The pictures are arranged in order of when parts of the day happen (circle time, snack, outside, free play). If the day will look different from a typical day for any reason, the change is noted in the schedule. A child I see at TLC was very anxious about what he would be doing during our sessions. He would ask questions repeatedly and become very upset if there was something in the room that was unfamiliar to him when he walked in. We have a routine now, of sitting together first thing and drawing our schedule on the board.  It allows him to understand what his time with me will look like, gives him some control of the activities, and keeps him organized as we mark off the activities that we have completed together.  His anxiety has lessened significantly throughout his time coming to TLC, and now he is much more able to try novel things.

Schedules can be as specific or as general as you need. Some kiddos benefit from a personal schedule that they keep with them, while others can check in with a general schedule to help keep them organized and knowledgeable throughout the day. At home, you can experiment with something as simple as a white board that allows you to draw pictures or write words depending on what is appropriate or works for your child.  It can be specific like the morning routine, or it can be more broad, as in what will happen that next day, or week (or both!).

At our house, typing up a general list of “to-do’s” before getting out the door helps immensely. Instead of me needing to ask what has and has not been done (“Did you brush your teeth?  Did you pack your lunch?  Did you get your book?  Do you have your backpack?”), my one direction is: “check your list.” 

A photo routine that can be used at home

  • Give consistent cues

Transitioning between activities can be challenging, too. Giving a consistent visual cue (turning off or dimming the lights), giving a “2 minute” warning or singing a transition song, can help prepare the child for change.  These transition songs are nothing complex.  Mine often consist of a silly song about what we are completing and what will be next and is regularly sung to the tune of “Twinkle Twinkle Little Star” or “BINGO”.

We all benefit from the comfort of predictability.  For our kiddos, providing routines and schedules not only helps with some of the struggles related to transitions and change, but helps them develop a sense of security and control, and supports increased confidence and independence.  This is what we all want for all our kids.

A photo schedule on Velcro in a TLC classroom

To learn more about how working with an Occupational Therapist may help your child, or to learn about how our classrooms help build independence in children, contact TLC at (303)776-7417.