[00:00:01] Speaker A: Welcome to Shining Inspiring Voices of Autism.
[00:00:04] Speaker B: With show host Jennifer Dantzler.
[00:00:05] Speaker A: My name is Matthew and I'm on the autism spectrum.
[00:00:08] Speaker B: Thank you for taking the time to.
[00:00:09] Speaker A: Learn more about the world of autism.
[00:00:11] Speaker B: If you enjoy what you hear today, don't forget to follow this podcast.
[00:00:14] Speaker A: Hey everyone, this is Jennifer Dantzler and I'm the executive director and founder of inspirend, a nonprofit whose mission is to create truly inclusive communities through education and engagement. The goal of this podcast is to shine a light on real people and their stories in hopes of inspiring others who are on this journey of autism. Either themselves, their child, their loved one, their co worker. I truly believe ignorance is not bliss and we cannot be inclusive communities if we do not understand the people in the community. With autism now affecting 1 in 31 people, we need to get louder about this topic. We recognize that autism is a spectrum. There are a lot of people with a lot of different needs, a lot of resources available or none available. And we know that in every episode we can't meet everyone's needs for their specific interest.
However, we hope that in each episode you do gleam some kind of insight as to how you can help your child or yourself be a better advocate. And as we go through our podcasts, our goal really is to address the entire spectrum, the various needs, the various environments that we're going to be in. And we hope that there's something in every episode for each one of you. So let's get started.
We actually have something a little different today. We have a returning guest. His name is Armando Bernal and he was actually on season one, episode eight. From Autism Diagnosis to CEO, A Story of Perspective and Purpose. And he shared a lot about his journey from early diagnosis on the autism spectrum up to now being the CEO of an ABA company. He is a BCBA himself. So thank you so much for coming back, Armando.
[00:01:48] Speaker B: Oh, it's a pleasure. No, this was so fun the last time I was here. I'm really happy to be here.
[00:01:51] Speaker A: I encourage people to go back and listen, if you hadn't already, to episode eight in season one, because Armando talks a lot about his struggles, but then, you know, and how he now runs his own ABA company named Autism International Consulting. So as you and I were talking before we started recording and you've already had some updates and progress since our podcast. So why don't you tell the listeners a little bit about Autism International Consulting and the services you have.
[00:02:16] Speaker B: The only autistic owned ABA company, Applied Behavior Analysis Therapy Company in Houston, Texas, one of two in the State of Texas. Since we last spoke on this podcast, I now have two clinics. One clinic that does primarily the typical kind of aba, which is more early intervention child based, but then we also have a school based kind of clinic where we work with kiddos that may have inside thoughts that become outside thoughts.
[00:02:38] Speaker A: I love how you say that.
[00:02:39] Speaker B: That.
Yeah, and it's, it's been really helpful for them because a lot of those kids will have issues with making friends, being able to live on their own, and being able to do things for themselves. And so we help them through that. Also started a group kind of collaboration with the community.
We created a new Facebook page called Autism Moms and Dads of the Woodland Spring Area to better support not just the mothers that have children on the spectrum, but also any fathers that may need help as well and get any kind of resources.
[00:03:10] Speaker A: Wonderful. Because I know there are a few groups out there who are locally, but it's all Autism Moms.
[00:03:14] Speaker B: Yes.
[00:03:14] Speaker A: So I love the fact that you include the dads.
[00:03:16] Speaker B: Yeah, yeah, absolutely. I mean there's, there's just a lot of resources. And I was just thinking to myself now as a father, as I spoke in my last presentation, that there has to be a lot of maybe either single fathers or just dads that want to be involved in what's going on with their children. So, yeah, we started Facebook group actually the week before this. We've grown to like now like 75 people and hopefully get way more of the community involved. And it's really just about trying to get as many resources out to the public as possible.
[00:03:42] Speaker A: Wonderful. I love it. Okay, but today we have you here for a very specific reason. We want to talk about the very ominous topic of sleep.
[00:03:50] Speaker B: Oh yeah.
[00:03:51] Speaker A: And so since you are also on the podcast, you received a new certification in the world of sleep. So why don't you talk a little bit about that?
[00:03:59] Speaker B: Yes. So now because of Dr. Emily Varin, who is in charge of Ready Set Sleep, she has a specific certification that we can given only to board certified behavior analysts, called a certified behavioral sleep specialist. And so we as behavior analysts will take several different of her classes that are both asynchronous. So we just see videos that are able to teach us more about sleep. But then we also meet with Dr. Varen to discuss any kind of children that we want to do a case study with and also just better support the individuals that we're working with all around.
[00:04:32] Speaker A: And that's so wonderful because I know sleep is a big challenge in for our families that have a child or themselves are on the autism spectrum. And I've always said in everything in life, you can handle a lot of things if you have sleep. You can handle almost nothing if you don't have sleep.
And it does seem like there is a pattern for our people on the spectrum that sleep is hard and they almost don't seem to need as much of it as the neurotypical person. But yet it's so vital because mom and dad have to be able to sleep. They have to be able to sleep. So let's talk a little bit about what are some of the things that you think are the root causes of our sleep challenges?
[00:05:09] Speaker B: Right. So I'm really glad you said that because I don't necessarily think that a lack of sleep is the concern here, but more so a regulation of schedule for the sleep patterns. Right. So what that means basically is that we are kind of just jumping all over the place when we put a child to sleep, trying to get sleep wherever we can. Right. Maybe the kid, kiddo, goes to sleep at 7 one night and then the next night it's 9, and then the next night maybe it's 8 or 11 and there's no real routine. And we know this already from Autism spectrum disorder, that a lot of the individuals on the spectrum do require some kind of routine or kind of structure and expectation. So that may be missing here, and we can better support the parents through that.
[00:05:48] Speaker A: So the first thing you're saying is routine is very important. Time and consistency is important. And I know for me personally, like, our family is not routine based.
[00:05:54] Speaker B: Right.
[00:05:55] Speaker A: So one of the very first things is for parents to think about, is there no routine? And could that be some of the cause of the sleep challenges?
[00:06:02] Speaker B: Right. Yeah, absolutely. So we have, for instance, a third of our life is going to be used to sleep. Right. I love sleep. My wife loves sleep. Thankfully, our baby has started to love sleep now too. And those things really play a factor here, right? Because the more sleep that we're able to gain as ourselves, we're able to function better. Our body is able to remove any kind of toxins or any other kind of issues that we may have. If we can focus on some kind of structural expectation, we're going to ideally and likely see see a change in the behaviors that a child is going to be seeing. Right. So much like has typical behavior analyst may say, hey, during the day we need you to be able to do XYZ material, maybe have a set schedule when that happens. The same goes for the nighttime. But the issue typically is going to be that a lot of parents, because they've worked so long, they want to spend time with their kids. Right. They want to roughhouse or play or whatever it may be. This can inadvertently cause a lot of different kind of concerns when it comes to sleep. Not necessarily interacting with the child, but more so the kind of activities that we're doing with the child.
[00:07:05] Speaker A: Okay, so, Yuri, I know we're gonna talk about that a little bit later. What are other types of things that might be interfering with, say, even just the getting down to sleep, do you think? Anxiety, sensory needs. What are some of the other contributing factors?
[00:07:16] Speaker B: Honestly, sometimes it's going to be the kind of sensory acceptance that we're giving to these children. For a lot of the times, a lot of individuals will use iPads or phones, YouTube videos, things like that, to kind of wind down, if you will, for these individuals on the spectrum. But quite frankly, we all do it. We all watch television before bed, or we do certain things before bed that make us seem like we're night owls. Even the adults that say, oh, I can stay up to 1, 2, 3am Because I just can't fall asleep, and then they scroll on their phones. This kind of activity, and more specifically the screen, is going to cause people to stay up longer because of the blue light that is found within these kind of screens, whether it be a phone screen, television screen, or an iPad. And it all can affect it. Essentially, it's like looking at the sun. And so it's causing your retinas to work in overtime to try and protect them.
And so it's. It gets it to be more difficult. And your body looks at it as, oh, it's daytime right now, so I must be up as a body. If we can lower the amount of screen time that we're giving these children, then we can see a decrease in that kind of sensation within ourselves.
[00:08:25] Speaker A: Well, and you bring up a good point, because I know for a lot of our families, especially if they've had any kind of behavioral therapy, a lot of times, you know, your reinforcer or the thing that they earn for making good choices is often screen time, as it is for most of us, and that screen time might be after dinner, before bed, because they made good choices all day, or they ate the vegetable at dinner, what have you. So I guess that's an important piece to this when you're thinking about their behavioral systems. Is screen time the thing that they should be earning later in the day?
[00:08:54] Speaker B: And here's the thing, I love that point, right? Because here's the thing. It's I don't want to come on here and say don't ever use screens. They're awful, right? Because I watch television. We're in the middle of a show right now ourselves, those kind of things, right? It's not about removing screens entirely. It's about the timing of that screen, right? So maybe instead of putting it right before they go to bed because they had a really great day, give it to them for some other kind of activity earlier in the evening, right? Maybe they see it at 5 or 6 before it's 8pm is their bedtime. That kind of things, right? It turns into more of a level type of system when it comes to activities. So we may start out with something that is really engaging, really active. So this would be like our roughhouse play or iPad usage and watching something with the family.
But then we move from that kind of high energy active activity to maybe drawing or writing or coloring or playing with different kinds of tools.
And you can see it kind of slowly go a little bit less, a little bit less to kind of wind down. Now in my life, ever since I've started this certification, I read at the end of the night and I do my best to keep up with it. And then I have to shake my head a little bit because I just can't stay up because the act of reading is just making me sleepier and sleepier. And then I'm able to go to bed a little bit more as well.
[00:10:10] Speaker A: Okay, are there any kind of blue light screen protectors or anything that people could get? And I'm trying to think why do our phones not have like click to blue light protector? Because I know some of us in the room might watch Netflix to go to sleep. So like I could use this also.
[00:10:26] Speaker B: You and me both. So it's definitely. So you can add in different kinds of. For instance, I'm an iPhone user, right? So there is an ability with on our iPhones to kind of dim the light or make it a little bit less. But regardless, the light from the screen is still going to impact you in some way. Maybe not as much the lower you make it, but it is still going to impact. It's still the matter of there's being something bright right in front of your face that is causing your brain to think in a certain way. And so that's the difficulty.
[00:10:53] Speaker A: There is that while we stay on the screens, is there a general rule of thumb like when ideally screens should be done like an hour before bedtime.
[00:11:01] Speaker B: Two hours before bed, everyone's going to be different. Right. In this sense. So individualize it for sure. I would say start at an hour, see how your child is doing, have the data or the kind of permanent product if you will, of determining is this working for my child or not? Are we seeing a little bit more of that kind of increase in sleep? Right. But in addition to that we have to look at other factors. We have to determine the differences between what is sustainable sleep and what is unsustainable sleep. So if we have it where we're putting our child to sleep by rocking them or interacting with them in some kind of way, then that can be difficult because if we start to try and take even that kind of activity away, well, maybe they can't sleep anymore because of that. So that becomes difficult. What we want to do instead is replace the unsustainable with something sustainable. So this may be white noise machines, this may be sucking their ability, suck their thumb if they're younger, some kind of self soothing. We want to focus on self regulation because if they are able to regulate themselves then we can see peace throughout the whole family. Right? Because sleep is so significantly important.
[00:12:01] Speaker A: Well, and I think that's such a good point again for all parents. How many of us have done the whole like rock the baby and then it takes you about 20 minutes to lay them down so that you don't wake them up and then they wake up with one, one wrong movement. And that whole to your point of self soothing is just a hard it is thing to train yourselves to do. Right.
[00:12:20] Speaker B: It's now as a parent, the kind of suggestions I give are significantly different than when I was married with no kids in this situation because it is hard. It's hard to hear your child cry or whine or whatever it may be in their room. So I would suggest starting out with something really, really small, something that you're able to take away and know that your child is going to be safe. For my family as well, because I do have an 8 month old, I'll try to work my way out of the room in some sort of way or I'll give leave the room and then only have a certain time limit for myself before I go in and check on her with the camera going. So maybe I would say that okay, I'll give her five more minutes, 10 more, 15 more minutes before I say okay, something is going on. Either she's wet or I need a feeder or other things like that. The same thing for even our older individuals is giving them some kind of time limit of let's practice. Let's try and regulate as well. And these are different kinds of examples to do.
[00:13:16] Speaker A: So that brings up a good point about. I know for a lot of our families, they'll often say, well, they're worried that there's some kind of medical component to this, and that's cruel. Right. You have some of our, especially, you know, maybe later elementary, early adolescents that have learned, oh, to say, I need to go to the bathroom, because then that gets them up, that gets them going to the bathroom. They can see themselves in the mirror. They can get mommy or daddy's attention. And so is there any, like, tips or tricks or signals? Like, how does a parent determine if this is medical or behavioral?
[00:13:45] Speaker B: It's actually in the ethics code for. For all behavior analysts is if there is something that it could be medically a reason why something is occurring, to go specifically, speak to a doctor first. So I always recommend that to my parents is if you have a concern regarding medical. Maybe this is something with the brain or something, you know, neurological or whatever it may be, speak to that doctor, that specialist first to try and roll that out. And once that is rolled out and we can have the doctor say, this is not medical.
As far as I can tell now we can get back into, okay, this is a behavioral approach. I do need the professional opinion of a behavior analyst. And so we try, especially at Autism International Consulting, to collaborate with as many doctors as possible to make sure we're giving the right advice and the right supports to the parents we serve.
[00:14:27] Speaker A: Again, if they end up getting up and going to the bathroom, but two drops of urine comes out or they don't even use the restroom. Right. Pretty good signal that it was behavioral, you know, not medical. And I know there are things like the wet stop and other signals to help them, like learn when they're feeling that sensation to get up and go. I mean, I do think it's hard. So to that point, if I had to guess, one of the first things that you're gonna ask these parents to do is to take some form of data.
So talk a little bit about the data. And what kind of data are you looking for from the parents?
[00:15:00] Speaker B: Yes. So a couple of things. So, again, what we try to do is focus on what is useful to the parent rather than so much just being useful to me. I want something that we can both have a conversation on, not some kind of fancy graphic representation that the parents don't even know what they're looking at. Right. Because that's not gonna do any good. To them. So we'll look for how many times did they get up? How long did it take them to get up? Were you able to put them down for sleep at 8:00pm, 7:00pm Whatever it is, how long did it take you? These kind of situations will be helpful. Right. In addition, typical antecedent behavior consequence data, which basically, for anyone that may be curious on that, is looking at what happened right before we put him to sleep, what happened right after. Let's discuss your routine. These are just different kinds, either permanent products or things that we can discuss with the parent to get a better idea. And a lot of the times when we have this kind of representation to parents, not only are they more willing to speak on it because they understand it, but they're also willing to see different changes that could be made because it is in a more physical form. It's a lot like when we deal with typical behaviors during the day where a parent may come to us and say, they just cry all day long. And when we actually look at the data and we look at it with them, they're like, oh, they only cried actually for five minutes total that day. But it feels longer when you're in the. In the situation rather than looking at it from a graphic representation.
[00:16:17] Speaker A: Well, and to that point, you know, I beg any parent out here listening, whether you do use or going to use Armando or another sleep specialist, please be honest with the data. Because I think sometimes the parents are also worried that they're going to feel judged. Where you sat down and you said you explained the importance of routine and they agreed. And then, you know, the next week they got into it and it was really one night, seven o', clock, one night eight o', clock, one night 6:30, one night nine o'.
[00:16:40] Speaker B: Clock.
[00:16:40] Speaker A: But they don't want to tell you that.
[00:16:42] Speaker B: Right.
[00:16:42] Speaker A: But that's not going to help you in making meaningful behavior change.
[00:16:46] Speaker B: Yeah. It is not my place, especially ethically. It is not my place to judge in any way or form. Right. And I do that with whether it's talking about sleep or whether it's just typical behavior analysis. At Autism International Consulting, none of my therapists are here to say, oh, I can't believe so and so let so and so do this that night. That's not what we're here for. Right. We're in the business of ensuring that your family gets plenty of sleep. We're in the business of memories, making sure that you're getting the kind of activities and the kinds of joy that you always wanted for your family.
[00:17:19] Speaker A: Yeah. So true. And I think that's something that our families struggle with. Let's talk a little bit about the environment, the bedroom.
Is there anything that could or should be done in that environment to help set up this possible success?
[00:17:32] Speaker B: Yeah, absolutely. So it's the same thing that we see with a lot of.
I'm going to give a comparison to television shows. Right. We see a lot of more behavioral concerns when a child is watching something that is bright colors, overstimulating, just really active movement, fast. And we can see a higher level of behaviors there as opposed to maybe a television show that has muted colors that's a little bit more calming or soothing. So keeping the bedroom in that kind of format is going to be significant. Right. Whether it's muted colors on the walls, maybe pale greens or pale blues or whatever, it may be very active toys. Right. But more so that involves their imagination rather than something speaking with them or needs some kind of running around movement, these kind of activities that can be difficult. Right. So the more calming, relaxing that you may have the room, the better it's going to be. It's a lot like also seeing a therapist. Right. Where they have the candles going or spa and they have the quiet music. All of that makes you feel a little bit more sleepy than if it was like loud rock music in the spa room.
[00:18:31] Speaker A: Yeah, good point. So I guess in the ideal world, the child's bedroom is not also their toy room or playroom, if we can ideally set it up that way.
[00:18:39] Speaker B: Right, right.
[00:18:40] Speaker A: Or do we possibly go so far as maybe those things come out of the room at nighttime, like if that has to be their playroom or their downtime. Right, right. But maybe those things either get locked up or just are inaccessible at bedtime.
[00:18:53] Speaker B: Yeah. I think it's important too where you that's a good opportunity to give responsibility to a child where we're trying to give them that independence. Right. Maybe they're only are able to get their toys in the living room and they have to go and unlock them or they have to go and pick them up from a certain room or do XYZ things with them. That can all be really significant for them. It makes them feel good too, because it makes them feel really independent, like they can do things for themselves.
[00:19:16] Speaker A: You know, I see this a lot also with things like food allergies, where from the beginning I want to teach the child, no, this is bad for your brain, so you choose to not have it.
[00:19:26] Speaker B: Right.
[00:19:26] Speaker A: And this happens occasionally, you know, in the clinics where a child accidentally gets a Food they're not supposed to have. And parents get upset with the therapist. And it's like, but we also want to teach the children to say no. Like, that's bad for my brain. So I'm going to say no to it. Right, Right. So it's the same kind of empowerment, like, we all should be doing. Like, I know I should be reading before bedtime. And I said, I choose to binge watch Netflix.
[00:19:47] Speaker B: I mean, they got some good shows on there.
[00:19:49] Speaker A: They do. But then I force myself to have to change my behavior when I'm on the third night of only having five hours of sleep because I know how bad I feel.
[00:19:57] Speaker B: Right. It's about habit changing. Changing habits is really going to be important because it can really change one's mood. It can change one's whole attitude toward the day. So if we can make these certain little changes. Right. To make it not as overwhelming to the parent, then we can see really significant change.
[00:20:15] Speaker A: Well, and I think also because habit change, we also know does not happen overnight.
[00:20:20] Speaker B: Yes.
[00:20:20] Speaker A: And I think for a lot of our families, they might try your beautiful plan on day one. It backfires, and then they just say, you know, screw this. Yeah, yeah, I can't do this.
[00:20:30] Speaker B: What I try to tell the parents that I work with, too, is just, you know, give it. Give it a week and let's see, can you see any change at all? And then we can determine what needs to change next? Or were we trying to do too much if we bite off more than we can chew? But that's also where you can come to a sleep specialist and let me know as an example and say, hey, this didn't work. What am I doing wrong? Or what can I do differently? And then that's where I step in and say, oh, well, let's try this. And instead, and having that kind of guidance, because a lot of this is new for parents, Whether it be just the diagnosis itself or sleep being a problem and trying to change it, it can be changed over time. It just takes that support and that guidance from maybe a professional.
[00:21:09] Speaker A: Okay, so now let's talk about that dreaded. The child wakes up in the middle of the night and gets in this habit of either getting up a to play with toys, turning on their screens, or coming down and waking you because they need you.
What are the, I guess, top offenders that you see that mistakes that parents.
[00:21:27] Speaker B: Do, Walking them back to bed and then going back into I'm going to rock you or I'm going to sing to you. Things that again, are listed as unsustainable things that involve you removes that kind of self regulation. It would probably be saying, okay, you can only get five more minutes with the toy since you're already up these kind of things because the parent is already half asleep anyway. They're not in their full mode yet and it can be difficult. But we have to kind of stick to that routine. Which is to your point earlier when you were talking about maybe locking things away or having activities at only certain times of the night, that's going to be really important because as that habit changes, we can see real development.
It's. It's just a matter of keeping up with it and more specifically making sure all family members are keeping up with it. There's a lot of the times that maybe it works with mother or father and then the father or mother doesn't say that to the rest of the family. And so the child learns that and they say, well, if I'm not going to get something from mom or dad, I'm going to go and get it from brother, sister or whoever may be living in the household.
[00:22:28] Speaker A: Yeah, no, that's a really good point. And you know, and I think for our families the hard part is we know from a behavioral standpoint then the more attention you give them, like that's reinforcing that behavior. And for a parent maybe of a child who's maybe not normally affectionate or doesn't give them a lot of attention, then middle of the night, you know, they want to be all cuddles. And it is very hard to say to mom or dad, but you can't do that right? Now I see this a lot when it comes to things like showering.
A parent of a 19 year old male, the dad will stand there and say, well, I don't have to do much, I just have to stand in the doorway, right? And I'm like, but then that young adult knows that's when I get dad's attention. So I better not be independent in the bathroom. If not I don't get dad's attention.
[00:23:09] Speaker B: Right.
[00:23:10] Speaker A: You know, that's an important thing for our parents is how do you then. Well, take that cuddle time then and let's transfer that to daylight hours, right? And make time for that so they don't feel like they have to do it in the middle of the night.
[00:23:21] Speaker B: It's so interesting to me now as a new first time parent going through these different kinds of stages.
My daughter was initially a newborn, just kind of there, right? Little potato. And now she's at a Point where we may sit her in a highchair, but if she didn't want to sit there in the high chair and wanted to be held, instead, she looked at my wife and then to me, my wife and then to me, just begging, praying that somebody would look at her so she could try and get that kind of attention. We had the same issue once at night again where my wife was trying to put her down and I was right next to her doing my own thing and my daughter was trying to like stick her tongue out and was smiling, doing everything she can to stay awake, trying to be as cute as can be. And it can be hard. It's really about holding that line. And that's where you can lean on your partner or the other guardian or maybe even the professional. If it's just you as that single parent, right, giving that kind of support is going to matter a whole lot. And if also to have grace for yourself, if you mess up on a day and you say, hey, I gave in, I'm sorry, it's okay. Right? Because that's where I think a lot of the beating yourself down comes from, is that you try it one day and it doesn't work and you say, oh, I messed up because I didn't do xyz, I'm not gonna try anymore. That's not what you should do. You should always look to others and say, hey, you know what? Tomorrow's the new day. I'm gonna try again and we're get it right there this time.
[00:24:40] Speaker A: Right? Well, and then that, that mommy gut or daddy gut, I mean, there might be that night that the child gets up and yes, they do have 101 fever. And so they really do need cuddles.
[00:24:49] Speaker B: From mom or dad. Exactly.
[00:24:50] Speaker A: You know, or that teddy bear that, that favorite item. Part of what happens is there are these little infractions, I'll call them, that parents think, well, that's not that big a deal, right? But then they multiply and combine. And then next, you know what, we'd have what we'd call treatment drift. And next thing you know, like you said, it's a three hour bedtime routine that's not sustainable long term.
And it's about how do you become aware of those little things? And there's an expression in the world of hr, easy now or hard later. Meaning either hire someone now that might not be so good, but they fill the spot, but later you're dealing with trouble or vice versa. It's the same thing here, right? You might be dealing with a couple Nights of some cries, some yells, but long term they have to have sleep and so do you. And I think, you know, it's important for our parents to remember that.
[00:25:36] Speaker B: Yeah.
[00:25:36] Speaker A: So for our families though, of our, of our kiddos who might deal with some aggression and self injury.
[00:25:42] Speaker B: Right.
[00:25:43] Speaker A: How do we handle that? Is it okay to say to a parent, you know, if your child's in there and they're frustrated and they're biting their hand, when do we intervene and when do we say, well, he's got to work through this because if not, we're never going to get through this.
[00:25:56] Speaker B: So it comes when safety is involved. Right. We have to make sure is a child safe first and foremost. Is any other family member that may be in that room. In addition, because some siblings, my sibling and I, we shared a room for a while. Are they safe in that room as well? So that's going to be really important. It goes into determining what steps led up to that cause of getting self injury or aggressive in that way. There's a lot of talks that Dr. Hanley, who's another individual within the field of applied behavior analysis would say that no one goes from zero to 100. Right. Nobody goes from being upset that they couldn't sleep to now flipping a table. There's little steps in between. And so as that parent understanding what are those kind of little micro behaviors or microaggressions, if you will, that led up to the bigger aggression and working from that point. Right. If we get to an aggression or self injury and it is the middle of the night, safety is going to be first. And then tell yourself, tell your partner, whoever it may be, hey, we're going to try again tomorrow. Let's reevaluate. When we have gotten some sleep, they're put down. So let's talk about what happened and how can we stop it from happening the next day.
[00:27:03] Speaker A: Okay. And so how much does medication play into this? Meaning medication maybe they take during the day that might affect nighttime sleep or talk a little bit about medication.
[00:27:11] Speaker B: Right. Medication is definitely something that can play a factor not just in sleep, but really everything that child is doing. Right. We are working with parents that are just trying to have as much support and help for their child as possible where medication may come in. Right. By all means, if a doctor has prescribed that for you and recommends it, listen to your doctor. I cannot stress that enough, but understand that medication may have side effects much like. And we may be speaking about it later. But also melatonin is something I see a lot of parents Use and these kinds of ways, medication is going to be something that we should use ideally as something that lets us understand what is happening, what's causing it and then moving toward more self sustaining, regulating kind of activities that can better support that individual. And so when we're looking at sleep, ask your doctor, not be afraid, be very transparent, say hey, my kid is autistic, my child is taking this medication. How will that impact sleep? What should I be looking out for? Are there any other alternatives to using this medication or any recommendations you would have when sleep is on the line here as well?
[00:28:18] Speaker A: So what are your thoughts since you brought up, what are your thoughts on melatonin?
[00:28:21] Speaker B: It's real. I'm really glad you brought that up as well. Right. So with melatonin it's very interesting. So melatonin typically needs to be prescribed in every country except for the US and Canada. We are the only two countries that just kind of let you buy it store bought. And there's a million one of reasons why that happens. Right. With regulations. And that's for another time. The issue here is that the amount of percentage of melatonin that is being bought in this way goes anywhere between being under the typical use that needs to be done during the day. About 48% to even over 400% of the amount that a typical body should have. Right. Because melatonin is not meant to be something that to be used, but rather it's, it's a hormone within ourselves and if we use too much of it, our body says I don't need to use this, I don't need to make this anymore, so I won't. Initially it was meant as a way of resolving jet lag or some kind of short term concern. I think when we are struggling with behaviors like aggression, self injury and parents see this as a really useful tool, it becomes the only tool that a parent is willing to use and then that becomes a bigger problem. To your point of saying that little issues may become those big problems. So I use melatonin as an anecdotal person right now. Right. But it's not an everyday kind of situation. It's I just can't get to sleep and I have a really important podcast to get to or I have a big exam or preparation that I need to do and I need to definitely go to sleep in those situations. So that's my opinion on it, is use it sparingly and have it in your back pocket rather than using it every day. Where a child may get used to that same thing. Like with medication, if you use something for too long, your body gets used to it, you need a higher dose or a more intense dose and that can bring a problem in of itself.
[00:30:01] Speaker A: So they could talk to their doctors about it though, because the doctors should have in theory, some idea on, on how to use it.
[00:30:07] Speaker B: Yeah, absolutely. Right. And but you want to make sure that the information that is being given is something that is coming from a knowledgeable source. Right. From that doctor.
Any kind of evidence based journal articles that are peer reviewed, these kind of things are going to be really important because not everyone can go to the doctor. And so just make sure that that research that is being reviewed is something that can be important to your family, but also from a reputation repeatable source.
[00:30:31] Speaker A: Okay, let's talk a little bit about tools and supports, meaning things like visual systems before bed. What are some kinds of, you know, tools that you would recommend?
[00:30:41] Speaker B: Right. It definitely is going to be those visuals for sure. That's first and foremost. I do that with every individual that I work with. Communication aspects as well is going to be really important choice making activities and having a, as I had mentioned earlier in the podcast, a leveled system of activities. Right. What, what are the only activities allowed from 5 to 6? What are the activities allowed from 6 to 7? They should be less intense than maybe running around, a roughhousing, plane chase. And then we go from that seven to eight. What are those activities? Right. In addition to that, including some kind of daily activities like showering or toothbrushing, put that in the mix as well. Things that can set up a routine for those individuals to follow that make them feel more at home or more understanding of what expectations are given to them at night.
[00:31:26] Speaker A: Well, and to your point, you know, that's an executive functioning skill that a lot of our guys don't have, where we know the order of things and we know our nighttime routine, but some of our guys might not. So even though they've done it the same way the last hundred days, doesn't mean they automatically have memorized or know this routine moving forward.
[00:31:43] Speaker B: Right. That visual schedule helps them really see what that expectation is. It allows them to understand what is going to come next. And to your point earlier, you were speaking on, does anxiety play a factor here? Right. Anxiety and autism sometimes go hand in hand. As an autistic individual myself, I have anxiety and they go hand in hand. I could say that.
But knowing what comes next helps kind of relieve that pressure that an individual may have and so therefore allows them to really be a lot more comfortable with following any kind of tasks or skills that are being given to them as well.
[00:32:15] Speaker A: So would it be fair to say. I know this is a big leap, but in my experience, more often than not, the sleep challenges are more behavioral than medical in nature. And whether there's comorbidities with other diagnosis. Would you agree with that statement?
[00:32:30] Speaker B: Everyone is going to have individual concerns. Right. If we think on where behavior comes into our lives, it happens in everyone's life. And it's important to know that there is a reason always that something is occurring. So whether that be something that may be medical. Right. That needs to be checked in on. But also maybe looking at just asking the question, why did so and so get up this evening? Why did so and so not go to sleep as easily as they usually do? These are all going to be really important. So I would challenge a lot of the listeners today. Right. Is instead of looking at the discouragement, looking at any kind of situation that occurs with their child and asking why? Why did this happen? And right after you ask that question, say, how do I resolve it? Or how do I change it for the next?
And those two questions are really going to be your best friends. To determine what can I do to either increase or decrease some kind of behavior that I'm seeing in the child?
[00:33:25] Speaker A: And probably things like food journaling and analyzing diet from the night before or dinner time the day before, or the amount of fruit punches they had during the day. You know, I think that probably goes across the board, not just sleep that we need to. We all probably need to food journal more to see how it affects our moods and our anxiety and all of those things.
[00:33:45] Speaker B: Right. Nutrition matters. I go in and out of health kicks. And I always see every single time I do this that I am a lot more energetic or more livelier when I am eating vegetables and different kinds of healthy snacks and foods, as opposed to if I just ate different kinds of junk foods throughout the day.
[00:34:04] Speaker A: Because diet coke's really good for you. Right. I'm supposed to have that every day.
[00:34:06] Speaker B: Yeah, that's what my doctor said. I'm kidding.
[00:34:09] Speaker A: Yep. Total joke.
[00:34:10] Speaker B: But with it, it does play a factor. And if we can regulate not just what happens during the day, then we can also see that kind of regulation happen at night. And I think at the end of the day, our kids will thank us for that as well.
[00:34:23] Speaker A: Yeah. Is there anything else that we didn't talk about that you feel like is really important for parents to just start thinking about from sleep? We talked a little bit about environmental Modifications, things like taking data and being honest about. Right. The things that happen before and after. Is there anything else that we didn't touch on?
[00:34:39] Speaker B: Yeah, I would say, say to make sure that you're doing your research, make sure that you're reviewing things with your medical doctor, to your point, about being honest about what's happening, not just with a professional, but with your medical doctor and say, hey, this is what's happening. They are there to work for you above all else. Right.
It's one thing to take maybe my opinion on things or your doctor's opinion, but make sure that it feels right to you and your family, because that is who you have to live with. And so always ensure that you're doing what you can for your child, because I know you are. It's just making sure that you have the right evidence to back up what's happening.
[00:35:14] Speaker A: Right. And to your point, you start out the whole thing talking about the importance of sleep. Not even just for sanity, but for true health.
[00:35:20] Speaker B: Absolutely.
[00:35:20] Speaker A: For true health. So. Okay, Armando, well, we can't thank you enough for being here. Tell us again where we can find you and all of your support services.
[00:35:28] Speaker B: Right, Absolutely. So you can find us on Instagram at Autism Intl. Our
[email protected].
and we now also have a Facebook group that you can speak to us on, where it's called Autism Moms and Dads of the Spring Woodlands.
[00:35:47] Speaker A: Wonderful. And can people join that that are even not necessary from Spring Woodlands if they want to find resources?
[00:35:52] Speaker B: Absolutely. We are just here to try and help out as many people in the community as possible.
[00:35:56] Speaker A: Well, we are so grateful for you to be in our community and thank you for all of this insight today. And as we said, I think, you know, sleep often is underrated and not as much of a focus as it should be. So we are so also grateful for that certification and that you feel such a value in helping our families with that. So thank you.
[00:36:12] Speaker B: Thank you.
[00:36:13] Speaker A: If you need help or resources, whether you're a parent, someone on the spectrum, a business or a community organization who want to know more or need help or want to share resources, please reach out to us at info.
Org.
[00:36:28] Speaker B: Thanks for joining us on Shining, inspiring Voices of Autism. If you enjoyed this episode, be sure to follow us, leave a review and.
[00:36:35] Speaker A: Share with others who want to celebrate neurodiversity. Until next time, keep shining.
