Deirdre Budd’s Blog

Archive for June 2009

It has previously been demonstrated in animals and humans that sleep is important for information processing, learning and memory. Researchers have also suggested that the fact that infants spend much more time in sleep than adults is related to the fact that sleep facilitates brain development that occurs mostly in the first 3 years of life.

A recent study performed in kittens have shown that sleep indeed enhances the growth and development of nerve cell connections, a process called plasticity. These findings provide substantial evidence for the importance of sleep for brain development in infancy.

Source ;- Frank MG. Issa NP and Stryker MP

Mums who have post natal depression have difficulty interacting with their children. The baby tries hard to  elicit response from mum and when mum’s respond,  but without facial expression, the child becomes distressed and cries inconsolably. Yet a mum who attends to her child and uses a sing song voice,  and recites nursery rhythms often finds that, if she does not complete the rhythm, the child does.

We have long been aware that children understand rhythm from early development but the newest study done on newborns in Netherlands highlights  just how early this is demonstrable. While in the womb the regular heartbeat of mum surely must contribute to this phenomenon.  Now there is also the possibility that this is one aspect of learning which may contribute to learning language.

What helps a child, who has no language understand the nuances of mothers vocal communication? It could be that tone of voice provides some colour as much as facial expression when seen along with hearing the voice.

Some children react in a different way to food than we expect them to. This may be because they are processing the sensory information from the food differently. This can be upsetting or uncomfortable for the child when they have, what they perceive as ” “difficult to eat food”  in their mouth or on their plate. For some children mashed potatoes may feel like gravel when in their mouths. The issue may be the look, texture, taste or smell of the food.

It often helps to first identify the preferred texture. Children may not like lumps or skin,  and may require food to be at a particular temperature. Make mealtimes as relaxed as possible by avoiding introducing new foods or challenges at this time. Introduce new foods gradually and as an aside rather than as part of a mealtime. Before mealtimes use deep touch and resistive oral motor and total body excercises to decrease touch defensiveness.  Put small amounts of food with sauces apart and to the side of foods on the plate rather than pouring sauce over the foods.

Have a specific time limit that you expect your child to sit at the table and allow a movement break after a set number of mouthfulls.  A “move and sit cusion” will enable the child to move while remaining seated and can take some of the pressure off both child and parent.

Praise your child when they have eaten something you thought would be difficult for them and when they have tried a new food/texture/taste. Even holding the smallest amount of a new food on the tongue for a few seconds is worthy of praise. Try to ignore bad behaviour around foods as battles at mealtimes will not encourage the taking of good or satisfactory amounts of foods.  The more relaxed you can be the less tension you pass to your child.

Children who have sensory difficulties often also experience problems in settling to sleep. There are a variety of strategies which can be very effective for these children.  It is very important that there is a familiar and well maintained pre bed routine. This should be a routine which happens at the same time EVERY night. Bed time should be the same time every night with no play station or television for an hour before bedtime.

A relaxing bath, where the bath is run before the child is undressed.  Moderate pressure providing deep touch input by, keeping your hands on your child’s shoulders, undressing and getting into the bath as quickly as possible, using a fragrance free soap if the child has sensitivities, and letting the child wash themselves with a large sponge or a loofah may help.  Self imposed touch results in less defensive reaction’s and being rubbed firmly, is often more comforting than a lighter touch. Setting a definite time limit to washing can also help.

Using a heavy or a weighted blanket, (Dolphin wrap), flannel sheets  and creating a snug space with lots of pillows or a sleeping bag can help provide deep pressure which is more reassuring and relaxing for the child. If the child requires a light to be left on ensure that it is dim.  Story tapes or white noise can be helpful for some children.

If the child gets out of bed frequently return them to bed and remind them that it is bedtime. Do not get into any sort of conversation or argument. For some children a communication card on the inside of the bedroom door saying ” STOP, Return to your bedroom” using a stop sign may help, or a sign the child has made placed near the inside of the bedroom door or light switch saying, “STOP, remember to stay in your bedroom!”

Children who have difficulty in getting up in the morning benefit from having a clock in the room placed away from the child’s bedside.  Having a morning routine with set times for completing each activity can also be helpful and reassuring. Everything asked of a child in the morning or evening should be necessary and achievable. Repetition is comforting and reassuring and will often calm an otherwise easily irritated child.

Babies  have to learn the difference between night and day. Therefore the first lessons are about distinguishing between the two. This is accomplished by encouraging naps in daylight, in normal ambient household noise, and night sleep in a darkened and more quiet environment.  By about three months most infants are aware of the difference. At this age the child is more alert and more aware of their surroundings.  It is then even moreimportant to encourage a routine which is reassuring to the child and helps to re enforce the body clock.  Naps form an important part of a day’s routine and should be two complete sleep cycles long. (1.5-2hours)

It is often difficult to settle a baby of three to four months,but with perseverance and a good routine every child can learn to use nap time appropriately and to self soothe and sleep.  A child who naps twice a day for two sleep cycles is less likely to be over tired and should be easier to settle for a night sleep. Every child has one sleep in the day which seems easiest to settle for and the routine that precedes this sleep can often be used to encourage settling to sleep at other times.

Inappropriate sleep associations which are started or continued from 3-4 months often become ingrained and more difficult to alter as the child grows. If feeding, rocking, being held or stroked when drowsy and about to sleep, are continued then the child will find it very difficult to sleep without these interventions. Consequently when waking between sleep stages or sleep cycles the child will cry and expect the same procedures to allow sleep to return. There is a similarity here between the infant of under a year requiring these measures and an older child who is allowed to fall asleep on the couch, or in parents bed who then has difficulty settling in their own space.

It is often quite difficult for parents to avoid creating these associations and to be calm, confident and comfortable in changing them once they are recognised. A distressed child is not easy to listen to and controlled crying is not always the best method of resolving the issues. Fortunately there are other methods of altering the inappropriate associations and resolving the issues.

If you need help in changing your child’s sleep behaviours contact Dream-Angus.com.

The higher incidence of sleep disorders in children with handicapping conditions has long been recognised. Children with Autistic Spectrum disorders and those who are Epileptic may be on medications which may contribute to the sleep disorders. Many have sleep disorders which can be resolved or reduced by modification of their sleep and pre sleep routines.

In a recent study of children with ADHD, 17 percent  were currently suffering from primary insomnia, versus 7 percent of controls; lifetime primary insomnia occurred in 20 percent of children with ADHD, compared to 10 percent of controls. Nightmare disorder affected 11 percent of children with ADHD and lifetime nightmare disorder affected 23 percent, versus 5 and 16 percent of controls. The presence of at least one psychiatric co-morbid condition increases the risks for insomnia and nightmares.

According to principal investigator Susan Shur-Fen Gau, MD, PhD, symptoms and consequences of ADHD and sleep problems in children often overlap. Some primary sleep disorders are found to be associated with inattention, hyperactivity, behavioral problems and impaired academic performance, which are often mistaken for symptoms of ADHD. 

Adolescents with a childhood diagnosis of ADHD, regardless of persistent ADHD were more likely to have current sleep problems and sleep disorders such as insomnia, sleep terrors, nightmares, bruxism (jaw clenching and/or tooth grinding) and snoring.

Findings of the study indicated that the rates of nightmare and lifetime nightmare disorder were more prevalent in girls and snoring was more prevalent in boys. Snoring may be more prevalent in boys due to an increased rate of sleep-disordered breathing in boys. Mothers were found to be more aware of symptoms related to ADHD in the presence of primary insomnia, sleep terror disorder or sleepwalking disorder, whereas teachers may be more sensitive to ADHD symptoms in the presence of primary hypersomnia and nightmare disorder.

According to the study, sleep problems in children with ADHD may be caused by a variety of factors, including Internet addiction, hyperactivity, use of stimulants and the presence of other psychiatric disorders. Authors of the study state that the etiology of sleep problems and disorders need to be identified in children with ADHD, in order to create a modified treatment regime for sleep disorders and ADHD symptoms.