Parent-Implemented Bedtime Fading and Positive Routines for Children with Autism Spectrum Disorders
Bedtime fading works for autistic kids, but newer studies show gentler or pill-based options can work even better.
01Research in Context
What this study did
Delemere et al. (2017) asked parents to run two bedtime fixes at home. One was bedtime fading: push bedtime later so the child is truly tired. The other was positive routines: add calm, happy steps before lights-out.
They tracked sleep with diaries and actigraphy across a small group of autistic children.
What they found
Bedtime fading gave clear wins. Kids fell asleep faster and stayed asleep longer. Positive routines helped some nights but not others. Mixed bag overall.
How this fits with other research
Woodford et al. (2024) now says start with the gentlest fix first. They used the same multiple-baseline design and got strong sleep gains across seven of eight kids. Their results update and outshine the mixed findings here.
Sadeh et al. (2023) took a pill route. Parents gave melatonin and saw steady, medium-level sleep gains. This seems to clash with the mixed behavioral results, but the studies test different tools—hormone versus habit—so both can live on your menu.
Pitchford et al. (2019) stretched the idea further. They moved parent coaching online and still beat sleep problems. If families liked Delemere’s approach but can’t reach clinic, telehealth is now an option.
Why it matters
You now have a ladder of choices. Start with bedtime fading for quick sleep wins. If progress stalls, add online parent coaching or consider melatonin. Keep positive routines as a support, not the main lever. Match the step to the family’s time, tech, and comfort with meds.
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02At a glance
03Original abstract
Sleep disorders affect a large portion of those with autism spectrum disorder. Behavioural interventions have been found to increase appropriate sleep behaviours. This study sought to examine the efficacy of two stimulus control interventions (bedtime fading and positive routines) on total sleep duration, sleep onset latency and frequency and duration of night wakings for children with autism using two multiple baseline designs. Secondary dependent variables, namely, educational opportunities, challenging behaviours, parent acceptance and social validity were also analysed. Results suggest some efficacy for both interventions. Increased total sleep duration and decreased sleep onset latency were achieved with bedtime fading. Positive routines showed mixed results with decreased sleep onset latency and increased total sleep duration for two of three participants.
Journal of Autism and Developmental Disorders, 2017 · doi:10.1007/s10803-017-3398-4