The effectiveness of function‐based interventions to treat sleep problems, including unwanted co‐sleeping, in children with autism

McLay et al. (2019) asked parents to run a sleep plan built from a quick FBA. Seven kids with autism and co-sleeping joined. The parents watched for triggers, then used rewards, bedtime fading, and escape extinction each night at home.

The team tracked sleep with diaries and actigraph watches across a multiple-baseline design.

Five of the seven children stopped co-sleeping within weeks. Night wakings, bedtime stalling, and early rising also dropped. Gains held one and three months later without new meds.

Wright et al. (2011) and Tyrer et al. (2006) showed melatonin pills can add about an hour of sleep when behavior plans fail. McLay offers a first-step option that skips drugs and still works for most kids.

Waddington et al. (2020) found that seizures, mom stress, and low income raise sleep risk. McLay’s parent plan can be tweaked for these same factors.

Xenitidis et al. (2010) and Somers et al. (2024) proved parents can run complex home programs if coached. McLay uses the same training model, just for sleep instead of toileting or flossing.

You can teach parents to end co-sleeping without pills or nights in the clinic. Run a brief FBA, pick one reinforcer, and coach caregivers through telehealth. Start with the bedroom check: light, noise, and escape routes. Fix those first and you may solve the problem before you ever write a medication referral.