The Behavioral Sleep Blueprint with Nicole Shallow, Part II

ABA is proud to host Nicole Shallow (Part 2 of 2):

Nicole Shallow is a Board Certified Behavior Analyst (BCBA) specializing in sleep and behavioral consultation, particularly for neurodivergent children and their families. She holds a Master of Education in Special Education and became a BCBA in 2019. Her passion for sleep stems from her own personal experiences with sleep difficulties since childhood.

Nicole is the founder and CEO of Your Behaviour Gal Consulting Inc.. What started as a single practitioner's sleep and behavior consulting practice has expanded to include a team of BCBAs who support families and professionals throughout Canada and the U.S. She's developed the Sleep Competency Certification Program to educate and empower other professionals in the field.

Her services include sleep coaching for individuals and families, corporate sleep coaching, and sleep workshops. She also provides behavioral consultations for the autistic and neurodivergent community, encompassing family, school, and sleep support, along with home team coordination. Nicole emphasizes compassion, knowledge, and inclusivity as core values in her practice. 

Beyond her consulting work, Nicole is a public speaker, educator, and mentor. She believes that everyone can improve their relationship with sleep through the right tools and information. Nicole speaks happily about her role as a wife, mother of a young child and canine enthusiast. She takes time out of her busy schedules to pour a bright-eyed brew for ABA on Tap, one that is sure to prove soporific for your clients.  Get on with your sleep hygiene, and always analyze responsibly.

Transcript

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SPEAKER_04 0:10

Welcome to ABA on TAC, where our goal is to find the best recipe to brew the smoothest, coldest, and best-tasting ABA around. I'm Dan Lowry with Mike Rubio, and join us on our journey as we look back into the ingredients to form the best concoction of ABA on TAC. In this podcast, we will talk about the history of the ABA brew, how much to consume to achieve the optimum buzz while not getting too drunk, and the recommended pairings to bring to the table. So without further ado, sit back, relax, and always analyze responsibly.

SPEAKER_03 0:54

All right, all right. This is your grateful co-host, Mike Rubio. We are learning about sleep. So welcome back to part two of our interview with Nicole Shallow. Enjoy.

SPEAKER_00 1:08

Because again, like general practitioners, they don't get a lot of training in sleep either. I'm sure they wish they did, but there's so much to cover. And then getting access to a sleep doctor. Here we have long wait lists, and it's gotta be extremely urgent in order to access it. And the support is quick, um, but hopefully helpful. And then there's like the medication side of understanding, like supporting parents and understanding, okay, here's how medication could help, or here's like some questions. Can we ask the doctor when you go in? Like help them advocate for more information. Because sometimes it does get written off as behavioral, and I have written many letters saying this is not behavioral, and or I cannot address it yet because I just need you to look at this and look at these different things for us. Um so that's where I start first with night wakings. Okay, the medical side. The medical side, because it can cause like constipation definitely happens at 3 a.m. Like stomach issues will pop up around that time. Um, if they're wetting the bed or like different things, who knows? Headaches, uh, if they're grinding their teeth all night, sometimes they wake up because they have headaches, like who knows what could be causing it, possible sleep breathing disorder, like issues. Um, kids who snore, like anyone listening, if you have a client that snores, please it's not normal, make sure they got that checked out. Um if we get rid of the medical side.

SPEAKER_03 2:46

You're saying any any snoring in general or just for kids?

SPEAKER_00 2:51

Any snoring in general is good to get supported for sure. Um, because it's a blockage of the airway.

SPEAKER_03 2:56

Okay, so your breathing's affected, and that's bound to then affect your sleep pattern.

SPEAKER_00 3:00

Yeah. Mouth breathing, like kids who really only breathe through their mouth or breathe louder. And I was this too as a kid, and I still am without support. So it's like how like why is that happening? And what is it structural? Is it because there's something else going on? Um, so doctors, dentists, they can all help with that too.

SPEAKER_05 3:21

And you mentioned um medication. One thing that I've heard a lot of parents ask about uh is melatonin, uh having their kids take melatonin. What are your thoughts on that?

SPEAKER_00 3:32

Yeah, so melatonin is the hormone and it's naturally produced, but then it's figuring out why like and usually melatonin, so melatonin supports the initial onset usually as a hypnotic effect. However, if it's if a kid's client or someone is low in melatonin, which is possible, there's research showing that's it may occur where kids on the like autistic children or um kids in general or people in general may have lower levels of melatonin, then a supplement may be helpful while trying to figure out why. Um could be nutrition, it could be, you know, all sorts of things. And again, I'm no doctor, so I hope to get a doctor on my podcast as I plug. I'm gonna do that so I can find out more info and deep dive. Um, but some parents have say it said it's been so effective, it works so well, they sleep through the night. I've had other parents say it has the opposite effect. They're like wired um and won't go to sleep when they take it. Others will fall asleep really well because it that hypnotic effect, but then they wake up like wired in the night.

SPEAKER_03 4:44

So that's the one I've heard most when it doesn't work, is that one. Yeah.

SPEAKER_00 4:49

But it can be too much. So I've had clients where the dose was too high, then they peeled back on the dose a bit, and then it worked okay. So that's where melatonin, it's over the counter here, so it's not prescribed, it's not monitored. Um, I think in the States it's very similar where it's it doesn't have to be prescribed, you can just buy it, and every melatonin brand is gonna be different, every pill is gonna be different because it's not regulated. So that's the struggle with melatonin is if you're taking a pill that says five milligrams, it might not actually have five milligrams in it.

SPEAKER_03 5:25

Interesting, right?

SPEAKER_00 5:27

Yeah.

SPEAKER_03 5:28

Um does that play in at all with light exposure as well? And or is there some correlation there in terms of of melatonin? Yeah, production and and I guess uh absorption of light.

SPEAKER_00 5:44

Yeah, so the morning is great. So if you can get light exposure in the morning, it actually helps like a little bit of melatonin onset later on. Okay. Um, the eating and nutrition, of course, you need all the fundamental building blocks in order to have melatonin. Um so it's interesting. And melatonin, I mean, it's a hard one to test, like you have to do a urine test that's timed, or it's like a blood test at the time. And so it's not common to test for melatonin, and that's what I've heard from doctors. It's not really common to test for it, but it's trying to figure out why it's not working, what's happening, and so understanding what could interfere. And I think there's still a lot of research to be done in this area for sure.

SPEAKER_05 6:34

So you don't really have a um a stance one way or another on like, hey, I'd recommend taking it or not recommend taking it. It's a little bit more nuanced if the body's deficient in it and looking at the types of melatonin and more of a consult with the doctor than my child's not sleeping, let me go to the store and pick up melatonin.

SPEAKER_00 6:51

Yeah, I would say consult your doctor or your pharmacist, ask them what they think, tell them about your child, tell them the issue, and make your decision. As a behavior analyst, we can't make recommendations on supplementation, we can't make recommendations on dosing. I can just say, talk to your pharmacist, here are the specific questions I would ask, and you do with that what you will. And some parents will go and do that, and some parents won't, and that's totally their choice. Um but for as a behavior analyst, I need to be very, very cautious of how I make recommendations because people are coming to me for advice. It's easier access to get to me than their doctor. And so I have to be very mindful of that.

SPEAKER_03 7:39

And so, I mean, again, you're saying I'm just gonna I'm gonna help you gauge the response to that if you choose to use it behaviorally, and that's where that's where we're at. Yeah, and that makes a lot of sense. Um, so medications andor other supplements that in your experience, and again, you're not making recommendations, but that in your experience you've been like, oh, that seemed to have worked well in this particular circumstance. Anything that that you might you know suggest to people, maybe ask your doctor about this, that, or the other aside from melatonin that in your experience thus far maybe is proven successful or helpful?

SPEAKER_00 8:58

Yeah, I think so there are some cases where there's more to it. Like sleep seems to be more the symptom. The sleep challenges are more a symptom of maybe high anxiety during the day, you know, other pieces. Maybe there's some ADHD medication adjustments that they're making. So understanding again, it's using the sleep data to help parents make form informed decisions and how to ask the right questions to the doctor, understand the side effects long term, what's the plan long term? Do they have to take this forever, or is it just for now? And I've seen cases where it's extreme and there are their body clock is completely flipped and they're not going to sleep, and the medication has just settled things down. You can actually start teaching the new sleep hygiene routines, build stimulus control, and then figure out can we wean off this and do it in collaboration with the doctor? Always, always, always. And if parents are trying to do it on their own, do not let them because there is so much more to know around that.

SPEAKER_03 10:09

I I really appreciate what you just said. Let me make sure that I got it right. And what you're saying is the medication is the pill, it's likely just to conjure up the needed circumstance in which you can now learn to get yourself to sleep. Fair enough.

unknown 10:28

Yes.

SPEAKER_03 10:29

I think that's really important for people to need to understand that because I think that I mean, me as a consumer, as a parent, I can think about things behaviorally all day. Excuse me. If I take my child to the pediatrician and they give medication, inevitably I'm expecting that thing to take care of it. Um and and yeah, it's the same with uh stimulants for ADHD, right? The idea that this is just gonna get your child into the right circumstance. And um, we might think that that means that they're gonna be sitting down attentively. No, in fact, it might make them move more, but it still might mean they're more attentive as they move more. Uh how do we take advantage of whatever therapeutic effect we see as a result of that to then kick in behaviorally? And again, I think that's a really important premise that maybe we miss in other circumstances, and it sounds like you're saying uh here with sleep, it's not necessarily that medication or that supplement that's gonna solve the problem, but more likely gonna foster the circumstance in which you can now kick in with your behavioral parameters, your sleep hygiene, your routine.

SPEAKER_00 11:29

Exactly. So you can start building, you can start moving forward. And I, you know, parents will try the behavioral route, and there's a certain point where you just need extra assistance based on life circumstances. And I think there's a conversation out there, it's like, oh, medicated sleep is sedated sleep, which yes, but if the child's waking up alert and they're regulated and they're learning, they're engaging socially, they're probably okay. Like they're doing better than they were. And so I have seen and I've supported, you know, the B C VAs that I mentee and like current clients where prior to getting better sleep, and maybe it's medical plus some behavioral pieces, they weren't speaking, they weren't engaging socially, they weren't showing up for like they weren't able to learn. And then within a couple weeks, like they're speaking, they're talking, they're communicating, they're seeking out like other kids, they're more attentive to their environment because they're just not so sleep-deprived and overtired. Yeah, and that's so incredibly cool, it's just so cool.

SPEAKER_03 12:42

It's very cool. Wow.

SPEAKER_05 12:43

And there's so many on the flip side of that, so many ramifications about being sleep-deprived and tired, which are gonna have behavioral effects throughout the rest of the day. Uh yeah, and then yeah, I mean, we've always said that you can run the best ABA program in the world, but like you said, if your child's not eating right and sleeping right, it's not gonna go anywhere because they're not ready to learn. Um, I do have a question for you. Something you mentioned earlier that's probably the number one thing that the parents listening are gonna want to hear your stance on, your opinion of um, is crying it out. You've mentioned some method, the the crying out method. You had a name for it a little bit earlier. Um can I I've used it a lot like with extinction when I use my extinction examples, you know, as a uh BC, a younger BCBA who's still pretty ignorant of the sleep science, talking about, well, your kid cries, just let them cry it out, and you know, so eventually it's an extinction burst and it'll eventually decrease. Uh, but there may be more nuanced research, and uh I forget again the method you specifically referenced in there, uh the firmer method, okay. Um please speak to the crying it out, your thoughts, suggestions, whatever.

SPEAKER_00 13:50

Yeah, I um there's it's there's a it's I I think there's an over generalization of what crying it out actually means, where it's like like what my parents did. Shut the door and let them just cry. Yeah, just like a clue. If they read the whole book, I'd have to, I'd I'd have to ask my mom. I'd have to ask her if she actually read the whole instruction manual. Um, but there's ways to do it where it also prize co provides co-rel regulation and support. So the one I talked about with the visits, and I have friends who have done a similar method, and I think um cry it out is just the common label for it. Yeah, it's every parent's perspective. Is it something that I'm gonna do? No, because I'll be crying at the same time. And I was like, he can't regulate if I'm not like I just know who I am, and I've never like that's even as a young behavior interventionist when I was asked to put things on extinction fully, it was incredibly hard for me. Yeah. Um, so it's just not who I am, and it's I think you know, if I told my husband to do it, he probably would, but I don't think anyone would have any my my baby's also very sensitive and persistent, I think. Um, but there's ways to do it, like with visits and give them some time and eventually they do settle down. But I think there's other ways to do it where it still supports the connection.

SPEAKER_01 15:16

Okay.

SPEAKER_00 15:16

And it helps build trust and it helps communicate to them the plan and what's happening, and just building confidence. Um, I think cry it out to the point of like get into a complete stress response, you're so tired and you just fall asleep. Like, I remember doing that as a kid. I would just have a massive tantrum and then just like pass out. Like it's that's not really learning anything. Um, but some kids do learn, they they cry, but then they all settle down, and then when the parent comes back in to check on them, they start crying again. And so it's really attuning to the child because I have supported families where they've tried that method, it's very common. Yeah, it's what you'll find on the internet, it's what a lot of sleep consultants may support with. And they're like, My kid cried till they threw up. And what am I gonna do now? Like they didn't go to sleep, they just cried until they threw up, and then they cried some more, and then they threw up more. So that's different. Okay, that is a different experience, and so it's really teaching parents to attune, and the clinician needs to know the child and recognize where they're at and try to find empathy and like figure out what they're like, there's a need that's unmet here. Something's not clicking.

SPEAKER_03 16:31

So um, you know, and again, without overgeneralizing too much, we're in a field that is very keen on protocols, those protocols can become very singular. You're saying, uh-uh, not here, especially not with sleep. It's it's gonna be every I mean, if we've ever talked about something that's truly individualized, that's what you're pointing to here. Because yes, some I mean a some kiddo might be able to cry it out for 30 minutes, uh, fall asleep, you know, in exhaustion. You do that for 30 days, and suddenly everything is fine for whatever reason. And then you're citing the other side of it, which is if your child is is crying it out to the point of vomiting, that this method clearly isn't gonna be the approach that you'll be adopting long term.

SPEAKER_00 17:17

Yeah, that's not that's not gonna teach that right what we want regularly. What we want is for yeah, we want kids to get into their bed and be calm. Right. Because you can accidentally like kids who build associations and condition quickly, now they see their bed, they immediately go to a stress response. Yeah, like they they are not calm. How can you fall asleep if you're calm not calm, if you're not happy, you know, feeling connected. So, I mean, I haven't dove into the attachment research, but I know like, you know, the authors like Gaber Mate. His work is so profound, and I think the world is really resonating with what he has to say. And I always reflect on that and like how he talks about the early childhood experiences. As behavior analysts, we need to take all of that in. We have to take it all in and know because our field is young. There is more going on in other fields, and that's where um, as preparing for this, I was looking at the research, and there aren't a ton, like a lot of the research and behavior analysis around sleep is like single-case study design, which is totally, I guess, our classic go-to. Um, but a lot of the random control trial studies are outside of our fields, and they're showing effectiveness for behavioral intervention, but the detail in how they do the intervention is not always clear in those. That's more like a dissertation where you would probably find like the details for each case study and all of that, not necessarily the published article. So there's just so much more to know. And how do we build in all angles and the current research around, you know, parenting, because that's changing parenting and how to approach, you know, it's always changing. And, you know, emotion regulation and co-regulation, what that all means. Like I snuggle my baby to bits all the time. And he seems like he's doing great, falling asleep, putting himself back to sleep. I haven't really taught him specifically. I'm lucky though. I know not every child's gonna be like that. Yeah, and I'm sure it might bite me in the butt one day. And I'm just every night I give him his bottle and he goes to sleep. I'm like, I will figure this out one day. I don't think it's now, but I'll figure it out one day when I need to, if it becomes a problem. Yeah. Um, but leading with love, leaving with compassion and understanding and letting go of control.

SPEAKER_03 19:44

It's uh what you just said there that you know, if you can adapt that that mantra uh in that, you know, nth minute as you're sitting there next to your child's bedside trying to soothe them and they're not going down, and you're thinking about the dishes and you're thinking about other stuff that you need to get going, that can be really, really challenging. And then there's the premise that you're presenting very parsimoniously, which is how do you embrace that? How do you hold on to that? Because whether you spend those you know 20, 30 minutes all tense and frustrated, or just leaning into it and trying to enjoy it, that time is gonna have to be invested. That's you know, and again, I can say this all day and then I have to be at my four year old's bedside at minute twenty two, and I'm like, all I want to do is get back to the couch and and start my evening and and chill out. Um that's that's a lot. That's a lot. That's uh you know, true, true embracing of that that parenting responsibility and Uh but it's worth it. It's worth it. And then I'm sure you're learning that too as a young parent. Um, the more you front load, the more you put it on the front end, the you know, the the more prepared they're gonna be, and there's still gonna be things that you have to figure out and little problems you're gonna run into. What in your experience, what has been the the red flags that pediatricians or in your advocacy, what are the buzzwords? What are the things that pediatricians will listen to and then go, oh, oh, now I might refer to that subspecialty through the insurance coverage? Or because I think that's one constraint, and sleep might fall into that. One constraint that pediatricians do face is um we're gonna look at it from a developmental trajectory. Yep, that's a pretty common problem across the board. Uh, maybe we're gonna use this the grow out of it uh phrase. It's not really something that we're well versed in, and then now I'm referring you to a subspecialty that might take you six to nine months to access. What's your experience with that in terms of in your advocacy? What do these medical professionals listen more clearly to if you can give that information or point the parent in that direction and say, hey, tell them this is happening, and then oh yes, let's move toward medication or something else?

SPEAKER_00 21:52

Yeah, so I I usually support with a letter because I know families will get overwhelmed going into stuff. And especially when you only have like a here, like with your GP, you get about 10 minutes.

SPEAKER_03 22:03

I think it's 16 minutes on average here in the States.

SPEAKER_00 22:06

Right, exactly. So you got you got and you gotta have one comp you gotta have one complaint. It's like one minute, one appointment, one one issue. So um I support the family in advocating that like you know, your general sleep routine and sleep hygiene pieces are you know in check, and or this is how why we can't get them in check. Um, some of the top ones definitely is the breathing thing. Um if there's any sort of airway breathing issues or maybe cyclical constipation issues, those are huge because I've worked with clients where they'll sleep well for like three weeks, and then all of a sudden, like their behavior and their um cognitive like awareness, even like it impacts like their ability to learn, they're not sleeping for about a week and a half, and then all of a sudden they start kind of back. Their sleep isn't perfect, but you know, they're sleeping back in their general rhythm. Um, that has been like a blockage, like full blockage. Parents didn't know they were constipated, but constipated doesn't mean not pooping, it can mean other things, and that's not always known. Um and something I've learned over the years. And then kids who have really picky diet, like really restrictive diets. Maybe they're drinking a lot of milk and they only eat like cookies and fries, you know, like that's it.

SPEAKER_05 23:33

Uh and chicken nuggets.

SPEAKER_00 23:35

And chicken, probably chicken nuggets, yeah. Always like you know, you're but even I've had clients that like cookies and milk, that's it. Like that's all they'll consume, maybe some something else here and there, but very rare. Um I feel for those. So how do we like I now know from my clinical experiences sleep can only move to a certain point until we address the feeding, and it's usually more complex in that way. And then also like a blood panel might be necessary. Are they low in iron? Are they like nutrient nutrient deficient? Is there like thyroid issues? Is there anything else going on? Because you can like, and again, I've tried done it. Parents are like, Yeah, I'd still like to go ahead and try a few things, and I'm like, okay, we can try this because the feeding part is hard. Adjusting feeding is way harder than I think that's even sometimes can be harder than sleep. It's also more intensive and costly um to do that direct feeding intervention that's um required in those cases. So, but I have only ever been able to get so far, and sometimes nowhere, like improvement for a little bit, and then it just spirals right back. And that's when I know this is a bigger, deeper issue, and we need a bigger team around us to get this sleep on track. It's not just a stimulus control issue. Although the stimulus control issue is still present, uh, there's something else going on.

SPEAKER_05 25:06

Okay, I was gonna say that's how you use a microbial word, multivariate, multivariate.

SPEAKER_03 25:11

Yeah. So so and again, you you sort of delineated sometimes you're gonna move some basic things forward in terms of routines, knowing that uh you it might be a drop in the bucket. And then sometimes you have to flat out say, no, we just have to wait until you resolve this eating or feeding issue because without this being resolved, there's very little that we can do. It's fair enough.

SPEAKER_00 25:34

Yeah, and gather more information, I think, to really portray to the doctor who's who ideally, if they had more time, I think would be able to lead a team like this. We just don't live in that, um, it's just not available. But the doctor can then figure out, okay, is this like a children's? Do I need to like refer them to children's? Do I need them to get for the sleep doctor that they have? We have like a really great hospital here. Um, can they see that sleep doctor? Like, is there they they might need a sleep study? Can we get them on the list for a sleep study? Find out what's happening, what is causing the wake up? Is it neurological? Like, does their EEG report anything? Like, what's what is it? And so, because kids can wake up by seizure and parents like might not even know. Like, we don't we don't know. Um, so that's where it's like always and I used to just ask a blanket question because that's how I was taught. Are there any medical concerns? We're we're familiar with that question, you know, and then it's like, no, there's nothing, there's nothing, nothing, and I'm like, okay, and then I would ask the list, oh maybe, oh, maybe this too, maybe that. And I'm like, okay, so it sounds like there's actually a lot of maybe medical issues. Let's put together a request for the doctor so the doctor can clearly see like these are the symptoms. Here's another professional who's done a more detailed assessment to rule out like your pamphlet of sleep problems. Like, don't send them home with that. Um, get I need them to get a referral.

SPEAKER_03 27:10

So and and you uh you're working with uh kids, people all across the board, or are you specific to uh individuals on the autism spectrum?

SPEAKER_00 27:22

Yeah, so uh the coverage, so how coverage works here in British Columbia is autism funding. So BCB services are covered under that. We're not covered under extended health yet or any government funded resources other unless it's created in a way that allows for that.

SPEAKER_03 27:41

Okay.

SPEAKER_00 27:42

Um, there's other grants and and things like that that we can get coverage from, but like your general public wouldn't necessarily have coverage. Um, that's why I'm creating, that's why I'm creating the podcast, that's why I'm creating more resources because I mean, at this time where you know funding can get cut at any moment, families should still deserve to get information, have access to the knowledge. And that's what I've learned. When parents know they can make changes for a large majority of the of the cases that I support and that uh parents that I talk to. Sometimes I'll get inquiries too, where they're like, I have this problem. Like it's usually after a night of poor sleep, and then they've done some more research and they found the knowledge, so they figured it out. So that's for me why I wanted to make it accessible to everybody and then support other behavior analysts to then infiltrate systems in different areas too, because I can't help everyone one-on-one. Right, right. And I think like the future, if the BACV is listening, like I would love for this to be like an entire course, like feeding and sleep and understanding it from like the behavioral lens and then how complex it can be needs to be part of it because you can't learn. You can't learn if you're not sleeping, and all we do is teach.

SPEAKER_03 29:07

That's great. That's that's a great point.

SPEAKER_05 29:11

No, then we get past this. That's such a good point. I think one of the things the BACB always hides behind is that competency piece, right? Well, if we're not competent, if we're not like fully trained on it, then we can't even talk about it. So, yeah, I agree. Even like a basic training, a rudimentary training, we give BCBA so much, and not that we would necessarily be advocating um for specific medications or whatever, but parents are coming to us all the time as my child's having difficulty sleeping. And even with a little bit of knowledge, we would be able to give substantially better advice than we're currently giving now of literally shut basically what you said not to do earlier, shut the door and let them cry it out.

SPEAKER_00 29:48

Yeah. And there's, and this is something where again, again, why I'm making this podcast because sleep is sometimes the issue, but it's also a symptom of something else. And so is it anxiety? Is it regulation? Is it like the high stress that kids are experiencing every day? And how can we support them in developing the skills to reduce their stress levels, to learn how to relax, to learn how to connect and move towards their values and all those things? Sleep sometimes comes alongside. You don't even have to tackle it head on. So that's why I'm so passionate about it. And I've shifted my lens to be bigger, because I was like kind of like in this like sleep specialist role, and but then I'm building a clinic myself. I have other BCBAs, and I'm like, you know what? This sounds like not as like it's an anxiety sleep case. And again, I've supported kids with anxiety and sleep, and I've only been able to get so far. Because if there's a day where there's a big trigger and there's a huge panic and there's just more and it just snowballs, then the sleep falls away. And so it's actually the anxiety. If you can, I know from personal experience too, if I can manage my stress, I can manage my anxiety, if I can learn two strategies to regulate and you know, stay present and bring myself down, sleep, you don't even have to think about it.

SPEAKER_05 31:14

That's the goal. To not think about sleeping. I love it. I love it.

SPEAKER_03 31:19

That's awesome the way you just said that, because you might be considered a subspecialty, but the way you just described that, you're really hitting just about every other part of a child's day, for example, to ensure that you can get to that sleep hygiene part. That we started talking about sleep hygiene, and that's a that's 20, 30 minutes at the end of everything else that you are supposed to be trying to do on a daily basis with your child. And yeah, that's I mean, that's amazing.

SPEAKER_00 31:50

It's living a fulfilling purpose-driven life, yeah, right? And kids should be deserving of that too. And I've worked with, and it's unfortunate because I know like every behavior analyst is doing the best they can with what they know. Yeah, and I've worked with kids, I've had discovery calls, and of course, like I don't necessarily live where they live, and there's still that model of like 40 hours a week, highly intensive, like drilling type of support. And now this child's like so stressed, like so incredibly stressed, the family's stressed, they don't want to go to sessions, they are or if school is a problem, now school refusal, and the best way to refuse school is to sleep through it, to be honest.

SPEAKER_05 32:32

Yeah, sure.

SPEAKER_00 32:33

So I mean, I've supported so if I can get kids up and out and happy to be awake and purpose in their days, from and this is from ages two to teen, sleep will get better. It will. But if I have kids who you know, I've teenagers who lock themselves in their bedroom, they are on the internet all night, their best friends live in Australia. What am I gonna compete with that? Their Australian friend is up at night.

SPEAKER_05 33:03

I can't I can't compete with that, right? Um so you work primarily with individuals with autism because of the funding. How do you think the autism diagnostic piece plays a role in how parents approach or even how you recommend them dealing with the sleep piece?

SPEAKER_00 33:21

Yeah. Um it's coming out in a way that supports them and based on understanding how their brains work and how they learn. Um, how do I support them through regulation? Because some kids, you can't explain it. Like I've had one case where I think the kid must have been listening in the background, to be honest. And uh I explained to mom like the how like light TV, like light from the TV and just having the TV on when falling asleep could be causing night wakings, um, difficulty falling asleep, and blah, blah, blah. Then and I just gave the science and some rationales. And then the next night the kid decided that he was gonna sleep in his room as long as the dog was with him and he slept in his room through the night, didn't need mom. And mom was lord. Just like that's all they needed was the rationale. That's like, you know, not always, but sometimes. Other kids, it's how do we go about it in a way that just supports them and how they learn and understanding what they need at night and why are they needing this at night? Are they not getting it during the day? What is scary about nighttime? What is interfering? Um, because it's behavioral, but there's also like the thoughts, the feelings that come up at night. And so it's so much more complex than just throwing interventions. Like you really have to have a really good understanding of that person and their daily living and and where they're at.

SPEAKER_05 34:45

For sure. I think um we run a lot of parent groups, and um a lot of the parents that we work with, a lot of times younger individuals, uh, they may have one child on the spectrum. Um, and their question is always like, is it the autism, right? Like, my child's not sleeping, is it the autism? And it's like, no, the individuals without autism struggle sleeping, and it doesn't matter whether it's the autism or not. What are we gonna do to uh you know deal with it? But do you get that uh kind of thought process with your families like that that autism piece now? Because my child has autism, is that why they're not sleeping? And kind of how do you advise through that?

SPEAKER_00 35:22

So I support them in understanding that yes, of course, autism, there's a higher prevalence of sleep problems. Okay, between 40 to 80 percent, like in the research, prevalence research. That's good. It ranges, big range, but it's a it's a lot. And you talk to any behavior analyst, they'll be like, Yep, that math kind of masks out based on my caseload. Um, so there's many reasons, and we talked about like how the physiological differences are horse sleep is very much a brain thing, and autism is a brain difference. And so we can kind of hypothesize that that could be why too. And there's and then when you get into the day-to-day, they are exposed to more stress, and they have there's more challenges every day. And so people who are in high stress positions, or even like neurotypical people or other diagnoses who experience high stress, their sleep will be impacted as well. And so that all makes sense too. And then same thing with autism, like the research is showing that versus neuro, like I guess the neurotypical track based on the research that they're doing versus autism. Autism, they don't necessarily grow out of it. And we kind of touched on that earlier is that routine, that rigidity, that sameness helps feel safe. The brain feels safe, the nervous system feels safe with sameness. So changing it may require more nuance than maybe a neurotypical who could like a parent might read some blogs or hire a sleep consultant that's not specifically trained and see results. Whereas if you highest hire a sleep consultant who doesn't understand that difference, may not see the same results.

SPEAKER_03 37:05

Wow. So that I mean that pertains to anything from getting a bigger bed to I don't know, changing bedding to what items you're trying to grow out of to soothe you. I mean, am I am I getting too nuanced, or is that is that right on?

SPEAKER_00 37:20

Yeah. Yeah, like I'm supporting clients like right now where it's trying to transition from a room they've slept in for like over 10 years.

SPEAKER_03 37:29

You're gonna disrupt something, you know you're likely to disrupt something.

SPEAKER_00 37:32

Yeah, and I can write amazing social, I can do a social story and try to prep, you know, with visuals and all that, but when it comes down to it, yeah, they're gonna have to move spots and it's gonna be uncomfortable and it's gonna be scary, like their nervous system reacts like there's a bear in front of them because they're just it's terrifying, changes hard. Sure, and sometimes persistence, you know, the parent can be persistent, but I'll tell you, some of the kids I work with are so persistent, and we know that, yeah, right? Like they're more persistent.

SPEAKER_03 38:07

We have we have other we have other adjectives we use instead of persistence, persistent, persistence a nice one, yes. Yeah, we'll go with that.

SPEAKER_00 38:14

They're very driven, yeah, very driven um to get that sameness back for sure.

SPEAKER_05 38:21

Um, another question I have that I think people will be very interested in. Um, it's something I know Mike's dealt with with his uh little one, is naps. So, what are your recommendations, or do you have recommendations around naps? How long they should be, when you should start them, when you should fade them out. If the uh person doesn't want a nap, should you fight that? Like, what are your thoughts on naps?

SPEAKER_00 38:45

Yeah, so I always bring it back to the science. I mean, I'm in the midst of figuring out do I drop the second nap? Do I let the one nap go? And I uh I know you're at that age you have the second nap.

SPEAKER_03 38:58

You just reminded me of that.

SPEAKER_00 39:00

Yeah, and I'm like, do I let it go for three hours? That seems extensive, but I'm like, ooh, but I also love that idea. You know, like is this gonna like is this gonna hurt me later? And so under two years old, it's very different. Um, there's the two naps, and then you end up dropping it. And so I'm not clinically trained in under two, like I haven't dove deep into that, and I'm shocked myself actually. Like, I haven't dove deep into it for my just follow his cues and um follow, you know, like oh he's teething, okay. Of course, like things he's starting to walk, of course. I also see in young kids who are moving through developmental milestones at a different um age. So let's say kids who start talking at like age three, or they're starting to learn a lot of new things all at once, sometimes their sleep will get disrupted. And that's almost like a like that regression that maybe they didn't have when they were babies and toddlers, but it happens later. So it's just reassuring parents that let's just let this ride out and see what happens in the next week or so before like trying to control it. And that's where I catch myself right now. Um and now I forgot the question. Yeah, no worries.

SPEAKER_05 40:15

So naps, um, you mentioned under two. You're not that's not necessarily your area of expertise, but you've got the two naps. Then as they get older. So um also recommendations on if you recommend people take naps, should fade naps, uh, at what age. Any any thoughts on that?

SPEAKER_00 40:30

Yeah, absolutely. So between the ages of like two to five, there's that nap window, and the nap range and duration will shift. Um, so what you're looking at is how much sleep. Are they supposed to get over 24 hours? And so um there's the Sleep Foundation is a great website, it gives you a rundown of how much sleep everyone needs, it's always being updated. Um, and we can put that in the show notes too. But for your kids, sometimes they'll be on the higher range or the lower one, but you're looking at total when it starts to become naps start to become something to look at, is if you're seeing delayed sleep onset. So let's say, and I see this a lot. So kids who go to daycare, daycares typically won't wake children up, sleeping children up, it's almost a mandate, plus that's when their staff gets the break, and the ratios are different, I think. And you know, there's a lot of nuance to that too.

SPEAKER_03 41:28

And they also insist on the the rest time or the nap time differently. So even if your kids not needing the nap, so to speak, they're gonna get it anyway.

SPEAKER_00 41:37

And they likely will fall asleep because they set the stage and the conditions for kids to fall asleep.

SPEAKER_03 41:42

You're describing my current situation with my four-year-old continuous.

SPEAKER_00 41:46

I know four-year-olds are tricky, like four, like when they're just moving into kindergarten soon and they still fall asleep. You're nice, so it impacts that sleep pressure. So if we think about sleep pressure building over the day, you know, as soon as you have a nap, it cleans out half like part of that sleep pressure. So now you're building, building, building. So for your four-year-old, if they're taking an hour and a half nap during the day, that could add a lot more time in the evening. And you're like, I would like you to go to bed at eight. You're still up and it's 9:30. It's like and now they've spent too much time in bed awake. It's this back and forth, everyone is frustrated.

SPEAKER_03 42:27

You keep the routine because that's the good thing to do, and she's sitting there going, but I don't want to go to sleep.

SPEAKER_00 42:32

And and usually kids are like, they're pretty accurate, pretty honest. And all of a sudden they're like hungry, they're thirsty, they have to use the bathroom three or four times. You're like, What is happening? It's usually because their sleep pressure is just not there. Yeah. And that's it. And that's what I and that's what I tell myself when I'm getting like, Why aren't you sleeping? I'm like, Oh, yeah, mommy did let you sleep till four because she just wanted to do a little extra work. And I'm like, that was my bad. Yeah, um, you know, it happens, and then there's other days where it's not a problem, like the nap, the nap may not be as interfering, so it gets confusing. So I support families if you're struggling with the nap, log the data for like five days. Okay, see what the patterns are, notice how it's different on weekends when they don't nap and when they do nap, and see how much sleep they're getting in 24 hours. That'll tell you. Yeah, and maybe it's a moving into an acceptance piece because sometimes we can't control the daycare environments um or the other environments that are causing the nap. So, what can we do? Just might be a different routine on weekdays until they're in kindergarten or until the nap is 100% gone.

SPEAKER_03 43:44

And then the schedule dictates it. Yeah, no, that's uh so the weekends. Um, she doesn't want to nap because she's here with us and she wants to be up, and all that means is an earlier bedtime, but it also means we're gonna have a little bear, you know, roaming around toward the end of the evening sometimes. Uh so yeah, I think you I think you're nailing it.

SPEAKER_05 44:03

And I really saw that at your last birthday party.

SPEAKER_03 44:06

Well, she was very she didn't want to go to bed for sure at the birthday party. Um, but yeah, I think that's really important, just the the variability that is very easily interpreted as misbehavior or as challenges. And it's not to say that it's not. That's where the the data tracking is is what you're uh pitching, and it's very important to do the observation, the keen observation. But then within that, I think that it's very important to think about the gradual nature of change in these things, the idea that there's developments gonna change these patterns naturally, um, and that and that yeah, that that you know one or two days off kilter or off-routine aren't necessarily a big deal, and in fact, are to be expected. And the next question is what do we do next to to get back on track, whatever that means. I mean, that's a lot, that's a lot, and I think again, I really want to stress that because we can all get very comfortable with our linear solutions, and this is certainly not a situation that's gonna to be linear, at least not for very long.

SPEAKER_00 45:01

No.

SPEAKER_05 45:02

One last question. Um, and this is relevant to me, but I think it'll be relevant to a lot of people. Um, so I've heard that blue light, um, electronic lights, not the best thing to absorb right before bed. For me personally, um, I find that my brain likes to turn on like right when I lay down. That's when I think about work and what I can do better with clients and things like that. So my sleep routine, and I'm actually pretty good sleeper for the most part, is like watching something mindless on TV or scrolling my phone for like a half hour that gets me into like repetitive, like mindless mode, and then I pass out. Um which might not be recommended because that's bringing in blue light into my life, but it works for me. Um, any thoughts for what you'd recommend parents to do either with their kids or themselves about kind of that blue light um I love this conversation now because the research coming out is just it just debunks the whole thing. Yeah. Really?

SPEAKER_00 46:00

Yeah, it's debunking the whole thing. It's there was a lot of money made in blue light blocking, and I think there's a space to understand how blue light affects, you know, certain things. I have a blue light protector on my screen because I found my eyes got really strained with the screen, and it's been great for the most part. Um but daylight exposure in the morning is a great way to block effects of blue light in the evening. We have night shift mode. Um the blue light blocking glasses. I think people have overused them and they actually use them during the day when like you actually want like blue light in your eyeballs, like you want that. And so people like I know my sister was using is still uses them a lot, she stares at screens, but her sleep was getting all messed up. I was like, you need to take them off at some point, like you have to you have to take them off. Um and the research is showing like max 10 minutes, it might delay your sleep, but nothing crazy.

SPEAKER_05 47:00

Interesting. Okay.

SPEAKER_00 47:01

So I also the when they're looking at how screens impact sleep onset, and there's an amazing um professor, sleep doctor, I will link it link his LinkedIn. I always mess up his name. Um I think it's Dr. Gradis here. Anyway, I'll send I'll send his stuff, but he always is bringing new research forward and debunking a lot of these like um pop culture sleep hack things because he doesn't like I also don't like seeing people buying a lot of things to fix their sleep. Um, there's a lot of money in the sleep industry for products, and so I'm always very cautious. I mean, there was this one iMass that someone gifted me once, and I was like, this is the best. His business no longer is around, but I was like, this is literally the best IMAS I've ever had. Um but buying things to fix it, it's unfortunately it usually never really does, and maybe there's a placebo effect. But what you say, watching a mindless show, I also felt so guilty about it. I was like, wait, isn't this like not this is against sleep hygiene? But friends, hello, like that would be on repeat, and I could fall asleep so quickly. Um, now I'm so tired from being a mom that, like, no problem. Um so, but I also there's this stimulation piece, like sometimes video games versus watching a mindless show. Very different interaction with the screen. Same with like YouTube and scrolling on Instagram or TikTok, um, because you never know like what you're gonna get. Um, I think there's also a difference between children's brains, teen brains, and adult brains with use of screens and how it impacts. So asking yourself, is this helping me come down and fall asleep? Yes, then great. Use it. Is it keeping you up? Because I know the other night I started watching Sirens, and I was like, Whoa, this show is so fun, and I don't get a lot of time to watch TV anymore. And I stayed up till 11:30 watching the show, and I was like, Yeah, that was a sleep displacement moment.

SPEAKER_03 49:17

And then your son reminded you the next morning that you stayed up too late. I definitely mom, you were up too late.

SPEAKER_00 49:24

Yeah, yeah. I was like, hopefully I don't have to get up tonight, but like I think that was worth it. And so it's understanding how the screen or how the the the choice you're making is impacting it. And if you're just full acceptance around it, like it's all good.

SPEAKER_03 49:40

All right, it's more about stimulation and engagement in a sense than it's well.

SPEAKER_05 49:44

It sounds like blue light isn't even necessarily bad, so I'm not even necessarily making a sacrifice. So thank you. There you go.

SPEAKER_03 49:49

There you go.

SPEAKER_00 49:50

We know the research is yeah, definitely not strong on that one.

SPEAKER_03 49:54

Well, good. That's good, and that's good to know. Um, we have covered a tremendous amount of ground. Uh, before we wrap up, uh, tell people out there a little bit more about where to find you, about your upcoming podcast. Have you uh published yet? Are you guys when when's the prospective date for first publication? Uh yep, give give all your pitches. Make sure people know where to find you.

SPEAKER_00 50:18

Yeah, absolutely. So I'm on Instagram at Your Behavior Gal. I'm pretty active there. Uh, the podcast I am working on as one does is have a few episodes ready to go to launch, and then we'll be continuing that. Um, like fingers crossed, early August. That's done and out.

SPEAKER_01 50:37

Good luck.

SPEAKER_00 50:39

And yeah, so excited. I was like, I don't need I have my mic, I am good, and nice.

SPEAKER_03 50:45

Um you'll be great at it. Don't drop it.

SPEAKER_00 50:48

Yeah, I've done so many interviews. I'm so excited for it, and I just want to deepen the understanding and the awareness. I just have a like I'm just very passionate about this topic, and I'm excited to bring in other professionals and go even deeper um around it. So yeah, you can find me there. And then I have a free guide for BCBAs just diving into sleep. That can be found. Um, you'll find that in the link and bio on the Instagram. I can also link it in the show notes here. So yeah, when you download that, you'll be added to the mailing list. So you'll get all the updates as we go.

SPEAKER_05 51:23

Um so you said um, and we'll link all these in the notes. You said the behavior gal is the Instagram. You said the podcast you didn't say you said you could find it there. You didn't say where. Is it the behavior gal Instagram? They would find the podcast.

SPEAKER_00 51:34

Yeah, it's gonna call the podcast, it's gonna be called your behavior gal podcasts.

SPEAKER_05 51:38

Oh, there you go.

SPEAKER_00 51:39

And all of that, like I mean, if you follow me on social, you'll get the you'll get the details. Absolutely.

SPEAKER_05 51:45

So follow Nicola, uh, the behavior gal. Your behavior gal. Your behavior. Your behavior gal.

SPEAKER_00 51:52

Your behavior gal spelled with a you, the behavior spelled a you because I'm Canadian.

SPEAKER_03 51:56

That's right. Very nice. That's good you pointed that out. However, uh ABA on tap can be of assistance, please let us know. Reach out. We've been doing this for a little while, so glad to uh lend whatever knowledge we might have gained along the way. Nicole, it's been a real pleasure to speak with you. Thank you so much for your time. Uh, we wish you all the best and hopefully see you again soon in the future.

SPEAKER_05 52:19

Maybe on your podcast.

SPEAKER_00 52:20

Yeah. Yeah, absolutely. Thank you so much.

SPEAKER_03 52:23

I'd like to do a quick little wrap-up here. So uh lead with love and compassion, work through the medical rule, practice sleep hygiene, and always analyze responsibly. Thank you so much. Cheers, Nicole.

SPEAKER_04 52:35

Always analyze responsibly.

SPEAKER_02 52:38

ABA on tab is recorded live and unfiltered. We're done for today. You don't have to go home, but you can't stay here. See you next time.