Sleep disturbances are highly prevalent among children with autism spectrum disorder (ASD)
and can significantly affect not only the child’s development but also the functioning of the
entire family. This master’s thesis explores the planning and implementation of an
individualized structured bedtime routine program for a child with ASD, with the goal of
improving sleep quality. The research is based on a case study that included the planning,
monitoring, evaluation, and adjustment of the bedtime routine over a twelve-week period.
Data were collected through a parental interview, the Children’s Sleep Habits Questionnaire
(CSHQ), and a custom-made evaluation scale, designed on the basis of insights gathered from
the interview and questionnaire. The focus was placed on the areas of the routine in which the
child experienced the greatest difficulties – such as evening calming, clearing the table after
dinner, selecting calming activities, and falling asleep. Based on these findings, individual goals
were formulated and weekly progress was monitored.
Results indicate that the program contributed to gradual improvements in the child’s
cooperation with the bedtime routine, particularly in areas supported by clear structure,
consistent verbal and visual cues, and persistent, coordinated parental engagement. The greatest
progress was observed in routines such as clearing the dinner table and selecting calming pre
sleep activities. Conversely, the most challenging aspects included falling asleep in the presence
of the father and independently choosing a calming activity before bedtime, where the child’s
rigidity and need for specific security cues (e.g., the mother’s presence) posed a significant
barrier.
The study emphasizes that successful implementation of a bedtime routine for children with
ASD requires a thorough understanding of their sensory, communicative, and behavioral
characteristics, as well as active and long-term parental involvement. The need for accessible
professional support for parents is also highlighted, as the research revealed that parental
fatigue, uncertainty, and emotional strain significantly influenced the implementation of the
routine.
Based on the findings, the thesis proposes guidelines for designing and implementing a
structured bedtime routine for children with ASD, grounded in individualization, gradual
introduction, visual support, consistency, and empowerment of parental competence.
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