Back to Blog

5 Sleep Foundations Every Pediatric OT Should Know

Aug 04, 2025

Research shows that nearly half of all children struggle with sleep, and the numbers are even higher for the populations occupational therapy practitioners serve. As an occupational therapy practitioner, honing your sleep expertise can transform bedtimes, accelerate goals, and restore peace for families. Here are five foundational approaches to guide your next intervention.

1. Start with a Compassionate Assessment

Before suggesting bedtime tweaks, develop a holistic view of each child’s sleep:

Combine caregiver interviews with simple tracking tools and clinic observations
Create a safe space for families to share frustrations without judgment
Identify patterns in routines, environment, sensory differences, and coexisting conditions

This groundwork reveals where small shifts can unlock big changes.

2. Optimize the Sleep Environment

Neurodivergent children may need more than a dark room and a white-noise machine. Focus on key sensory elements:

Calibrate light levels to match wind-down cues
Manage noise with flexible sound options
Balance room temperature and tactile comforts

A few strategic tweaks help anchor circadian rhythms and reduce nighttime restlessness.

3. Introduce Co-Regulation Techniques

Parents and caregivers are your greatest allies in sleep support. Teach them to:

Use gentle, attuned presence at bedtime transitions
Layer calming signals—voice, touch, visuals—to ease into sleep
Reinforce small wins to boost family confidence

These co-regulation skills build trust and smooth the path to independence.

4. Address Breathing and Posture

Subtle airway or posture issues can fragment sleep without obvious signs. In your sessions, you can:

Screen for oral motor or core stability concerns
Offer simple exercises that encourage better nighttime breathing
Integrate playful activities that double as clinic-to-home tools

A targeted focus here often translates to fewer night wakings.

5. Support Gradual Independence

Moving a child into their own bed requires both structure and flexibility. Consider:

Short, coached intervals in the child’s sleep space
Consistent yet adaptable bedtime cues
Positive reinforcement that honors neurodivergent needs

A clear roadmap lets families celebrate progress at every step.

To dive deeper into evidence-based assessments, sensory-smart routines, adapted CBT-I strategies, and respiratory and core strengthening exercises, and more explore the full occupational therapy sleep CEU Supporting Pediatric Sleep for Behavioral Regulation.

Led by an expert, neurodivergent instructor. In just two hours, you’ll earn 0.2 AOTA CEUs and gain 16 downloadable resources designed for children 0-18 with various conditions. Equip yourself with the complete toolkit to transform sleepless nights into restful ones for your clients and their families.