As sleep continues to earn its rightful place in the conversation around behavioral health and autism services, more BCBAs are finding themselves in unfamiliar territory: supporting families through bedtime battles, night wakings, and inconsistent sleep patterns. And naturally, one of the most common questions I’m asked is, “Can we bill for this?”

As behavior analysts—and especially as Certified Behavioral Sleep Educators—it’s our responsibility to support healthy, functional sleep for the learners and families we serve. But here’s the challenge: sleep isn’t one-size-fits-all. The way families sleep, when they sleep, and with whom they sleep are all deeply influenced by cultural norms and values. When we walk into a home or clinic with a rigid definition of what “normal” sleep looks like, we risk missing the mark—and doing more harm than good.

As behavior analysts, we’re trained to spot patterns, build systems, and write precise behavior plans. But when it comes to sleep, the science only goes so far. Sleep is personal. Emotional. Often wrapped in layers of guilt, fear, and frustration—especially for families of autistic learners who have tried everything and are still running on empty.

That’s why effective sleep support doesn’t start with a checklist. It starts with connection.

When it comes to providing full-day ABA services for younger learners, daytime sleep isn’t just a bonus—it’s a biological necessity. But unlike preschools, where group nap times are the norm, many ABA clinics struggle with scheduling and supporting naps in a way that aligns with each learner’s developmental and biological sleep needs. And for autistic children, whose sleep can already be unpredictable, finding the right rhythm requires a collaborative, informed approach.

As behavior analysts, we’re trained to spot patterns and assess function—but when it comes to sleep, many of the biggest red flags show up not in the data sheets, but in the little moments we might be tempted to overlook.

That’s because caregivers don’t always disclose that sleep is an issue. Sometimes, they may not even realize it themselves. In many cases, chronic poor sleep has become the “new normal,” making it difficult to recognize when things have gone off course. And yet, sleep plays such a vital role in behavior, learning, and emotional regulation that it deserves a closer look—even (and especially) when it isn’t brought up directly.

If you've ever supported a learner who seems to shift into overdrive the moment bedtime begins, you’re not alone. Many children—especially those with autism—struggle to calm their bodies when it’s time to wind down for the night. As behavior analysts, we know that bedtime is not the ideal time to first introduce new behavioral expectations. And yet, that’s exactly what often happens when learners are expected to suddenly shift from active, sensory-seeking behaviors to stillness, separation, and sleep.

As BCBAs, we are taught to look at skill acquisition through the lens of building prerequisite competencies. We wouldn’t expect a learner to independently cross the street before they’ve mastered responding to their name, right? Yet when it comes to sleep, we often skip the developmental scaffolding altogether and assume a child will fall asleep peacefully, alone, in the dark, without the same kind of skill-building we’d apply in any other behavioral domain.

For families of individuals with profound autism, sleep problems aren’t just frustrating—they’re deeply disruptive and often inescapable. For too long, these challenges have been minimized or misunderstood. But as we grow in our understanding of the autism spectrum, it’s time we give the profoundly autistic community the specific support it deserves—starting with sleep.

When we talk about improving sleep in the autism community, we often focus on bedtime routines, environmental cues, and behavior-based interventions. And while those are all incredibly important, there’s one piece of the puzzle that’s often underestimated—the schedule itself.

When it comes to bedtime struggles, many caregivers—and even professionals—are quick to reach for a behavior plan to address "big behaviors" at night. The meltdowns, refusals, screaming, elopement, or demand avoidance can make bedtime feel like a battle, leaving families exhausted and feeling defeated. But before we focus on reinforcement schedules, extinction procedures, or token systems, we need to take a step back.

As behavior analysts, we often focus on early childhood development, but sleep challenges don’t disappear as learners grow. Adolescents—especially autistic adolescents—experience biological shifts in sleep timing that must be acknowledged and supported. Many families struggle with long bedtime battles, excessive sleep latency, and unsustainable sleep dependencies because their child’s sleep needs are being treated as developmental rather than biological.

For over two decades, I’ve worked in behavior analysis, and for the last 14 years, I’ve dedicated my career to sleep. Why? Because sleep is one of the most critical and overlooked variables in behavioral success. And yet, despite its significance, most BCBAs aren’t trained in sleep science.

For many caregivers, bedtime is a nightly battle, with children resisting sleep, pushing bedtimes later and later, and sometimes staying awake for hours past what seems reasonable. A common approach among well-meaning caregivers is to allow children to “listen to their bodies” and fall asleep when they feel tired. The problem? The internal sleep clock isn’t always the most reliable guide—especially for children.

When caregivers tell us, “We finally got them to sleep—thank goodness for that medication,” it can be tempting to breathe a sigh of relief right along with them. Sleep challenges can push families to their limits, and any sign of improvement often feels like a win. But as behavior analysts working alongside families, we need to understand what’s actually happening beneath the surface. Sedatives may look like a solution, but when it comes to sleep quality, the reality is more complex.

For many caregivers, bed-wetting can feel like an ongoing mystery—why does it happen? When should we be concerned? And most importantly, can it be “taught” away?

As BCBAs, we know that behavior is influenced by reinforcement, learning history, and environmental factors. But when it comes to bed-wetting, developmental readiness plays the biggest role. It’s not just about behavior—it’s about biology. So, let’s dive into what we actually know about bed-wetting, what we don’t, and what we need to stop doing immediately.

If you've ever wondered why some kids crash into bed at night while others seem to gain a second wind as the evening drags on, the answer may lie in a little-known sleep chemical: adenosine.

For many learners, particularly those with a history of trauma, sleep isn’t just a biological process—it’s an emotional one. Trauma can disrupt the ability to settle, feel safe, and transition into restorative sleep, making it critical for BCBAs to approach sleep programming with sensitivity and care. A trauma-informed perspective recognizes that sleep challenges are not just behavioral hurdles to overcome but are often rooted in deep emotional and physiological responses.

In the world of sleep science, there’s one hot topic that keeps grabbing headlines: screen time. It’s no secret that technology has become a massive part of our lives, and for many learners in the autism community, screens can feel like a lifeline. But when it comes to sleep, these glowing devices may be doing more harm than good.

When families come to us with concerns about their learner’s sleep, the symptoms they describe often sound like a behavior checklist:

• “They won’t stay in bed.”

• “It takes them two hours to fall asleep.”

• “They refuse to go to sleep.”

• “They come out of bed six times a night.”

As the new year inches ever closer, it’s the perfect time to reflect on 2024—a year filled with milestones, growth, and connection. Whether through training Certified Behavioral Sleep Specialists, speaking at conferences, or sharing sleep resources with thousands, 2024 has been nothing short of transformative for me and Ready Set Sleep.