Sometimes I play the "at least he's not" game. Kids with autism can have so many disparate issues, ranging from the ones people tend to be aware of, like speech delays and sensitivities to light or sound, to less apparent ones like digestive issues. When Moe was first diagnosed, his issues were social and communicative, but we would look across the spectrum and think "at least he's a good eater" or "at least he likes to be touched."
I've discovered that this is a dangerous game to play. For one thing, all kids, including spectrum kids, change so fast. As soon as I thought "at least he's not a hand flapper," he started flapping his hands. At first this really freaked me out, not because of the flapping itself but because I thought it was a sign that things were getting worse. But then the flapping would go away for a while and something new comes in. Sometimes he needs to chew a lot, sometimes he gets really manic and has a hard time settling down. These things come and go and although we employ strategies to manage them at the time, I'm learning not to read anything into any new behavior because it is likely to disappear as quickly as it came. Sometimes they return and sometimes they don't.
But lately we've been having an issue we've had trouble managing behaviorally. Moe has, from the time we did sleep training at four months old, been a good sleeper. He'd fall asleep quickly and stay asleep for a good 12 hours, with only the occasional exceptions for teething or illness. I'd always say "at least we don't have sleep problems." You can guess what happened next. A few months ago, Moe started waking up in the middle of the night. He wasn't upset, but we'd hear him in his crib, laughing. Not a normal laugh, but an out of control hysterical laugh. It was cute, but was interrupting all of our sleep. Sure enough, however, that resolved itself after a week or so. Unfortunately, now Moe is having trouble falling asleep and it hasn't resolved on its own. It's been a month or more.
We do everything you're supposed to do, have a consistent bedtime routine that lasts 20-30 minutes, keeping the lights low and distractions minimal. We tried using deep pressure, brushing techniques and swinging. Moe would calm down for a while, but ten or fifteen minutes later, we'd hear him in his crib kicking, playing, screaming and sometimes crying. He was staying awake until 9:30 at night and then we'd have to wake him in the morning, still exhausted, so he'd be ready and fed before his 8 session. Everyone was miserable.
Last week, we happened to have an appointment with our developmental pediatrician, Dr. S, and we mentioned this concern. She suggested melatonin. I'd read about people using melatonin with autistic kids, but I wasn't sure if it was a legitimate thing to do or another snake oil remedy. Apparently, many kids with ASD do have problems producing the melatonin required to fall asleep at the correct time. So we decided to try it.
And thank goodness we did! It is working like a charm. Trader Joe's sells a small, chewable, 500 mcg (0.5 mg) dose. Moe eats it, then we start the bedtime routine. One half hour later, his eyes get heavy and he falls right asleep. We've been experimenting with a half dose (really a quarter dose, since Dr. S said we could give him 1 mg if we needed to), with mixed success. Our goal is to wean him off it and hopefully his brain will get back on track.
But for now, it's wonderful, and it is making a difference in his days. This week, he's been more engaged, verbal and alert. He's having fewer manic times where he can't calm down and I've even noticed he doesn't need to chew (on his chewie) as much. Of course, yesterday, right when I said "at least we've got this figured out," he woke up at 2:30am. That's life, I guess.