What is your approach to helping parents manage sleep disturbances in patients with autism spectrum disorder?

At our center, we start with sleep hygiene education, using tools such as the Autism Speaks sleep toolkit which has a printable PDF that is free for parental and clinical use. We also try to do therapy on sleep hygiene and our therapists will often try to find out what factors may exist in the home that are obstacles to implementing behavioral approaches. If addressing hygiene issues is not helpful or only partially effective, we start with melatonin, utilizing the lowest effective dose by titrating up from 1-5 mg depending on the weight and age of the child. It is important to distinguish whether the individual has sleep latency issues, night wakenings, or a combination because that will determine whether to recommend short-acting or time-...