(Trigger warning: contains info about child abuse and neglect)
Children who come into foster care and/or are placed for adoption will have had a range of experiences in respect of bedtime, sleep and waking up and will bring those experiences with them into the foster or adoptive home. Looked after children may have come from backgrounds that were chaotic, neglectful or abusive and, as a result, bedtime and sleep may have become associated with negative experiences. The bedroom may have been used as a punishment, the sleep environment might have been cold and dirty, children might have been punished for wetting the bed or left crying alone for extended periods and, for some children, bedtime and night time may have been a time when they were most at risk from sexual abuse.
Instead of a warm, safe haven the bedroom and night-time may have become a place and time of fear. If bedtime has become associated with feelings of fear and extreme anxiety its approach is likely to leave a child in an alert hypervigilant state, not the calm drowsy state conducive to falling asleep. Whilst not all children coming into care will have had negative experiences around bedtime and sleep, bedtime and falling asleep may be a time when those children feel the separation and loss of their birth family most acutely.
Fostered and adopted children might display a range of behaviours in respect of sleep, as a result of trauma and disordered attachment. They might be unable to settle at bedtime, struggle with the separation of going to bed, wake up during the night or very early, may experience nightmares and might struggle with transitions, including the start of the day when they wake up.
A fundamental part of supporting foster/adopted children with bedtime and sleep issues is to address the underlying causes. “The Secure Base Model” developed by Gillian Schofield and Mary Beek can provide foster parents and adoptive parents with a really helpful framework for addressing the anxiety and lack of trust caused by insecure attachments.
The Secure Base Model is drawn from attachment theory (Bowlby, 1969, Ainsworth 1971, 1978) and includes five dimensions of care giving: availability which helps the child to trust; sensitivity which helps the child to manage their feelings; acceptance which builds the child’s self-esteem; cooperation which helps the child to feel accepted and family membership which helps the child to belong. If foster carers and adoptive parents would like more information on how to use The Secure Base Model, “Promoting Attachment and Resilience – A guide for foster carers and adopters on using the Secure Base model” (Schofield and Beek) is a valuable resource.
There are many ways foster carers and adoptive parents can encourage and support attachment and the following suggestions are just some of them. Introducing and involving children in the family routines and rituals is an important step in helping them feel as if “they belong”. It can be really helpful to explain to a child from the beginning how the household works, e.g., a drink and snack when coming in from pre-school/school, putting out school clothes the night before, having a story and a drink at bedtime. It can also be beneficial to find out what the child likes and incorporate some of that, where possible, into the family routine. Having photographs of the child on display, alongside photographs of other children in the family, is another way of promoting that sense of belonging.
Having a regular routine in respect of mealtimes, getting up in the morning and bedtime is really important. Consistency, predictability and reliability enables children to know what to expect and when. Using a calendar, picture chart or social story can really help children to predict and anticipate what is going to happen and can help reduce anxiety around transitions.
Some children who have missed out on early nurture can become “stuck” at an earlier emotional stage which means they behave as a much younger child would. For these children responding to their emotional age as opposed to their chronological age will help them move through those missed developmental stages. For an older child this might mean having a bedtime routine which might be thought appropriate for a younger child – a warm bath with bubbles, warm towel, cosy pyjamas and dressing gown, a night time drink, a cuddle and a story will be of benefit whatever the age of the child.
Bedtime can be a good time to read stories that remind children of being safe and loved as this can be really reassuring. Some older children might regress and want a bottle of milk and a dummy at bedtime, especially if that is part of the night time routine for younger children in the household. Whilst some foster carers and adoptive parents might be worried about the appropriateness of this with older children, it is usually short lived but it can meet a missed developmental need.
Storytelling, in the context of Life Story Book work, is an important way of helping a child to integrate their past into the present, in order to help them to move into the future. However, more general storytelling can also be a really powerful way of helping build attachment, as well as help children learn, talk about and manage emotions. Storytelling involves the process of speaking and listening and provides a natural way of learning about feelings and relationships. Because it is not a one-way process but an interaction between the storyteller and the listener, storytelling can echo some of the things that take place with healthy attachments, i.e., eye contact, emotional attunement and turn taking.
Reading to children boosts educational attainment, but storytelling also provides adults with an opportunity to teach children about the world and how to deal with it. Books such as “Owl Babies”, “Can’t You Sleep, Little Bear” (Martin Widdall) and “The Invisible String” (Patrice Karst) can help children with feelings around sleep, separation anxiety and loss.
References
Schofield G and Beek M, 2014, Promoting Attachment and Resilience, Coram BAAF
Schofield G and Beek M, 2018, Attachment handbook for foster care and adoption, Coram BAAF
Bowlby J, 1969, Attachment and Loss (Vol 1), Random House
Ainsworth MDS, Bell SM and Stayton AJ, 1971, Attachment and exploratory behaviour of one year olds, The origins of human social relations, pp 17 – 52.Ainsworth MD, Blehar M, Waters E and Wall S, 1978, Patterns of attachment.
