Why Every BCBA Needs Foundational Knowledge of Sleep

If you’ve been a BCBA for more than five minutes, you’ve probably had sleep show up on your caseload in some way. Bedtime battles. Middle of the night wakeups. Kids falling asleep in session. Parents who look like they haven’t slept since 2019.

And yet, sleep often sits in this weird gray area. We know it matters. We know it’s impacting behavior and learning. But many of us were never taught what to do with it.

Here’s why having some foundational knowledge around sleep is necessary for BCBAs, even if sleep isn’t your main focus.

1. Because sleep issues are the norm, not the exception, for kids with ASD

Some studies suggest that over 80 percent of children with ASD experience sleep difficulties at some point.

Let that sink in.

If you have 10 kids on your caseload, statistically around 8 of them are likely struggling with sleep either now or at some point in the future.

That means:

• More irritability

• Lower tolerance for demands

• Slower skill acquisition

• Bigger reactions to small changes

• And data that suddenly stops making sense

  
  

When sleep is off, behavior is louder and learning is harder. If we ignore sleep, we are missing a huge variable that directly impacts progress.

2. Because doctors are not getting the sleep training people think they are

A lot of families assume sleep concerns will be fully addressed by medical providers. And sometimes they are. But research shows that many doctors receive very little formal training in sleep, often less than two hours total. Other studies have found that many providers do not routinely ask about sleep at all.

This is not about blaming doctors. They have an enormous scope and limited time.

It does mean, though, that families are often not getting practical, behaviorally informed sleep guidance from medical providers. As BCBAs, we are already trained to look at behavior, routines, environments, and patterns over time. Foundational sleep knowledge fits naturally with the skills we already have.

Sometimes just knowing what questions to ask and what variables to look at can make a big difference for families.

3. Because our daytime programming can either help or hurt sleep

Whether we realize it or not, what we do during the day carries over into evenings and bedtime.

High energy activities, lots of screen time, or constant stimulation can make it harder for kids to settle at night. That doesn’t mean we should always avoid these activities, it just means we want to be thoughtful about balance.

When we understand how the nervous system relates to sleep, we can:

• Teach leisure skills that help kids wind down

• Be more intentional about transitions between highly stimulating activities

• Support families in adding calming activities to the routine at home

  
  

Without sleep knowledge, we may accidentally be setting families up for harder nights without realizing it.

4. Because “just walk them back to bed” is not enough anymore

Let’s talk honestly about this one.

Many of us were taught some version of extinction as the default response to night wakings. And yes, sometimes it reduces kids leaving their bed.

But reducing a behavior is not the same thing as teaching a skill.

If a child stays in bed but is still lying awake for hours, what have we actually accomplished?

Extinction is also incredibly hard for families to implement at 3 a.m. when they have not slept well in months or years. Even when parents are motivated, it often falls apart because it is not sustainable.

Having foundational sleep knowledge means we can offer families more options. We can think about skill building, gradual changes, routines, and support that feels doable rather than overwhelming.

That tends to feel a lot more compassionate for everyone involved.

Final thoughts

Sleep is behavioral. Sleep impacts everything we measure. And sleep shows up on almost every caseload whether we address it directly or not.

Sleep doesn’t have to become your specialty and you don’t need to have all the answers.

But understanding the basics of how sleep works and how behavior impacts sleep helps you avoid unintentionally making things harder and gives you more confidence when sleep shows up on your caseload.

When kids sleep better, sessions tend to go more smoothly.

When parents sleep better, follow through improves.

When we sleep better, our work feels more sustainable.

That alone makes learning a little about sleep worth it.