The Behavioral Sleep Blueprint with Nicole Shallow, Part I

ABA is proud to host Nicole Shallow (Part 1 of 2):

Nicole Shallow is a Board Certified Behavior Analyst (BCBA) specializing in sleep and behavioral consultation, particularly for neurodivergent children and their families. She holds a Master of Education in Special Education and became a BCBA in 2019. Her passion for sleep stems from her own personal experiences with sleep difficulties since childhood.

Nicole is the founder and CEO of Your Behaviour Gal Consulting Inc.. What started as a single practitioner's sleep and behavior consulting practice has expanded to include a team of BCBAs who support families and professionals throughout Canada and the U.S. She's developed the Sleep Competency Certification Program to educate and empower other professionals in the field.

Her services include sleep coaching for individuals and families, corporate sleep coaching, and sleep workshops. She also provides behavioral consultations for the autistic and neurodivergent community, encompassing family, school, and sleep support, along with home team coordination. Nicole emphasizes compassion, knowledge, and inclusivity as core values in her practice. 

Beyond her consulting work, Nicole is a public speaker, educator, and mentor. She believes that everyone can improve their relationship with sleep through the right tools and information. Nicole speaks happily about her role as a wife, mother of a young child and canine enthusiast. She takes time out of her busy schedules to pour a bright-eyed brew for ABA on Tap, one that is sure to prove soporific for your clients.  Get on with your sleep hygiene, and always analyze responsibly.

Transcript

SPEAKER_04: 0:10

Welcome to ABA on TAC, where our goal is to find the best recipe to brew the smoothest, coldest, and best-tasting ABA around. I'm Dan Lowry with Mike Rubio, and join us on our journey as we look back into the ingredients to form the best concoction of ABA on TAC. In this podcast, we will talk about the history of the ABA brew, how much to consume to achieve the optimum buzz while not getting too drunk, and the recommended pairings to bring to the table. So without further ado, sit back, relax, and always analyze responsibly.

SPEAKER_03: 0:52

Alright, alright. And welcome to yet another installment of ABA On Tap. I am your ever-grateful co-host, Mike Rubio, along with Mr. Daniel Lowry. Mr. Dan, we got a doubleheader today, and we're done with the first one. Super excited for the second part. How are you feeling?

SPEAKER_05: 1:09

Great. Part two of Nicole Squared. We're we're excited for this. And unfortunately, I'm not tired, but we are going to find out some things to do when I am tired later.

SPEAKER_03: 1:18

Make sure you get your sleep in.

SPEAKER_05: 1:19

Absolutely. This is one that my girlfriend's going to have to listen to.

SPEAKER_03: 1:23

We cover a lot of ground as behavior analysts, and oftentimes we might think we know something about something we're dealing with, and we probably don't know enough. You don't say. And uh let me be uh number one to say guilty as charged. Uh but today we're gonna learn a lot from our very special guest uh who again knows a lot about sleep. Uh so anyway, without further ado, we've got Nicole Shalow. Nicole, thank you so much for your time. We really appreciate you sitting with us and talking on a uh what I'm sure is a lovely Sunday afternoon where you're at. So hopefully we'll have a nice conversation and get you back to your weekend. Uh, but thank you. Thank you so much for joining us. We're super excited to learn about your content expertise. Um I'm uh got a very strong developmental and uh human development background. Uh oftentimes as I'm doing clinical work, if we're talking about sleeping or eating challenges, I like to say, unless we address those, I'm really limiting my my outcomes and limiting my my success here in terms of what I can do for you. And uh, you've got a whole lot to tell us about sleep and the importance of it developmentally, behaviorally, and otherwise. Before we can you hear me okay?

SPEAKER_00: 2:45

Yeah, the your internet went red there for a minute. Oh, okay.

SPEAKER_03: 2:47

So thank you for telling us that hopefully that won't happen too often. Um, I don't know how much you missed, but without further ado, let's talk about the origin story because you came to this sub-specialty after a whole lot of very hard work learning a whole bunch of other things. Uh tell us how you got to where you are now and and uh what keeps you going.

SPEAKER_00: 3:07

Yeah, so I thank you. Thank you again for inviting me to be here. I am so grateful as well. I love sharing everything I can um with others. So origin story started one day on a pool deck when a parent told me that I would be, I was a lifeguard at a little community low-key pool, and we were just talking as lifeguard and parent do. As you do, yeah, as you do while saving lives. Uh preventing any sort of saving of life. Um she had a son uh on the autism spectrum, and she noticed how I supported during swim lessons, and she was like, Hey, have you ever thought of supporting in this way? And I had never heard of what um what we call them here is behavior interventionists, um, but it's kind of the same thing as like an RBT and uh so direct implementing. I had never heard of it, so I I applied for my first job on Craigslist at the time. That was when people would find jobs.

SPEAKER_05: 4:18

Same, same. Yeah, yep, yep. Absolutely find jobs and a lot of other things, but we'll stick with jobs.

SPEAKER_00: 4:25

Yeah, where is Craig these days?

SPEAKER_03: 4:27

Where is Craig at his list anyway? With we digress.

SPEAKER_00: 4:31

Yeah. Um, and then went from there. I think I met my first beast, like a first intro to a behavior analyst on my second team. On the first team, there wasn't anyone. And I realized I could actually do something with my psychology degree, which was a big win for me. You can work at Starbucks. You could you could work anywhere with a psychology degree. Um, so I know there's one way, there's two ways to go. I know some people go like supporting in the health side of things, and then some people go into marketing. My twin sister went into marketing, I went into the other way. Um, so I'm so grateful, yeah, to to be in this field. And uh I jumped into I spent a year just doing that work one-on-one, full-time, to make sure, yes, this is where I want to be. And then started my master's program at the University of British Columbia. And my sleep journey started there. Uh, I had clients at the time that were struggling and I could not make any progress at all. And they weren't sleeping and it was confusing for everybody. And as um the BCBA on the team, there there was the BCPA, there was SLP, there was a lot of professionals involved and there was just nothing going because no one was sleeping. Parents weren't sleeping, kids weren't sleeping. It was just incredibly heartbreaking to see and challenging because we want to make a difference. And that family I never actually got to fully bring that to fruition because I was still in my early days. Uh, however, my professor at the time, Dr. Pat Miranda, she I think is semi-retired now from teaching, but she's still around. Um, she challenged the class to take on sleep because no one in our area was doing it. And we have feeding specialists, we had like amazing feeding specialists, amazing toileting specialists in our area, but no one was tackling that third piece, that sleep piece. And so I was like, okay, challenge accepted. Nice. How I get your mother, how I met your mother was like on repeat. So I was like, yes, let's cope with that. Um, at the time, my my anxiety coping show at the time. Um, so yes, challenge accepted for sure. And so I always knew I wanted to do something big in this field, and I knew I was meant for like my vision for the work that I wanted to do was more than what I was doing at the time. And sleep that just sparked a passion for me that I didn't even know existed. And so I did my graduate project on sleep, and then I sought out mentorship after that.

SPEAKER_05: 7:18

Um you didn't know you were passionate about sleep, you spent a third of your life sleeping.

SPEAKER_00: 7:24

I know, and I was terrible at it. I don't know, I guess that's like the original story. The original, original. So when I knew that behavior analysis could support sleep, I was like, whoa, really? Um, that's cool. How can I apply this on myself? Because as reflecting on it and understanding how sleep works from a behavior analytic analytic lens, I realized that I actually didn't know how to fall asleep, which is the behavior that I'm trying to teach people and that how we're looking at it from a behavior standpoint. I had a lot of crutches around falling asleep. A lot of faulty stimulus control was occurring. And my parents had accidentally trained me with that because they also didn't know how to teach me how to fall asleep either. Um wow.

SPEAKER_03: 8:11

So that's I mean, you you're really uh explaining this fully, and at least personally, how far back you felt. Um, I guess it would be a habit. Your habit had been formed, and then how you were just practicing it perpetually, not actually ever hitting the uh the the full target in terms of the sleep you were supposed to be getting.

SPEAKER_00: 8:32

No, and um I talked to my mom about it too. I was like, well, how did I sleep as a kid? She's like, Well, terribly.

SPEAKER_03: 8:39

Um and uh And that wasn't just your temperament, is what you're saying. I think that's the important part here is people might then hear something like that and say, Well, it's it's genetic and your mom's a bad sleeper. And yes, part of that some might be true, but we wouldn't be having this behavioral discussion if you didn't have things to change that.

SPEAKER_00: 8:57

Well, I think about my history. I have a twin sister. I shared, I slept from the original, like in the womb with someone else, always. And so that's like so and it all starts then, like sleep happens when like during that time. And I've spoken to families who are like, yeah, they had weird hours, even like in there, like in the belly, like you would feel the different rhythms. So um, and then I would like when we were younger, we were always together, like it was just always you know, that similar. We had the same rhythms, my mom said. We would wake, feed, all that at the same time. And then as we got older, my mom at the time, I mean it's the 90s, early 90s. One of the only suggestions at the time was the cry it out method. The further method was big then. My mom would um mom and dad said, Okay, I guess we gotta do it. They're this age, they need to learn. And it was like a hold the door, let them cry until they figure it out situation. Yeah. Again, some kids maybe it worked for them to fall asleep. My data is not speaking too loud on that one. So my sister also has like some difficulties um on and off.

SPEAKER_05: 10:16

But maybe your data is speaking very loudly on that one.

SPEAKER_00: 10:20

Maybe like the other direction with a one single single case study, and it's not out of guilt. I think it's I think the biggest piece, and my mom wishes she knew what what I know now and how sleep actually works, and um because I struggled with sleep from early childhood, I would like sleepwalk, I would have anxiety about going to bed, like extreme anxiety. I slept on my sister's floor for two years, I think, on and off, because I would just have I'd try so hard and then I just couldn't fall asleep. And then as soon as I lay down on the floor, I'd fall asleep. Um, and then into teen years, it would take me forever. I was a competitive swimmer too, so we would be up early in the morning, like 5 45 in the water, kind of early. Um and I just wasn't getting a lot of sleep during my teen years. So, of course, when you're not sleeping, anxiety, emotional difficulties, like hormone challenges, like all of that came into play. And again, it's all past reflection. This is all me like okay, makes sense why I was like that as a preteen teenager. Sorry, mom and dad, like it's just and then it you know, into my twenties, and um, I think my it things, you know, you kind of mess around with your sleep when you're that age. Yeah.

SPEAKER_03: 11:44

You don't on purpose.

SPEAKER_00: 11:46

No, on weekends you're out all night, and then how little can I get and still function?

SPEAKER_03: 11:50

Right.

SPEAKER_05: 11:50

And wake up in time for the final.

SPEAKER_00: 11:52

I wonder why in my yeah, I wonder why in my 30s I had extreme hormone challenges and stress and some health stuff that popped up, you know?

SPEAKER_03: 12:00

Wow. Wow. Yeah, I have a I have a 19-year-old and I I marvel at how uh how little he sleeps and how he tortures himself with that. I see him sometimes go to work and it's like, wow, kid, good for you. How do you do that? You you really should just stay in bed. Oh, you want to be up. Okay, good for you. Okay, great. What can you do?

SPEAKER_01: 12:17

Yeah.

SPEAKER_03: 12:18

So you you uh you take on this sleep study challenge uh later in your life and you start learning a whole lot about yourself. Where does that go in terms of application? So we're gonna follow two threads very nicely here because I'm sure your sleep uh personal sleep journey has a nice resolution and and it sounds like you practice what you preach to some extent uh or to some good extent, and then we'll see where that takes us now in your professional applied setting. So do you start learning about your own sleep patterns first? Is it that you start working with uh you know, or taking data or doing observation and then uh start implementing help for others, and then you realize about yourself? How does it all transpire?

SPEAKER_00: 13:00

Yeah. Um, so I did mentorship with uh Dr. Kira Moore. So she's one of uh Dr. Hanley's graduate students. Uh Hanley at the time, he was out here doing like a lot of talks, and he was the only person that I knew who had created this or had done it really. And he had the YouTube videos, and that's kind of where I dove into that. And I Googled BCBA's sleep, and nothing would come up. Everyone's SEO was not great at the time.

SPEAKER_05: 13:26

Or BCBAs don't sleep, one of the two.

SPEAKER_00: 13:30

There was one one woman in California, I think, and I reached out to her and I never heard back. So yeah, I kept looking and found.

SPEAKER_05: 13:38

Um I thought you were gonna say there was one BCBA that slept.

SPEAKER_00: 13:43

Oh no, yeah, one who was doing sleep of some kind. Um so I did the original training with her, and so she walked us through, like walked me through the plans and how to you know understand sleep from a behavior standpoint and had my baseline knowledge there, but it wasn't I then I started supporting clients with it and taking it slow and continuing my education on my own, research and and all of that, um across disciplines, and it's been since 2019, which it feels like yesterday. I went to Norway and then I came back and I did this mentorship, and then and yeah, it feels like yesterday. I just remember it. I was reading articles in Norway there. I was like, I gotta get ready for my training.

SPEAKER_03: 14:34

Um so uh Norway, Norway too for as part of your study, because that there's interesting sleep cycles based on light in Norway, isn't there? Scandinavians are an interesting sleep specimen, aren't they?

SPEAKER_00: 14:48

I uh can only imagine because it is light out to like 4 a.m.

SPEAKER_05: 14:55

Or dark out for like 23 and a half hours a day in the winter, right?

SPEAKER_00: 15:43

Yeah, in Norway the light is very interesting. I actually lived there for four and a half months. Went to school, did a study abroad. Okay, and I did go up north, not super north, but the light, it's so dark during the winter. So dark, very strange. And then I what did get a chance to go in the summertime where it was just light out all the time. Um, so it was light is plays such an important role in sleep.

SPEAKER_03: 16:12

Okay, so maybe that's where we start. Let's let's start there in terms of of light cues, and uh so if you want to kind of give us a little bit of the science, which you probably know way too much about, and then you know, how how does how does that how would anybody take that information and now you know start to think about applying it with say a client who's having uh sleep challenges, whatever that may look like.

SPEAKER_00: 16:36

Yeah, well, light is the anchor to our body clock. It tells us when to be awake, tells us when to be asleep, and I am sure it has, and I know I can pull the research off, but I know it has a lot of health benefits just being outside and getting that daylight exposure. Um, there was this book, Chasing the Sun, I think. Um she did some studies with the Amish community and how they live in like the low electronic world and how light plays such a role. And it was so helpful in like maintaining those early wake-ups and the evenings and early evenings and just like an anchored schedule. But we live in a world that's full of light exposure and you know, fake light, real like we have our daylight, but a lot of us actually aren't spending enough time in daylight, and especially the clients I support they some clients will struggle to actually safely access outside and you need it for healthy circadian rhythm, you need it for that melatonin production at the end of the day. So when the light dims or the sun goes down, melatonin rises. That's how it's triggered. And if we're not getting those differences, the body's confused. And so light is a great way to anchor.

SPEAKER_03: 18:02

So something is, and I'm I'm hoping I'm not over-generalizing this, but something as simple as if you're talking about a child, the idea that they're getting some playtime outside sometime in the morning, and then they're getting some playtime outside sometime towards sunset. Uh again, not oversimplifying, but you're kind of pointing to the that particular part of a of the rhythm, right? So there's there's different kinds of light at different times of the day. And then to your point, some of the kiddos we see may not be but to access that safely. So, what what are the alternatives and and what you know, how do you help parents sort of work through this?

SPEAKER_00: 18:41

Yeah, absolutely. So just to add to that, to help people understand how in the inside light and outside light differ. So inside light is very so they measure light by lux, L U X, and outside is about 10,000 plus lux. Inside, you're lucky to get like maybe above 500. Okay. So what we really even on a cloudy day, you can get a lot of light exposure, light in the eyes. So the eyes is what communicates to the brain that it's time to get going. Now for kids who struggle, or people who struggle to have access to that much light, of course, going near a window is helpful, having windows open, all the lights on in the house. There are lights you can buy. So there is, um, in some cases, I haven't been formally trained on it, but there is bright light therapy. So a lot of sleep doctors will support their clients through bright light therapy. So you can buy like these light boxes or these happy lights that do have that 10,000 lux. Okay. I've used one before. It's almost like it can really feels like coffee. Like you don't need coffee, you just put this light at the corner of your eye, and it just really wakes up the brain and the body. Um it's not gonna give you a migraine.

SPEAKER_05: 20:01

That seems like that might be.

SPEAKER_00: 20:06

Um, and you can't like look at it directly. But there are ways to use light to support circadian rhythm shifts. Okay, even if you're in jet lag, light is a great way to support yourself. Like airplanes will use light and darkness to help. But when you're you know in a new country and it's daytime, like get outside, even though you're supposed to be sleeping. Like, that's the best way to get your body onto a new rhythm. So, light for kids, sometimes if I feel like that's the biggest issue is getting outside. That physical activity, getting the daylight, how can we do that safely? Balconies can be safe, sometimes not. Um, going out in the community might need to be worked on first and supported first, or as well as how can we support sleep at night too? Now it's not a make or break, but I have supportive clients who really struggle to get outside, and it's really challenging to anchor their circadian rhythm without it.

SPEAKER_05: 21:09

So you used to talk a lot about sleep routines. I remember um you talking about that with a lot of our clients, right? About how a lot of our clients would struggle with sleep, and you would say, Well, we're not the sleep experts, but we definitely know about developing routines and the importance of kind of that sleep routine. Um, I don't know if you want to say anything to that, and then we can have you obviously input a lot onto that, Nicole.

SPEAKER_03: 21:29

Um I think that the basic premise that I mean it was pretty basic premise, but just the idea that there was a uh a sleep hygiene of sorts, things that that you're doing um in similar ways at similar times of the day, things that are providing now environmental cues, that this is now where we're headed. Um as far as the routine, the idea that part of that rhythm is now um, you know, I'm sitting at this part of your bed, I've got these books ready, you know, to get a little specific there. But yeah, the idea that things that there's a pattern, there's a rhythm that's recognizable with recognizable stimuli that is preparing the child, if you will, to say it's we're we're heading in that direction. Uh and I I found it to be helpful just in terms of uh you know situations where there wasn't any semblance of a routine or uh structure, which is not a word I use too often. I think we can get we can be overly structured at times, but I think that sleep and routines as a father of three, you know, two teens and one younger, even now with my four-year-old, there's uh yeah, there's a pattern, there's a rhythm, there's a stimulus control, if you will, that is important to establish. And it doesn't always look the same. And uh, four-year-olds are are almost naturally built to try and sabotage any sort of routine or uh sleep hygiene that you do, and there's a lot to work uh through that, and when you establish, it's very rewarding. And then even when you have a good routine, um, again, four-year-olds, for to use my example, are built to sabotage that, and then you feel the effects of a child who's overly tired and agitated, you had a little bit of hunger to that, you've got yourself a nice afternoon. Time to parent. Time to parent. Let's go. Ready?

SPEAKER_00: 23:12

So I mean, sleep is the most common sighting event that increases probability for frustration and uh rigidity. So, um, and we all know what it's like, right not to sleep, but the sleep hygiene piece is very important. The routine, the the brain can't go from awake to asleep like that. I mean, some people can, I will say there are some people who can just so just so tired all the time, like gets into bed, head down, out. Um some people can, they know how to like engage in that falling asleep behavior that I talked about before. They really can just like turn it on. They don't need that routine necessarily to make to set the stage, but for kids, it allows, or for teens and adults, like everyone benefits from an evening routine, a wind down routine to get to that place of rested and regulated. So you're right, the last 20 to 30 minutes should be very similar. And I like the idea of flexibility within the structure always, because life happens. And so when I support families, that is my motto flexibility within structure. So it's just general time windows, options available. And so this also allows the family to offer choice within that structure because kids, teens really value that autonomy and that ability to feel like they have a say in something that you necessarily can't control. Yeah. Um, so that routine, it's finding one that works within the family and understanding the entire unit. Because yes, if there's multiple kids and they're all going to bed at different times, and then you're navigating those thoughts and supports because hey, why is my teenage brother going to bed at this time? But I have to go to bed at this time. Sometimes the your four years old doesn't always cut it. Um, so that's because I said so. Yeah, because I said so. Um, so that routine is so helpful. And then I also support families in daily routines. So the idea of the sleep hygiene is to set the physiology up for sleep to happen because it's a very biological process. Sleep isn't something you can just say, okay, go to sleep now. Like if that worked, we wouldn't have I wouldn't have a job probably. Um and no one would struggle with sleep. So how do we make sure, like by anchoring meals at the same time every day or around the same time, that tells our digestive system when to turn on, turn off? Interesting. If we're eating at sporadic hours, if our digestive system is wide awake at night, that's gonna keep us awake. So, how do we anchor that? How do we look at um our physical activity? How much physical activity are we getting? And then the byproduct of energy expenditure is adenosine, which is the neurotransmitter that builds up over the day, which allows sleep pressure to line up with, you know, your melatonin now needs to be high and rising when adenosine is high. And it all needs to line up at the exact right time for sleep to take over. And if things are in a line unaligned, then it's you know, you may have difficulty falling asleep, you may have bedtime resistance, you may get into the overtired window. Like, are you putting them to sleep when they're almost at their most alert? Because kids or people are most alert about an hour or so before bed, and then it dips. So if you put if so it's all about that timing. And so for me, I like to get data before I even do an assessment because I need to know what the time is. Like, what's happening? What's the rhythm? What's the flow? Is every night all over the place? Is it pretty much the same? If it's all the same, then I have further questions to figure out what else is going on. And so that for me is a big part of my practice. Is I have parents like really in our intake calls, I talk about how data is so essential, even working with adults. Everyone, I need something, I need numbers. If I don't have them, I can't help as well. I can try, but not as well.

SPEAKER_05: 27:31

So go ahead. So do you have some like generalized do's and don'ts when it comes to the sleep hygiene? I I know you mentioned about maybe having dinner time around the same time or physical activity, maybe around the same time. But do you obviously specifics might be specific to the flexibility within the structure as you mentioned, but do you have generalized like rules of uh rules of thumb to as baselines um for sleep uh hygiene or sleep window time?

SPEAKER_00: 27:57

Yeah, I look at it two hours before bed. So I'm like, okay, dinner, if dinner can wrap up about two hours or so before. Um a big piece that I like to support families with is reducing the rush into bedtime. So really focusing on the connection. So kids who have struggles with separating from parents at night, sometimes there's that rush of like, okay, we just got home. Now we have to eat, we gotta shower, we gotta do this, we gotta do that. And there's no downtime for connection and ease and like low demand time. So the only time they actually receive that connection sometimes is like 15 minutes before bed when parents are tired and laying down reading stories. But that wasn't enough for them to co-regulate to bring themselves down and get ready to fall asleep yet. And then their motivation to keep their parent there is higher as well because they haven't received it as much, especially kids with siblings. Sometimes that's the only time they get one-on-one. And that's like gold. So, why would you want to go to sleep when you've got like your golden ticket right here with you? And so supporting families and finding connection throughout that last two hours before bed has been really important in developing the sleep hygiene. Because if we're doing it as a to-do list and kids who are sensitive to demands or sensitive to being told what to do, especially after a long day, that's just adding fuel to the fire sometimes. So it's how do I help families find that place? And it hopefully, and what I've learned, I have my mom now, which is still weird to say, but congratulations, congratulations, 14 months.

SPEAKER_03: 29:44

Oh wow, you're in it. You are in it.

SPEAKER_00: 29:46

I am in it. He's so great, though. So I'm so lucky. I mean, I haven't done I've like I haven't done anything perfect by the book for the sleep stuff. I'm just letting it flow because I think before two, you just have to. Um right, but it's fine, like it's that moment of connection, and just by connecting with your child, you also get that regulated, calm feeling too. And I think it's flipping it from making it a have to as a parent, like, oh, I just want to be alone and I just want to have to get this over with go to sleep, right? But how do I find that reinforcement within that connection for them too to reduce parent burnout as well? And like, so I think there's like a nugget there, and it's been really helpful in developing the sleep hygiene plans. Um, because I used to do it as like uh, here are all the things you should do. And then I'm like, ah, it's not enough.

SPEAKER_03: 30:42

Yeah, not enough. Wow, you you you've opened up a lot of uh thoughts and ideas there, especially with your personal experience. Um, so I guess one of the things that I'll ask about is anything that that in your personal experience now you might have been recommending, and then suddenly you went, man, that's all wrong. Or, oh wow, I can't believe I've been saying that. And there's just that's you know, I I say that because with my three kids, I I like to you know say very honestly, I I got a thousand percent better at what I did every time the day after you know one of them was born. And a lot of that was was was learning something else about the practical aspects of parenting and being like, wow, I think I've suggested this, and that was really stupid. I'm gonna stop doing that, or I'm gonna stop doing that within these circumstances because that was really dumb. I missed. So I don't know. I don't know if you fit any of those in your sleep recommendations.

SPEAKER_00: 31:33

I think even more so now than ever, I'm like, mother's intuition is always right. So don't argue with it, just support it.

SPEAKER_03: 31:41

Go with it.

SPEAKER_00: 31:42

Parent dads, too, like parent intuition. Like, I always ask them, what do you think? Like, what's your gut telling you that will work for them based on what I've already talked about? And I've currently working with a parent too, right now, where like I'm just their soundboard because they know their kid inside and out. And I don't like like I don't approach my position as like I tell you what to do, you need to do it. It's more of a come along side and let me guide you to the end, but let me help you like just think about these decisions from a behavior analytic lens, yeah, in a way that's so received. Um, for me, I like oh my gosh, like there is we went through a 15-month sleep regression, which apparently I knew nothing about. I was like, why does he want me all of a sudden? Like, what's happening in the middle of the night? And so I tried a few things and I'm like, Oh, this is good. Scrap this. I was like, scrap it. I was like, I'm tired, I'm upset, he's upset. I can't like what worked in the past not working now. Like, he's he can come in my bed and we'll figure it out tomorrow. I'm like, it's always figure outable, it's not gonna be the end of the world. Yeah, there's always tomorrow, and guess what? He's fine now, it's just a regression and uh something different.

SPEAKER_03: 33:00

People get really scared with the whole co-sleeping thing. I don't know if you want to speak to that. It's like, oh, we do it once and it's gonna happen forever. And and yes, because there's uh a lot of negative reinforcement to the fact that now they're not crying and everybody's sleeping a little bit. Uh so I don't know if you want to speak to that. I I think that you're making a really good point. We get really fearful of these slippery slopes, and then there's this idea that there's a certain amount of soothing and regulation that is being taught during this time that sleeping is a huge part of, and that going falling asleep is a huge part of, and we continue to learn more about that as adults. And so it is this there, I mean, if if they're if it's ever more of a of being a cook than a baker, sleep training is probably one of those things. You gotta go with the flow. And and it, but but yet people can get so rigid with these, you know, sleep books, and there's these recipes that that you know seem very reasonable, you would say that just not individualized enough.

SPEAKER_00: 34:02

Yeah, I think so. Even within like my practice, I'm like, okay, it's like so I'm implementing this strategy, it's not working. Why? And I think that goes across all areas of behavior analysis. Like, there's a lot of interventions you can pull from. And I think that's just a big part of where your training came from. Was it cookie cutter? Or was it where you're taught to think like a behavior analyst? And that's where, but then there's also the humanity piece. Like this is literally a baby not trying to manipulate me. This is a child not trying to manipulate me. They have a need, they can't communicate it, and I am not ready to figure it out at 3:30 in the morning. You know, and I've tried everything I know in my toolkit, and it's the co-sleeping thing, it's cultural, it's there's definite, you know, there's risks for sure. And I will like there's a lot of shame that came for me while being an early mom, and I'm like, how the heck am I supposed to do this without sleeping? And my husband's getting up too. Like, we're all getting up, we're all not sleeping, and so how can I do this safely? Or there's times where you just fall asleep and you don't even know because you're that tired, and it's you know, like you have to, and for people like I have a sports system, but for people who don't, right? There's just there's a lot of self-compassion around it, and there needs to be a lot of patience for parents and families, and so the co-sleeping thing for sure, he's fine now, like he slept all night by himself, and we're not doing it. It was just like one night of desperation, like a couple nights here and there, desperation for him, not a slippery slope, but for some kids who really um and especially kids uh on the autism spectrum, autistic children, they like sameness. So sometimes I'll encounter families who will I'll be like, Well, when did the sleep problem start? And they say right from infancy, like they did all this when they were babies, and it never shaped out of it because of that need for sameness, that need for you know, that routine, that ritual stayed the same and it was hard to break. And so now it's how do we support them in breaking it? And so that I always find that very interesting.

SPEAKER_03: 36:34

A lot of do you oftentimes find yourself making recommendations which are likely to then lead to a little bit more disruption? Is that a quandary that you face in terms of having because you're you're often asking people to maybe push the envelope in one direction or another? And and that's gotta be so challenging because you know you're walking somebody into a little less sleep, but that might make a difference in the long run. So what what what's your thought on that?

SPEAKER_00: 37:01

Yeah, it's definitely ki parent capacity. Okay. So where are they at with capacity? Do they work full time? Do they have to be up at 5 a.m. every morning? Do they have to be like, you know, like if I how can I ask a parent to like to stay awake all night and try to teach their child to fall asleep on their own, but they have to be up at 5 a.m. because they need to get to work to make a living to keep their house, right? Like you can't and I can't tell them, I can't promise that it's gonna fix it right away. And it can't be like nonsense, yeah, right? So, how do I do it in a way that's so least restrictive? First, try the easy stuff that will hopefully need some reinforcement for them, they'll be able to see some progress. And then, I mean, the hardest one, the hardest one by far is always separating a parent from the co like from the sleep. If the parents really wanting to not be co-sleeping anymore for whatever reason, and they just really want to teach their child to feel confident in falling asleep on their own, sometimes that can be the hardest one. And usually, yeah, usually that's my big biggest. And I usually try to support families to find a time where they feel like they could handle a few rough nights because you will see like you're removing reinforcement, which usually is the parent bed um and just supporting them to fall asleep in their room. So sometimes there can be upset. I'd say like most cases, it's like a couple nights of if the child can cognitively understand, that can help. But for children who struggle with that piece, this is where it can get challenging. And so having a compassionate support person with you to troubleshoot and figure out how we can make this least disruptive and maybe not rush the process to help them understand, then why not? And that's why I don't offer packages with like time crunches and very much kind of like let's you know go with the flow of things and allow parents the space and time they think they need.

SPEAKER_05: 39:16

So when you said um you have a parent hypothetically that uh you know might maybe ask to work at 5 a.m. So you start with the easy stuff. Can you talk to what about what the specific easy stuff would look like?

SPEAKER_00: 39:28

Right. Well, you have like your bedtime routine. So sometimes starting with a bedtime routine, starting with maybe just bedtime fading or supporting that initial fall asleep. Okay. If there's if you can support the initial fall asleep first and then give permission for the night wakings to just let them access to reinforcement, we'll see what happens. I've had cases where you know, successful fall asleep on the onset will start to decrease with a few other like time changes, like some sleep rescheduling can be helpful. Those night wakings will dissipate. And then it actually wasn't that hard. Okay, and then there's other cases which are more complex, and so it's getting it's knowing when to push, and you'll see results in the data, you'll know within three data points, you know, or classic three data points, you know, you'll know within three data points.

SPEAKER_05: 40:25

So there's that initial fall asleep, and then there's the night waking. So, what about like the initial fall asleep? Do you have any kind of you know the easy stuff or some uh recommendations for that? We talked about the sleep hygiene and and sleep schedule, so maybe it's built around that. What if that's not working?

SPEAKER_00: 40:44

So the goal is to teach that falling asleep behavior. So we need to set the stage. The bedroom. Usually most parents who come to me have Googled how to do this already, like how to set a good bedroom up, how to set an evening routine up. They've usually gone through those first stages. So if they have in the assessment, we'll go check, check, check. Everything seems pretty okay there. Then we'll look at the numbers. Okay, let's time bedtime in a way that they're gonna be tired. If the goal, usually if we're the problem, the struggle with falling asleep is typically they need something else present to fall asleep that's not staying for the duration of the night.

SPEAKER_05: 41:23

Okay.

SPEAKER_00: 41:24

So if we can introduce something like um like some other environmental cues that will help, like a stuffed animal or something. You could do a stuffed animal, you could do white noise machine. Usually, I mean stuffed animals sometimes fall off the bed, and then you're dealing with like it's kind of like the soother situation, right? If the soother disappears, it's like, okay, throw five more in there. So hopefully they find one. Um it's the white noise machine, it's usually pretty good. Yeah, um, that's a great one to accustom kids to. Um, you know, they've got if there's a night light that's on, low, they can have their night light in their room. Um, those are some pieces that you might want to hook into that stimulus control and what fall when falling asleep, that's what's happening in the environment because that will stay all night.

SPEAKER_01: 42:15

Okay.

SPEAKER_00: 42:17

With the parent, again, the most common one is fading a parent out, especially when we have night wakings that are pretty disruptive. Um that would be the next phase. How do we do that? So there's ways to do that, and even with Google, you could probably find a few of them. Um, distance fading, so fading the parent out by distance. Again, there's nuance to that based on child anxiety too. So it's not some I've worked with some cases, even some of my actually had a um follow-up call with one of my mentees from the sleep competency program last time, and it worked amazingly. She's like, I told the parents the plan, they called me back um maybe three days later, and they said, Dad's out.

SPEAKER_05: 43:01

And she's like, Great. Hopefully, not too far out.

SPEAKER_00: 43:06

No, like dad's out in the room now, kids falling asleep, no problem. And she's like, That was the easiest plan I ever implemented. I'm like, Yeah, I know. Some of them are like that. Like, some kids are ready and they understand. Um, and then it can regress, like things can happen and and you know, it can come back. But now parents have a tool. Okay. Um, there's other ones like time-based visiting, which I talk a lot about in my CEs, as well as do different nuanced trainings within my program of how to fade a parent out with time. So they say goodnight or they say be right back, they go in, they go out, really teaching their child the trust. So whenever I leave the room doesn't always mean I'm gone forever. And then it also gives them reinforcement for staying in their bed. They can just wait there and the parent will come back and eventually they fall asleep without the parent present. So they just practice that behavior of falling asleep without needing to touch, see, hear, smell their parent to fall asleep. Again, we think of babies, right? Like they do that, they like to touch, smell, like all of that.

SPEAKER_03: 44:10

Yeah, I think of that with uh my youngest now, and uh the uh nursing cloth was a great thing to put in her bassinet, and then she was okay because she had that that sense. Um I I love the way you described, I guess it would be the variance, the variability, the the individualizing that you have to do across the board. So that is to say that you might, um, in terms of of changing co-sleeping, I'm gonna over-generalize this, but you might then get your child their own bed, and then you're gonna have to help regulate. Means you're gonna be at their bedside for a little while. Maybe you get them to fall asleep, and then you go to sleep, and they wake up in the middle of the night and they come to you. And what you're trying to say is depending on the child, depending on your situation, one answer might be, okay, it's time to sleep, just come into my bed, it's fine, we'll try again tomorrow. And then you might play yo-yo with some kids. The idea that if the parent is up for it, you take them back to their bed, you put them down again, you go back to bed, and you might see yourself doing that two or three times in the evening. And and both of those might be acceptable given the circumstance that you're facing. Fair enough?

SPEAKER_00: 45:21

Yeah, absolutely. Yes. So I have I I always I keep this one graph because it's just awesome. But it's like the first night there was like 150 back and forth trips for this client, and they had night wakings, and but it took three nights, it went from like 150 to 50 trips to like maybe 10, three nights was done. Wow. And the parents were like, whoa. Then we had to deal with like some had to deal with some like night wakings and like sleep rescheduling and some other things, but the fading of the parent happened, but it was a lot of effort that first.

SPEAKER_05: 45:56

That parent has to have an insane amount of trust in you after time 112 to get up and do it 130. They were motivated and not just be like, screw it, this person doesn't know what they do.

SPEAKER_03: 46:07

That's a whole different perspective on discrete trial.

SPEAKER_00: 46:10

Yeah, that was when I like would coach through in the moment. Um, I am very useless, though. I have found after nine, especially after having a child now. I'm like, my brain doesn't function. So I like really do a lot of, yeah, I got to sleep. Or like, I don't know. I'm it's like you can't drive under the influence. I can't coach parents under like sleep deprivation. You can't drive under sleep deprivation either. So it's um it's uh I really coach them and give them like what I would do and like talk a lot about like how to problem solve and help. I think help families really through our conversation. I can tell where they're at, and I support them in recognizing where they're at and giving them full permission of like, hey, if we go with this option, it's gonna take longer, but that's okay. We can if you do let them in your room, it happens because it does. And I will tell you, it happens all the time. And then parents avoid me because they feel like they did something wrong. And who won't then that's not helping anybody, right? If they feel like they're gonna get scolded because they did something wrong, but they were just being human, I was like, Yeah, I would probably do that too. Yeah, like a hundred percent would.

SPEAKER_03: 47:27

Inevitably, it's it's some ratio of how many times that you take them back and get them to be longer in their bed versus allow them into your bed. And I mean, I again not trying to oversimplify, but I I think that you're hitting the nail on the head there, and it's it's sometimes easy for us to understand that. And then I think what you're explaining, you've done a very thorough job of understanding the environment that you're dealing with and saying, Yeah, yeah, mom, dad, what what might you be up for? What are what are your tendencies thus far? And what do I think you might be more willing to implement over time? And the idea that somebody did a you know yo-yo back and forth 150 times, again to Dan's point, means they had a lot of trust in your plan.

SPEAKER_00: 48:04

Well, that was like the time-based visiting. So you go in for like that was like 150 trips to teach them that like over time I will come back. So just wait.

SPEAKER_03: 48:13

Yeah, yeah.

SPEAKER_00: 48:14

And sometimes you always had to start back at the beginning at one second, or just like two feet away from the bed, and then work yourself back up to one minute. And so it was back and forth, back and forth. But eventually, I think by day five, the child was like waving the parent away. Like, this is nonsense. Like, can you go? Like, I don't need you anymore. Like, I realized what you wanted me to do, so I'm doing it.

SPEAKER_03: 48:40

You know, and again, it speaks to like the consistency, the rigor, and then more importantly, how gradual this process can be, depending on how long you stretch it out. That's I think that's really important because you can find yourself in in uh you know dire straits, feeling very desperate as a parent when your child is facing sleep challenges, because that means you're also sleep deprived. Uh, and it this really hits your whole point in terms of settling into the routine. This could be gradual. And at the same time, the more rigorous you are in your fidelity to the plan, the you might end up, you know, resolving this in five days. Good for you, uh, which is an ideal situation. Probably doesn't happen all the time, but you're happy when it does.

SPEAKER_00: 49:19

Yeah, and sometimes what happens when you fade a parent out or you fade a sleep dependency out, the real sleep problem comes up. So like night wakings or even just like sporadic sleep schedules. So I know there's a lot of BHPAs who I talk with that have clients who one night will sleep 12 hours, the next night they'll sleep seven, next night they'll sleep six, and then they'll have another 10-hour night. And it's just up and down, up and down. And so when you fade, if you can fade the parent, then that will come up. And so, how do you support that now? So it's all fine and dandy. Yeah, they're sleeping on their own, great, but now we have a bigger problem. They're up at 3 a.m., right? And they're ready for the day. So, how do we build the sleep duration? And so there's other strategies for that, and it's understanding sleep. Like the more I dive into it again, the more you learn, the more you know you don't know, right?

SPEAKER_05: 50:17

Like you don't that's the Dunning Kruger effect right there.

SPEAKER_00: 50:20

Yeah. So it's it's but you have to know like what you're looking at, what's happening, how to come up with a plan and support in a way that's not frantic and panicky or like you know, avoidant as a practitioner, too, because you don't know what to do. So it's how do you do that? And I that's why I really want to support behavior analysts to think deeper about sleep rather than you write an article, implement the article. Like, oh man, like that's we know, like we know that's not how it goes. And sleep, if you mess with it, like it can cause harm.

SPEAKER_05: 50:59

Yeah, can kill you.

SPEAKER_00: 51:00

So you need to know what you're doing.

SPEAKER_05: 51:02

They did uh, I think it was it was a guy in Russia. I think there have been like three cases or something. There's like some syndrome. Definitely one guy in Russia had it where he wasn't able to sleep and he lasted like 16 days or 17 days, and then he died from not being able to sleep. And they did like an interesting case study on him and he went psychotic after like day 10.

SPEAKER_03: 51:19

Those are always fun studies to watch when they had the sleep deprivation studies, and you see people after like day two, and they're just goofy, they're useless. Well, it's a torture, right?

SPEAKER_00: 51:28

Yeah, it's it's torture, it's used for torture. Like it it and that's what that's why I'm very cautious because if I ask parents, and like if anyone like it once you have kids, you know what kind of torture it is to be woken up every two hours or more, right? And some kids will be like every hour. Some I've met some clients where the as infants they slept for 45 minutes at a time. That was it.

SPEAKER_03: 51:53

Sure.

SPEAKER_00: 51:54

And like couch, what do you do? Like that changes a person. It changes a person, it changes their brain, it changes how, and I know for me, my brain is still in recovery mode. I'm very surprised I have not fumbled my words yet on this podcast.

SPEAKER_03: 52:09

You're doing great.

SPEAKER_00: 52:11

I found like my brain would like short circuit, like things would disappear because as a parent, your brain actually rewires, which is wild to me, and I didn't know about that. And apparently it's only it's recent that like humans know about that.

SPEAKER_03: 52:25

So what I forget the uh there's a name for this effect, but uh especially with my my first child, my son, I marveled based on the sleep deprivation, how you get at least I got really good at at napping anywhere, uh, especially if like my son was was close to me or um and the idea that you uh I noticed this pretty early on. I could sleep through anything, but he would make a little peep and I would wake right up. And you know, there'd be all sorts of stuff going on around me. I'd be in the living room and you know, and I would sleep and didn't hear anything, but I would you know be awakened by hearing him move around. And there's these little things that that you do uh I guess you're you're trained by when you're uh when you're a new parent. And yeah, I bet you've got it, you know, more stories about that.

SPEAKER_00: 53:15

I love evolution, you know, like just like how did our bodies come this way? Like it's just so wild. Like we are wired to like we are wired to still sleep, we are meant to still sleep, but then we can survive. I was like surprised at how much I was thriving and like totally fine on very little sleep. Yeah, and it's just a difference. But again, kind of going back to it, is when we are supporting families, we're asking them to move into a little bit of a state of sleep deprivation, right? So we need to be very mindful. Like if I'm gonna ask a parent to stay up all night and they're gonna go drive somewhere with their child in the morning, that's dangerous, yeah. You know, it's dangerous, yeah. Sleep deprivation is way more dangerous than drinking and driving. I think it's dangerous.

SPEAKER_05: 53:59

Absolutely.

SPEAKER_00: 54:00

Micro sleeps, absolutely, micro sleeps are dangerous.

SPEAKER_05: 54:02

It's quick, yeah. Yeah, yeah, it's quick. Definitely been sleep deprived, and remember driving, and then all the headlights coming at you, they don't even register as headlights anymore. It's like some weird like sci-fi movie. Um, you mentioned earlier, um, talking about so maybe the parents have gotten sleep routine down, but now the kid's waking up at 3 a.m. Um in the morning, and then you said, well, then we have to deal with that. So, what would be some recommendations that you would recommend um to deal with that?

SPEAKER_00: 54:33

So the first thing when I see night wakings, actually, the first thing I do with any sleep issue is support the medical rule out and understanding what are some medical considerations because usually we are getting kids that have possible co-occurring medical issues, and not anyone has ever asked about it. Okay, and it's wild to me because but again, I wasn't fully trained on that side of things. I am I think in an I thought at one point I really liked human anatomy, physiology in my first year, and then I was like, nope, I don't want to do science for my degree, so like science, science, like bio, you know, like the intense math spread of science. And so I went with the psychology route. But I am very fascinated about the human body, about medical. My husband works in the medical field, and so I took it on myself to learn about okay, well, what do other I had spoken with a sleep apnea, um, like a respiratory therapist who runs like a Snore MD or a sleep apnea clinic here. And they had a whole list of things they asked their patients for medical reasons. I was like, okay, great. I'm gonna take that list, I'm gonna add to that list. I've spoken to sleep doctors, I've spoken to I've like through just learning about different co-occurring issues that can cause sleep difficulties from nutrient deficiencies to like gastrointestinal issues. If that's not taken into account when we see these night wakings, we shouldn't be addressing them medical or behaviorally because there are many cases that I've supported that I'm like, this sleep thing is a medical thing, and we need to figure out how to get medical support on this and how to help them understand and advocate within the system.

SPEAKER_03: 56:25

And pause. Sorry to interrupt. This is Mike, and this concludes part one of our interview with Nicole Shallow. Please do return for part two as she's lending some fascinating information. See you then.

SPEAKER_04: 56:40

Always analyze responsible.

SPEAKER_02: 56:43

ABA on tap is recorded live and unfiltered. We're done for today. You don't have to go home, but you can't stay here. See you next time.