10 Ways Home Visitors Should Respond to Sleep Concerns in Children
August 21, 2025
Figuring out a consistent, successful sleep schedule is a major priority for every parent of a baby or toddler. If you’re a home visitor who works with young children and their families, you probably often hear from parents who struggle with sleep concerns—and maybe you’re looking for ways to help.
Excerpted and adapted from Tackling the Tough Stuff and ASQ®:SE-2 Learning Activities & More, the tips in today’s post are a good starting point for helping parents and other caregivers navigate sleep issues with very young children.
Start with the right questions. Be alert for opportunities to ask and wonder about a child’s sleep behavior and be ready to share recommendations when caregivers ask for help. Some questions you might ask include:
- How is your baby sleeping?
- What time do they go to bed? What time do they wake up in the morning?
- Do they sleep through the night?
- How often do they wake at night? What happens when they wake up? What do you do?
- When do they nap? How long do they nap?
- What concerns or questions do you have about your child’s sleep?
Ensure that goals are age-appropriate. Make sure the sleep goals that parents have for the child make sense from a developmental perspective. Help caregivers recognize that their children’s needs for support related to sleep will change over time. What works for an infant may not work as the child approaches 3 years.
Set the stage during the day. Have parents arrange for playtime in a well-lit or sunny room to help a child establish a day and night cycle. Teach and support the family to use an appropriate daytime schedule and sleep routine.
Foster rituals. Show parents how to use rituals around their child’s sleep routine. Explain that rituals are something you do over and over, the same way each time. For example, when baby looks sleepy, parents can sing a bedtime song, gently rock them, and then lay them down to sleep. Baby will learn that this ritual means it’s almost time to sleep, and that will help the baby get ready for the change.
ASQ®:SE-2 Learning Activities & More
Available in both English and Spanish, the ASQ®:SE-2 Learning Activities & More include age-specific parent handouts on big topics important to social-emotional development: feeding, sleeping, and calming.
Support parents in helping babies fall asleep on their own. Research shows that children who learn to sleep on their own with little assistance may be the best sleepers. Paradoxically, active maternal strategies intended to help a baby settle to sleep were found in families in which babies were the poorest sleepers. Encourage parents to put the baby down for naps and bedtime when the child is sleepy but not asleep. This will help the baby learn to fall asleep on their own.
Discourage hovering. Advise parents to avoid frequently checking in on the baby, as this may disrupt their sleep. If the baby or toddler wakes at night, encourage parents to wait briefly (e.g., several minutes) to see if the child can fall asleep on their own. Tell them not to wait so long that the child becomes significantly upset or distressed. Encourage parents to resettle the child, if needed, while keeping a quiet and calm manner.
Make changes slowly. Support parents in slowly changing the routine as their baby grows. For example, if the parent wants the child to take fewer naps and sleep for longer times, tell them to try keeping the baby awake a few minutes longer before each nap. Remind parents that by making small changes and moving slowly, they cause less stress for the baby.
Want more guidance on working with parents?
Check out Tackling the Tough Stuff: “a vital tool for translating research-based strategies into comprehensive, actionable guidance for home visitors.”—Dorian Traube, Ph.D., LCSW, Washington University, St. Louis.
Encourage use of alerts. As babies become toddlers, they may benefit from several alerts before starting the bedtime routine. It’s hard for children to stop playing, and alerts may prevent upsets. Show parents how to use alerts, such as “In 10 minutes, it will be time to get ready for bed.” They can give additional alerts at 5 and 3 minutes.
Emphasize choice-making. Parents of toddlers should provide choices during the bedtime routine: “Do you want to wear your whale pajamas, or your cat pajamas?” “This book first, or that book?” All these small choices give independent toddlers a little sense of control over bedtime.
Consider underlying issues. Despite their best efforts, some families will experience ongoing difficulties with sleep, due to underlying issues such as genetic conditions, medical issues, or exposure to early trauma. Help support families in gaining access to other needed resources, including more direct interventions from medical or behavioral health professionals.
For more guidance on helping families navigate sleep and other challenging issues, add the books behind today’s blog post to your program’s library!
Tips 1, 2, 3, 5, 6, and 10 adapted from Tackling the Tough Stuff: A Home Visitor’s Guide to Supporting Families at Risk, Second Edition, by Angela M. Tomlin, Ph.D., HSPP, IMH-E®, & Stephan A. Viehweg, LCSW, ACSW, IECMH-E®, CYC-P
Tips 4, 7, 8, and 9 adapted from ASQ®:SE-2 Learning Activities & More, by Elizabeth Twombly, Leslie J. Munson, & Lois M. Pribble
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