Children who need naps must be allowed to sleep during ABA therapy when needed.
The Indiana Health Coverage Programs (IHCP), which administers Indiana Medicaid programs, has announced a policy about sleep and naps during applied behavior analysis (ABA) therapy. The policy is intended to make sure children can get the sleep they need while receiving therapy.
Sleep is important for brain development and can affect attention, learning, memory, and behavior. Providers must follow American Academy of Pediatrics (AAP) recommendations for sleep based on the child's age and work with parents and guardians to determine when naps are needed.
What does the policy say?
Beginning with this policy announcement, providers must follow these requirements:
- Naps must be included in the treatment schedule when needed. If a child needs naps based on their age and individual needs, the provider must include the necessary nap time in the treatment plan.
- Sleep-related medical needs must be considered. If a child has medical conditions or other issues that affect sleep, the provider must coordinate with the child's primary care provider and family to determine appropriate nap arrangements.
- Children must not be forced to stay awake. Providers cannot prevent a child from sleeping because nap time is not billable. They also cannot physically move a child, tickle them, or force them to participate in activities to keep them awake or wake them up.
- Families and providers must work together. If sleep concerns affect therapy schedules, families and providers must coordinate to determine an appropriate schedule and adjust therapy hours when needed.
The policy also addresses situations when a child becomes sick, experiences medication side effects, or has other circumstances that affect sleep. In these cases, the provider and parent or guardian should decide whether the child should remain in therapy while napping or go home.
What does this mean for families?
Every child is different. Although age and nighttime sleep may indicate that a child could benefit from a nap, not every child will need one.
If your child receives ABA therapy, you can talk with your provider about your child's sleep needs and how they are being addressed during therapy. If your child regularly needs naps or is repeatedly sent home because of sleep, the policy calls for the family and provider to work together to determine a more appropriate therapy schedule.
Remember: Children who need sleep during ABA therapy must be allowed to nap. Therapy schedules should support a child's essential sleep needs rather than require them to stay awake when they need rest.
Questions? Contact Indiana Health Coverage Programs Customer Assistance at 800-457-4584.
Source: Indiana Health Coverage Programs, Bulletin BT2026159, September 29, 2026.
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