Our 18-year-old daughter has Tetrasomy 18p (chromosome18 registry for info) and level 3 autism. She is a cooperative, sweet and nice girl. A common condition for T18p people is that their sleep is inconsistent; Zoe's sleep is short, 15 minutes to maybe 3 hrs, when she is tired. The point is that Zoe if often up late usually in her room on her Ipad. But, if Zoe is awake her parents are also up with her. To allow he parents typical sleep patterns, caregivers will come into the home around 9:30- 10 p.m. and stay with Zoe until she is clearly sleeping or until early morning. There is flexibility. During this time, the caregiver is in Zoe's room, at times engaged with Zoe, but also minor kitchen cleaning and processing family laundry. Zoe is non-verbal (sign language and Ipad) and incontinent. Occasional diaper changes.