|Behavioral Assessment and Treatment of Sleep Problems in Children With Developmental Disabilities and Rare Genetic Developmental Disorders
|Sunday, May 24, 2020
|12:00 PM–12:50 PM
|Walter E. Washington Convention Center, Level 1, Room 103
|Area: DDA; Domain: Applied Research
|Chair: Laurie McLay (University of Canterbury)
|CE Instructor: Amarie Carnett, Ph.D.
Sleep problems are often reported among children with developmental disabilities, such as autism spectrum disorder (ASD), and rare genetic developmental disorders, such as Angelman, Williams, and Rett Syndromes. Without treatment, these problems can cause cascading effects on the functioning and development of the child. The use of behavioral interventions is well founded in the literature for the treatment of sleep problems in these populations. Utilizing a functional behavior assessment can help determine the reinforcement contingencies that are prolonging the sleep problem and help guide the intervention selected for treatment. As such, this symposium contains a series of presentations that evaluate behavioral treatments for sleep problems as follows: (a) analysis the current literature on behavioral interventions to treat sleep problems in children with autism, (b) the efficacy of personalized and assessment-based behavioral intervention on the sleep problems of children diagnosed with ASD, and (c) the evaluation of circadian manipulations and function-based interventions for sleep problems in children with rare genetic developmental disorders.
|Instruction Level: Intermediate
|Keyword(s): autism, genetic disorders, sleep problems
|Learning Objectives: 1. Attendees will learn about the quality of behavioral research for the treatment of sleep problems for children with autism. 2. Attendees will learn about the procedures used in conducting behavioral assessments of sleep. 3. Attendees will learn about the procedures used to manipulation sleep-wake times, including faded bedtime procedures.
Quantitative Analysis of Behavioral Interventions to Treat Sleep Problems in Children With Autism
|AMARIE CARNETT (Victoria University of Wellington), Sarah Grace Hansen (Georgia State University), Laurie McLay (University of Canterbury), Leslie Neely (The University of Texas at San Antonio), Russell Lang (Texas State University-San Marcos)
Sleep is an essential activity for human development. Often, children with autism spectrum disorder (ASD) are affected by a lack of sleep due to various types of sleep problems. We identified and analyzed studies that were aimed at utilizing sleep interventions for children with ASD. A systematic search of databases, reference lists, and ancestral searches identified 18 studies for inclusion. Studies were summarized in terms of (a) participants, (b) targeted sleep problem and measures, (d) intervention components, (e) research design and rigor, and (f) results. The aim of this review was to analyze the literature by evaluating the most commonly treated sleep problems, the various treatment components, and strength of the results using a between case parametric effect size estimate. The most commonly treated sleep problems were night wakings and bedtime disturbance. For interventions, all the studies incorporated multiple treatment components, most often including the use of a consistent bedtime routine. Effect size calculations indicated a moderate effect size, however, limited due to the small number of studies. Results suggest the overall effectiveness of behavioral interventions for the treatment of sleep problems for children with ASD. Based on our analysis, suggestions for practitioners regarding current practices and future directions for research are discussed.
|Assessment and Treatment of Sleep Problems in Young Children
|SANDY JIN (California State University, Northridge), Frank Gutierres (California State University, Northridge), Sevan Ourfalian (California State University, Northridge)
|Abstract: : Sleep problems are prevalent and persistent in young children, especially children diagnosed with Autism Spectrum Disorder (ASD). These problems negatively impact the health and development of young children and are often challenging to address for caregivers and clinicians. Pharmacological interventions, such as melatonin, are commonly recommended for pediatric sleep problems despite limited research on their efficacy and social acceptability. Function-based behavioral interventions show merit as a promising alternative but has yet to draw to focus of mainstream treatment providers. This present study evaluated the efficacy of personalized and assessment-based behavioral intervention on the sleep problems of children diagnosed with ASD. Nighttime infrared video and sleep diary were used to measure sleep interfering behaviors, sleep onset delay, night and early waking, the total amount of sleep, as well as other relevant variables in the participating children. Parents and caregivers were encouraged to assist with treatment development during the assessment process and served as interventionists at home following behavioral skills training. A multiple-baseline-across-subjects designed was used to evaluate the treatments. Parents also provided feedback on the acceptability of each treatment and on their satisfaction with the outcomes.
Evaluating the Relative Effectiveness of Circadian Manipulations and Function-Based Interventions for Sleep Problems in Children With Rare Genetic Developmental Disorders
|LAURIE MCLAY (University of Canterbury), Karyn G. France (University of Canterbury), Neville Morris Blampied (University of Canterbury), Caitlin Busch (University of Canterbury), Emma Woodford (University of Canterbury)
The prevalence of sleep problems in children with Rare Genetic Neurodevelopmental Disorders (RGND) such as Angelman, Williams, and Rett Syndromes, far exceeds that observed in typically developing children. These problems are commonly attributed to biological and circadian rhythm abnormalities and, consequently, are predominantly treated medically/pharmacologically. While biological and genetic factors are important, this should not preclude considering the role of the environment and learning in the etiology and maintenance of the sleep problem. We present the results of a single-case, multiple baseline design study that investigated the effectiveness of multi-component interventions for up to six children with RGND and sleep problems. Phase 1 of intervention consisted of the manipulation of sleep-wake times, including faded bedtime procedures. Phase 2 consisted of the introduction of function-based interventions following functional-behavioral assessment. Short- and long-term follow-up data is also reported. Preliminary analysis indicates that circadian manipulations alone may be sufficient to reduce sleep problems in children with RGND, though in some cases, function-based interventions were also required. The implications of these findings for clinical practice and research will be discussed.