Targeting Insomnia in School-Aged Children with Autism Spectrum Disorder
Abstract
Rationale and Objectives: Children with autism often have difficulties falling and staying asleep at night. Those sleep difficulties can contribute to daytime problems with irritability, learning, and behavior. Parents are often stressed about their child’s sleep difficulties and, as a result, their sleep can suffer as well. Treatment that focuses on establishing behaviors and routines that help reduce arousal and support good sleep are helpful for improving the sleep of children without autism, but have not yet been tested in children with autism. We developed and did some initial testing of a new sleep treatment for children with autism. The results showed the treatment improved sleep in both children and their parents. Further, it helped improve daytime behavior in the children and reduced fatigue in the parents. Some interested families were not able to participate because they lived several hours from our center. We developed a remote version of the treatment so that those families could participate in the treatment from their own homes using computers with cameras. The remote treatment also improved the sleep of both children and their parents in our test families. Our initial tests of both the in-person (child and parent visited our center for treatment) and remote sleep treatment produced promising results. Now we wish to move forward with testing both treatments in more children. Both treatments include detailed therapy manuals that give providers step-by-step instructions on how to deliver the treatment. They also include patient workbooks that contain information and activities to help the child and parent to practice the techniques learned during treatment sessions at home. The treatment is tailored to each child’s most concerning sleep problems, and both the child and parent(s) work closely with their therapist on how best to incorporate the treatment techniques into their lifestyle. Having a remote version of the treatment can expand the number of children and families that are able to receive this promising treatment. This may be particularly important for children with ASD living in rural and underserved areas, as well as those in military families that may not have access to a healthcare provider with training in behavioral sleep treatments. The trial we are proposing addresses several of the Fiscal Year 2019 Autism Research Program Clinical Trial Award Areas of Interest. Specifically, it addresses the following critical needs of the ASD community: (1) behavioral and cognitive therapies to alleviate co-occurring conditions (i.e., insomnia, anxiety), (2) dissemination of clinically validated interventions, and (3) healthcare provider-focused tools to improve healthcare delivery for individuals with ASD (CBT-CI-A includes a therapist manual and patient workbook). Types of Patients Helped and How: We will test in-person and remote versions of the treatment in school-aged children (6-12 years) with ASD and comorbid insomnia. Both versions of the treatment use established techniques to promote behaviors that support good sleep (e.g., reducing or eliminating the use of computers and other screens before bed), help the child cope with thoughts that may interfere with sleep (e.g., concerns about school performance), and help the child relax before bedtime. Being too aroused before bed can interfere with sleep, and the techniques used in both versions of the treatment may work by reducing that arousal. Therefore, we will also see whether the treatments reduce that arousal. We will also compare the in-person and remote treatments to see whether they work equally well. Clinical Applications, Benefits, and Risks: We expect to see improvements in the children’s sleep and daytime behavior. We also expect to see decreases in their levels of arousal following both versions of the treatment. Further, we anticipate seeing improvements in the parents’ sleep, arousal, mood, levels of fatigue, and s
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010399
Entities
People
- Christina S. McCrae
Organizations
- Curators of the University of Missouri
- United States Army