OBJECTIVE: Sleep problems are common in children with autism spectrum disorders (ASD) and ADHD and impact adversely on child and parent well-being. The study evaluated the efficacy of a brief behavioral sleep intervention in children with comorbid ADHD-ASD.
METHOD: A subsample of children with ADHD-ASD ( n = 61; 5-13 years; 89% male) participating in the Sleeping Sound With ADHD study were included in the current investigation. The subsample comprised of 28 children randomized to the sleep intervention group, while 33 were randomized to usual clinical care. The intervention consisted of two clinical consultations and a follow-up phone call covering sleep hygiene and standardized behavioral strategies.
RESULTS: Children with ADHD-ASD who received the intervention had large improvements in sleep problems and moderate improvements in child behavioral functioning 3 and 6 months post-randomization.
CONCLUSION: These findings suggest that a brief behavioral sleep intervention can improve sleep problems in children with ADHD-ASD.
Abstract This study investigated the effectiveness of functional behavioral assessment (FBA)?informed interventions for sleep problems, particularly co-sleeping, in children with autism spectrum disorder (ASD). Seven children, who exhibited multiple sleep problems including unwanted co-sleeping, participated. FBA, based on information derived from interviews and parent-recorded sleep diaries, was used to develop individualized case formulations upon which multicomponent, parent-implemented interventions were based. These were evaluated using a single-case, non-concurrent multiple-baseline-across-participants design. Improvements were observed across all sleep problems, including the elimination of co-sleeping. Gains were maintained at follow-up for five out of seven children, though two children did not complete intervention. Parents reported high levels of satisfaction with the program. FBA-based interventions for sleep problems in children with ASD and their clinical implications are further discussed.
Sleep disturbance and executive dysfunction have been widely reported in children with autism spectrum disorder. While the positive impacts of physical activity on sleep quality and cognition are documented in children with typical development, similar studies in children with autism spectrum disorder are scarce. The objective of this study was to examine the impact of physical activity on sleep quality and cognition in children with autism spectrum disorder. A total of 40 children diagnosed with autism spectrum disorder (mean age = 9.95 years) were randomly assigned into two groups: physical activity intervention and control. Four sleep parameters (sleep efficiency, sleep onset latency, sleep duration, and wake after sleep onset) and two executive functions (inhibition control and working memory) were assessed. Results revealed a significant improvement in sleep efficiency, sleep onset latency, and sleep duration in the intervention group but not in the control group during weekdays. Moreover, a significant improvement in inhibitory control was shown in the intervention group but not in the control group. No significant improvement in working memory capacity was documented in either group (ps > 0.05). Our findings highlight the value of physical activity in improving sleep quality and cognition among children with autism spectrum disorder, but specific physical activity may be required to benefit individual executive functions.
This study evaluated the effectiveness of Bedtime Fading with Response Cost (BFRC) in decreasing sleep disturbances in children with Autism Spectrum Disorder (ASD) using parents as change agents by implementing treatment in the home environment. A non-concurrent multiple baseline design across three participants was used. Results indicate that BFRC was effective in eliminating unwanted co-sleeping, frequent night awakenings, and dependent sleep onset. Secondary improvements include reducing sleep onset latency, bedtime resistance, and disruptive sleep-related behaviors. Follow-up data demonstrate gains were maintained. Parents reported high satisfaction with BFRC and sleep outcomes for their children. This study extends both the practice and science of parent-implemented behavioral interventions as treatment options for children with ASD and co-occurring sleep disturbances.
This study examined the associations between sleep and challenging behaviors for average and night-to-night fluctuations in sleep, in 39 children with autism spectrum disorder (ASD) receiving intensive behavioral intervention (IBI). Child sleep was recorded (via actigraphy) for five nights in conjunction with clinician-reported observations of challenging behaviors. Results indicated that on average, poor sleep was associated with higher rates of repetitive behavior, negative affect, and a composite of overall challenging behaviors. These findings suggest that average sleep patterns are important within the context of IBI (rather than night-to-night fluctuations). Interventions aimed at improving overall patterns of sleep may have important cascading effects on challenging behaviors and developmental outcomes for children with ASD and their families.
OBJECTIVE: To evaluate prospectively the effectiveness of cognitive behavioral therapy (CBT) in children with autism spectrum disorder (ASD).
METHODS: Drug-naïve children who met the DSM-V criteria for a diagnosis of ASD were recruited from a day care center, specialized in long-term treatment of children and adolescents with ASD. Symptom assessment was performed using the Aberrant Behavior Checklist (ABC) before (base-line) and after 12 months (follow-up) of CBT.
RESULTS: Nine boys with a mean age of 6 (±2.0) years were included. Compared to baseline, significant improvements of symptoms of irritability (p = 0.012), hyperactivity (p = 0.008) and lethargy (p = 0.008) were observed at follow-up.
CONCLUSION: Results indicate that CBT is an effective therapy for children with ASD. Larger studies are needed to give more details about which symptoms respond best in these patients.
Background: Physical inactivity, motor coordination difficulties, and sleep problems are often present in autism spectrum disorder (ASD). Sleep problems seem to persist into young adulthood. Physical activity (PA) may positively impact both sleep and daytime behaviour.
Objectives: The first part of the study investigated sleep, sleepiness, and PA in 15 young adults (age 18-35 years old) with ASD compared to typically developing controls (TDC). The second part of the study investigated the effects of a 15-week PA intervention on PA levels, gross motor proficiency, daytime functioning, and sleep in 12 of the young adults with ASD.
Methods: Young adults with an autism diagnosis (inclusive of all levels of functioning) and TDC wore a wrist-worn actigraph to gather objective PA and sleep data. Questionnaires on sleep, sleepiness, and PA were completed through participant or parent-report. Further, the ASD sample completed a daytime functioning measure, gross motor proficiency, and autism symptom severity assessment.
Results: The ASD group had more sleep duration but took longer to fall asleep than TDC. Objective PA levels were lower in the ASD sample, but those with more PA had increased sleepiness and earlier bedtimes and wake times. Fewer wake minutes during the sleep period in the ASD group were associated with more PA the following day. Results included an autism symptom severity by time interaction effect for objective PA, an improvement in subjective sleep quality, a reduction in behaviour problems - specifically Attention Deficit/Hyperactivity (AD/H) problems - and an improvement in physical strength. Correlations were found between objective PA and bilateral coordination, AD/H, and antisocial personality problems.
Conclusion: Our findings support previous research that demonstrates differences in sleep parameters and PA between ASD and TDC. Interventions aimed at increasing PA in ASD may be beneficial for sleep and more PA the following day. These findings indicate the potential benefit of group-based PA interventions on PA level, gross motor proficiency, daytime functioning, and sleep in young adults with ASD.
Children with ASD experience high rates of sleep disturbance, but there are limited interventions addressing sleep in this population. We investigated the feasibility and acceptability of a specialized swim program, Sensory Enhanced Aquatics, for children with ASD. Additionally, we examined the extent to which the physical activity intervention impacted children’s sleep behavior as well as specific child characteristics in those most responsive to intervention. We used a pre-post intervention design to test the effects of an 8-week swim intervention on sleep of ten children aged 5-12 years. Caregivers completed measures of sleep disturbance, autism severity, and sensory processing. Findings showed that children differentially responded to the swim intervention based on autism severity and sensory processing. Children with increased sensory sensitivity and decreased autism severity showed decreased sleep disturbance following the intervention. Results showed that the intervention was feasible and highly acceptable. Sensory Enhanced Aquatics differentially improved the sleep behaviors of children with ASD based on specific child characteristics. This is relevant to recreational therapist who may need to match intervention to child characteristics for best response.
The purpose of this pilot study was to determine if participation in an aquatic exercise program improves sleep in children with Autism Spectrum Disorder (ASD). Participants included 8 children. An A-B-A withdrawal design was utilized. Each phase lasted for 4 weeks. The treatment included 60 min of aquatic exercise 2X/week. Phone calls to parents of the participants were made throughout the duration of the study. Parents were asked questions related to sleep latency, nighttime wakenings, and sleep duration. A one way repeated-measures analysis of variance (ANOVA) was utilized to determine if differences existed between phases. Statistically significant difference existed for sleep latency ( p < .001) and sleep duration ( p < .001). These results suggest that participation in aquatic exercise may improve the sleep habits of children with ASD.
Background/Aims: Sleep and rest disturbances in children with an autism spectrum disorder and sensory over-responsivity are challenging issues to address. These are important self-care challenges that are commonly faced by many individuals with an autism spectrum disorder, with a high percentage of individuals with an an autism spectrum disorder reporting sleep disturbances. Many health-related professions, including occupational therapy, use weighted blankets to assist children with an autism spectrum disorder to calm, fall asleep and remain asleep. The purpose of this study was to explore the efficacy of weighted blankets with children with an autism spectrum disorder and sleep disturbances using a single case, multiple baseline design. Methods: This pilot study included two children with an autism spectrum disorder and sensory overresponsivity. Results: Using a single subject design found that there were minimal changes reported via caregivers, indicating that weighted blankets assisted in improving the overall quality of sleep for their child with an autism spectrum disorder, specifically time to fall asleep, number of wakings in the night, duration of sleep and behaviour in the morning. Using visual analysis, changes were noted in the variability of data points but not with abrupt changes in the slope of trend lines. Conclusions: This study provides a valuable springboard justifying the necessity for additional research studies related to improving the quality of sleep in children with an autism spectrum disorder and sensory over-responsivity using more robust single subject design methodology and objective measurement resources.
Sleep problems are common in children with autism spectrum disorders (ASD) and ADHD and impact adversely on child and parent well-being. The study evaluated the efficacy of a brief behavioral sleep intervention in children with comorbid ADHD-ASD.
METHOD:
A subsample of children with ADHD-ASD ( n = 61; 5-13 years; 89% male) participating in the Sleeping Sound With ADHD study were included in the current investigation. The subsample comprised of 28 children randomized to the sleep intervention group, while 33 were randomized to usual clinical care. The intervention consisted of two clinical consultations and a follow-up phone call covering sleep hygiene and standardized behavioral strategies.
RESULTS:
Children with ADHD-ASD who received the intervention had large improvements in sleep problems and moderate improvements in child behavioral functioning 3 and 6 months post-randomization.
CONCLUSION:
These findings suggest that a brief behavioral sleep intervention can improve sleep problems in children with ADHD-ASD.
