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Article: Cognitive behavioral treatment of insomnia in school‐aged children with autism spectrum disorder: A pilot feasibility study

TitleCognitive behavioral treatment of insomnia in school‐aged children with autism spectrum disorder: A pilot feasibility study
Authors
Keywordsautism
insomnia
child
parent
cognitive behavioral therapy
Issue Date2020
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1939-3806
Citation
Autism Research, 2020, v. 13 n. 1, p. 167-176 How to Cite?
AbstractInsomnia is common in autism and associated with challenging behavior and worse parent sleep. Cognitive behavioral treatment for childhood insomnia (CBT‐CI) is efficacious in typically developing children, but not yet tested in school‐aged children with autism. This single arm pilot tested 8‐session CBT‐CI in 17 children with autism and insomnia (M age = 8.76 years, SD = 1.99) and their parent(s) (M age = 39.50 years, SD = 4.83). Treatment integrity was assessed for each session [delivery (by therapist), receipt (participant understanding), and enactment (home practice)]. Children and parents wore actigraphs and completed electronic diaries for 2‐weeks to obtain objective and subjective sleep onset latency (SOL), total sleep/wake times (TST/TWT), and sleep efficiency (SE) at pre/post/1‐month follow‐up. Parents also completed the Aberrant Behavior Checklist [irritability, lethargy, stereotypy, hyperactivity, inappropriate speech (e.g., excessive/repetitive, loud self‐talk)] at pre/post/1‐month. Fifteen children completed all sessions. Average integrity scores were high [90%‐delivery/receipt, 87.5%‐enactment]. Parents found CBT‐CI helpful, age‐appropriate, and autism‐friendly. Paired samples t‐tests (family‐wise error controlled) found CBT‐CI improved child sleep (objective SOL‐18 min, TWT‐ 34 min, SE‐5%; subjective SOL‐29 min, TST‐63 min, TWT‐45 min, SE‐8%), and decreased irritability, lethargy, stereotypy, and hyperactivity. At 1‐month, objective TST improved, inappropriate speech decreased, but hyperactivity was no longer decreased. Other gains were maintained. Parent sleep (objective SOL‐12 min, TST‐35 min, TWT‐21 min, SE‐4%; subjective SOL‐11 min, TWT‐ 31min, SE‐11%) and fatigue also improved. At 1‐month, gains were maintained. This pilot shows CBT‐CI is a feasible treatment that holds promise for improving child and parent sleep and functioning and suggests a randomized controlled trial in school‐aged children with autism is worth conducting. Autism Res 2020, 13: 167–176. © 2019 International Society for Autism Research, Wiley Periodicals, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/293509
ISSN
2023 Impact Factor: 5.3
2023 SCImago Journal Rankings: 1.686
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMcCrae, CS-
dc.contributor.authorChan, WS-
dc.contributor.authorCurtis, AF-
dc.contributor.authorDeroche, CB-
dc.contributor.authorMunoz, M-
dc.contributor.authorTakamatsu, S-
dc.contributor.authorMuckerman, JE-
dc.contributor.authorTakahashi, N-
dc.contributor.authorMcCann, D-
dc.contributor.authorMcGovney, K-
dc.contributor.authorSahota, P-
dc.contributor.authorMazurek, MO-
dc.date.accessioned2020-11-23T08:17:48Z-
dc.date.available2020-11-23T08:17:48Z-
dc.date.issued2020-
dc.identifier.citationAutism Research, 2020, v. 13 n. 1, p. 167-176-
dc.identifier.issn1939-3792-
dc.identifier.urihttp://hdl.handle.net/10722/293509-
dc.description.abstractInsomnia is common in autism and associated with challenging behavior and worse parent sleep. Cognitive behavioral treatment for childhood insomnia (CBT‐CI) is efficacious in typically developing children, but not yet tested in school‐aged children with autism. This single arm pilot tested 8‐session CBT‐CI in 17 children with autism and insomnia (M age = 8.76 years, SD = 1.99) and their parent(s) (M age = 39.50 years, SD = 4.83). Treatment integrity was assessed for each session [delivery (by therapist), receipt (participant understanding), and enactment (home practice)]. Children and parents wore actigraphs and completed electronic diaries for 2‐weeks to obtain objective and subjective sleep onset latency (SOL), total sleep/wake times (TST/TWT), and sleep efficiency (SE) at pre/post/1‐month follow‐up. Parents also completed the Aberrant Behavior Checklist [irritability, lethargy, stereotypy, hyperactivity, inappropriate speech (e.g., excessive/repetitive, loud self‐talk)] at pre/post/1‐month. Fifteen children completed all sessions. Average integrity scores were high [90%‐delivery/receipt, 87.5%‐enactment]. Parents found CBT‐CI helpful, age‐appropriate, and autism‐friendly. Paired samples t‐tests (family‐wise error controlled) found CBT‐CI improved child sleep (objective SOL‐18 min, TWT‐ 34 min, SE‐5%; subjective SOL‐29 min, TST‐63 min, TWT‐45 min, SE‐8%), and decreased irritability, lethargy, stereotypy, and hyperactivity. At 1‐month, objective TST improved, inappropriate speech decreased, but hyperactivity was no longer decreased. Other gains were maintained. Parent sleep (objective SOL‐12 min, TST‐35 min, TWT‐21 min, SE‐4%; subjective SOL‐11 min, TWT‐ 31min, SE‐11%) and fatigue also improved. At 1‐month, gains were maintained. This pilot shows CBT‐CI is a feasible treatment that holds promise for improving child and parent sleep and functioning and suggests a randomized controlled trial in school‐aged children with autism is worth conducting. Autism Res 2020, 13: 167–176. © 2019 International Society for Autism Research, Wiley Periodicals, Inc.-
dc.languageeng-
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1939-3806-
dc.relation.ispartofAutism Research-
dc.rightsPreprint This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Postprint This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectautism-
dc.subjectinsomnia-
dc.subjectchild-
dc.subjectparent-
dc.subjectcognitive behavioral therapy-
dc.titleCognitive behavioral treatment of insomnia in school‐aged children with autism spectrum disorder: A pilot feasibility study-
dc.typeArticle-
dc.identifier.emailChan, WS: chanwais@hku.hk-
dc.identifier.authorityChan, WS=rp02506-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/aur.2204-
dc.identifier.pmid31566918-
dc.identifier.scopuseid_2-s2.0-85073952489-
dc.identifier.hkuros319278-
dc.identifier.volume13-
dc.identifier.issue1-
dc.identifier.spage167-
dc.identifier.epage176-
dc.identifier.isiWOS:000488566000002-
dc.publisher.placeUnited States-
dc.identifier.issnl1939-3806-

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