None listed
Conditions
Brief summary
This study aims to evaluate the efficacy of a brief behavioural sleep program (Sleeping sound) in reducing children's sleep problems and emotional behavioural disturbance and parents functioning and wellbeing in a sample of primary school aged autistic children with sleep problems, within a community clinic context.
Interventions
The Sleeping Sound intervention involves two 50-minute face-to-face sessions and a follow-up phone call at 2 week intervals delivered by a clinician (e.g., Paediatrician or Psychologist or Provisional Psychologist), experienced in working with autistic children. The first session will focus on assessing specific sleep difficulties that the child is experiencing and setting goals in relation to the specific sleep problems. Families will be provided with psychoeducation in relation to sleep hygien
The Sleeping Sound intervention involves two 50-minute face-to-face sessions and a follow-up phone call at 2 week intervals delivered by a clinician (e.g., Paediatrician or Psychologist or Provisional Psychologist), experienced in working with autistic children. The first session will focus on assessing specific sleep difficulties that the child is experiencing and setting goals in relation to the specific sleep problems. Families will be provided with psychoeducation in relation to sleep hygiene and normal sleep patterns, and a tailored sleep management plan that includes their agreed upon goals and tailored sleep management techniques. Examples of the behavioural sleep management techniques that may be individually tailored to participants include bedtime fading to treat delayed sleep phase and early morning rising, relaxation techniques for sleep anxiety, primary caregivers ‘camping out’ for sleep onset association disorder, and parent management techniques (such as enforcing boundaries) that may be coupled with a reward system for bedtime resistance. Sleep management strategies may be delivered using a range of study designed visual tools (e.g., visual sleep schedules, social scripts etc.) to reinforce learning. Families will be given a sleep diary and asked to record bed time, sleep time, wake time and any night time awakenings for the two weeks following the first face-to-face session. Clinicians will keep a study consultation form of the session to document precipitating, predisposing, and perpetuating factors impacting the child’s sleep problems, which includes bedtime routines, sleep environment, medications and co-morbid psychological disorders. The second session is held two weeks later and will be used to reinforce sleep strategies, monitor sleep patterns (by reviewing a sleep diary), and to troubleshoot any difficulties that the family may be experiencing. This will involving reviewing the sleep diary completed over the preceding period and discussing the use of the strategies recommended in the first session. These details, alongside any new strategies recommended and other relevant clinical information will be recorded. A follow up phone call (< 30 minutes) will then be made to the family two weeks later to provide further support and an opportunity to reinforce strategies. Again, there will be an opportunity to review the sleep diary, discuss strategies used, and to update the clinical/intervention record. The clinicians will receive training in the intervention prior to commencing sessions and participate in regular supervision sessions.
Sponsors
Monash University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
5 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Child is autistic and aged 5-13 years AND Having a moderate or severe sleep problem by parent report and need to meet criteria for at least one of the following behavioural sleep problems as defined by the American Academy of Sleep Medicine diagnostic criteria: chronic insomnia (due to problems of sleep onset association, limit setting, prolonged night time waking, primary insomnia, early waking, or anxiety) or delayed sleep phase disorder AND • Child has not been diagnosed with an intellectual disability on parent report • Living in Victoria Participants currently taking melatonin as well as any other medications (SSRI’s etc.) will be included in the trial, if they continue to meet the above eligibility criteria. Information regarding medication will be collected as part of the parent survey. Parent/caregiver eligibility requirements: • Parent/caregiver of child who meets child eligibility requirements AND • Living in Victoria, Australia AND • Have sufficient English proficiency to provide informed consent and answer online questionnaires
Exclusion criteria
Participants will be excluded if they have any comorbid medical (e.g., tuberous sclerosis, nocturnal seizures, blindness), neuropsychiatric (e.g., Tourette’s) or genetic (e.g., Fragile X disorder) conditions associated with intellectual disability or disturbing regular sleep patterns. Children with suspected obstructive sleep apnoea (OSA) will be identified using 3 OSA items from the Child Sleep Habits Questionnaire. If a parent endorses snoring usually or sometimes and one of the other two items of the OSA screening questions as usually or sometimes), that child will be referred to a paediatric fellow for a follow up assessment sleep apnoea. If the child is determined to have sleep apnoea from this assessment, they will be excluded from the research study and referred to their paediatrician for treatment.
Outcome results
None listed