A Randomized Controlled Trial to Evaluate the Effect of Tailored Behavioral Sleep Interventions for Non-Respiratory Sleep Disorders in Children with Neurodisability Compared to Routine Care

Participants will be randomised into one of two active intervention groups.: 1) Receive Intervention A- individual eADVICE-online sleep program accessed by parent as many times as they wish (IxA). 2) Receive Intervention B- parent group telehealth delivered by a psychologist or specialist sleep nurse trained in delivery of sleep interventions (IxB). Intervention group A will be an individualised program for the child accessed by the parent using an electronic device, The interventions will be structured by the initial answers given by parents when completing questions in the introductory part of the program, about their child’s sleep. Answers will lead to a decision tree for treatment advice, based on the problems described. The decision tree will include generic advice regarding sleep hygiene and routines and then lead on to specific treatments for specific sleep problems, funnelling participants to the correct advice according to their responses. For example if a participant reports sensory processing concerns advice will be directed to a module regarding management of sensory issues relating to sleep. Modules will include: psychoeducation around sleep, bedtime routines, special consideration at bedtime relating to diagnosis (example visual impairment and bedtime), how we change behaviour, specific sleep strategies directly treating a sleep issue (for example: camping out method for a sleep association). Age modules of preschool, school aged and high school aged show adapted content and examples to suit the age. Participants can choose to receive treatment advice in a printable text format or from an online character (“Dr Sam”) that interacts with them. Printable text will be dependant on how much advice is required, however generally would be 2-3 page handouts. The online interaction will be provided by short 5-10 minute interactions with "Dr Sam" for each strategy/advice. Parents can revisit the program to input additional information, resulting in modification of subsequent treatment advice. Families will be self-directed in their access to the online program, with up to them how often they access it. The families can access the program at any time through the 12-month study, with frequency of access the program logged. Intervention group B is a parent-based group behavioural intervention based on an intervention found to be effective in children with Attention Deficit and Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD), an important subgroup of the neurodisability (ND) population. For this study the program will be adapted to suit a wider spectrum of ND groups. The intervention will involve two group telehealth sessions (2 hours in duration) conducted 7 days apart. Each group session will involve the Educator (trained professional-sleep clinical nurse or psychologist) and 2-4 parents. Session content will include modules on sleep hygiene, sleep amount/timing/regularity, bedtime routine and finally strategies to minimise bedtime resistance, night wakings and co-sleeping (i.e., graduated extinction, bedtime pass, social story). Homework will involve datasheets to complete each night, including elements discussed in the sessions taking approximately 15-30 minutes to complete. Two follow-up phone calls 2 weeks apart with the educators and each parent will occur to check compliance and completion of homework tasks.