Effects of a Standardized Pamphlet on Insomnia in Children With Autism Spectrum Disorders

Abstract

OBJECTIVE Sleep difficulties are common reasons why parents seek medical intervention in children with autism spectrum disorders (ASDs). We determined whether a pamphlet alone could be used by parents to help their child’s insomnia. METHODS Thirty-six children with ASD, ages 2 to 10 years, were enrolled. All had prolonged sleep latency confirmed by actigraphy showing a mean sleep latency of 30 minutes or more. Parents were randomly assigned to receive the sleep education pamphlet or no intervention. Children wore an actigraphy device to record baseline sleep parameters, with the primary outcome variable being change in sleep latency. Actigraphy data were collected a second time 2 weeks after the parent received the randomization assignment and analyzed by using Student’s t test. Parents were also asked a series of questions to gather information about the pamphlet and its usefulness. RESULTS Although participants randomized to the 2 arms did not differ statistically in age, gender, socioeconomic status, total Children’s Sleep Habits Questionnaire score, or actigraphy parameters, some differences may be large enough to affect results. Mean change in sleep-onset latency did not differ between the randomized groups (pamphlet versus no pamphlet). Parents commented that the pamphlet contained good information, but indicated that it would have been more useful to be given specific examples of how to take the information and put it into practice. CONCLUSIONS A sleep education pamphlet did not appear to improve sleep latency in children with ASDs.

Non‐pharmacological interventions for non‐respiratory sleep disturbance in children with neurodisabilities: a systematic review

“…All RCTs were assessed as having high risk of bias for most items on the Cochrane Risk of Bias tool because of issues with randomization and incomplete outcome data. We were unable to find a registered protocol for 10 RCTs, and in all RCTs blinded outcome assessment was either not undertaken or it was unclear whether blinding had occurred . However, we do note that the type of interventions and outcomes under investigation make robust, blinded outcome assessment challenging.…”

“…Three RCTs and five before‐and‐after studies evaluated comprehensive non‐tailored interventions . Various modes of delivery were used across the studies (Table ).…”

“…One RCT compared a sleep training curriculum delivered by a booklet with no intervention; one compared two modes of delivering the same curriculum group versus individual face‐to‐face sessions supplemented by weekly telephone calls; and one compared group with individual delivery of a training curriculum . The before‐and‐after studies evaluated a group‐delivered intervention; a single session workshop; and an individually delivered intervention…”

The effects of Dexamethasone on sleep in young children with Acute Lymphoblastic Leukemia

“…The CSHQ is a widely used proxy measure of children’s sleep that is based on the parent’s assessment of their child’s sleep problems. It has been validated in children aged 4–10 years, and it has been used extensively in the study of parent-reported sleep problems in young children who are normally developing [13,14], and in children with sleep disorders [13,14], autism [15], epilepsy [16], ALL [5], and neurodevelopmental delays [15]. The CSHQ is a 56-item multiple-choice questionnaire that is summed into eight subscales and a total score.…”

Comorbid Conditions in Individuals with Intellectual Disabilities

“…They also feel that they need information and treatment that is specific to their child. For example, Adkins et al (Adkins et al 2012) enrolled 36 children aged 2-10 years with ASD in a study where parents were randomly assigned to receive an educational pamphlet or no intervention. Follow-up revealed no differences between groups, and parents who had been given the pamphlet indicated they would prefer a more individualized approach.…”