Faded Bedtime Intervention for Delayed Sleep Onset in an Adolescent With Autism Spectrum Disorder

Abstract

We report the case of an 18-year-old girl who had autism spectrum disorder (ASD) and demonstrated persistent delayed sleep onset after going to bed in her group home at a residential school. Intervention consisted of a faded bedtime in which her customary time to bed was extended later into the night, then gradually made earlier as she started falling asleep more rapidly over the course of many weeks. By conclusion of the study and at a 1-month follow-up, the girl was falling asleep in less than 30 min after going to bed and sleeping an average of 8.4 hr each night. Compared with previous research with children in inpatient and home environments, the study found positive effects from a faded bedtime intervention without additional procedures, targeted an adolescent with ASD, and was conducted by care providers in a novel residence setting.

Applied behavior analysis measurement, assessment, and treatment of sleep and sleep‐related problems

“…Finally, Luiselli et al (2020) extended faded bedtime without response cost to an 18-year old woman who had ASD and lived in a group home at a residential school. Preceding intervention, she averaged 2.3 hr to fall asleep and only 6.7 hr of continuous sleep each night.…”

“…Maintenance of behavioral treatment that improves sleep quality has been reported 3-14 weeks postintervention (Lichtblau et al, 2018;Luiselli et al, 2020;Piazza & Fisher, 1991;van Deurs et al, 2019) and as long as 9-12 months later (O'Reilly et al, 2004;Thiele et al, 2001). In some cases, follow-up results were measured while components of treatment remained in effect or for a period of time after sleep problems had resolved and treatment was discontinued.…”

The Effect of Napping on the Function of Problem Behavior for One Child With an Acquired Brain Injury

“…Overall, there is certainly a high amount of research documenting the prevalence of sleep disturbance amongst typically and atypically developing children. Behavioral treatment approaches to address sleep disturbance have largely been successful too (Adams & Rickert, 1989; Brown & Piazza, 1999; Finley & Cowley, 2005; Jin et al, 2013; Lichtblau et al, 2018; Luiselli et al, 2020). However, these common behavioral treatment recommendations may be less effective for individuals who sleep at night but become fatigued during the day, like some individuals diagnosed with ABI.…”

Parent-Mediated Home Intervention for Delayed Sleep-Onset and Night Waking in a Child With Autism Spectrum Disorder

“…Faded bedtime. In order to increase the reinforcing effects of falling asleep by manipulating physiological sleep pressure, Joe's typical bedtime was scheduled later in the evening at 8:00 p.m. (Luiselli et al, 2020;Piazza & Fisher, 1991). This new bedtime remained constant throughout the intervention phase.…”