Follow-up of telehealth parent training for sleep disturbances in young children with autism spectrum disorder

Cynthia R Johnson; Leah Barto; Sarah Worley; Rebecca Rothstein; Megan L Wenzell

doi:10.1016/j.sleep.2024.04.022

Follow-up of telehealth parent training for sleep disturbances in young children with autism spectrum disorder

Sleep Med. 2024 Apr 23:119:114-117. doi: 10.1016/j.sleep.2024.04.022. Online ahead of print.

Authors

Cynthia R Johnson¹, Leah Barto², Sarah Worley², Rebecca Rothstein², Megan L Wenzell³

Affiliations

¹ Case Western Reserve University, USA; Cleveland Clinic, USA. Electronic address: johnsoc@ccf.org.
² Cleveland Clinic, USA.
³ Case Western Reserve University, USA.

PMID: 38669834
DOI: 10.1016/j.sleep.2024.04.022

Abstract

Objective/background: Bedtime and sleep disturbances are ubiquitous in children with autism. The telehealth delivery of a behavior analytic parent training program was earlier reported to be efficacious in improving child sleep and parent sense of competency. Our aim in this brief report was to determine the durability of the telehealth delivered sleep parent training program (SPT) compared to the control condition in this randomized controlled trial. Telehealth delivery could be a means to expand access to such early treatment if efficacious.

Participants/methods: Parents of young children, ages 2-7 years, with autism and co-occurring sleep disturbances were enrolled in this study. Participants were randomized to either SPT or a comparison arm that included non-sleep related parent education except for one session Sleep Parent Education; SPE). Each participant was individually administered a 5 session program delivered over 10 weeks. Outcome measures were collected at weeks 5 and 10 and at post-treatment follow-up at 16 weeks.

Results: Follow-up week 16 data were available for 30 participants randomized to SPT and 24 participants randomized to SPE. Demographics for this follow-up cohort were similar to the full sample. At week 16 follow-up, there was a significant group difference between SPT and SPE the Modified Simonds & Parraga Sleep Questionnaire-Composite Sleep Index (MSPSQ - CSI) (p = 0.011) with an effect size of 0.68. Further, 8 of the 10 children in SPT who were negative responders at the week 10 endpoint were rated as positive responders at week 16 by the treatment masked IE compared to 2 out of 12 in the SPE group (p = 0.008).

Conclusions: Post-treatment follow-up data suggests SPT is durable over time compared to SPE, the active control group. Further, for some participants in SPT, a positive responsive emerged after the treatment endpoint. This brief report adds to the efficacy of SPT as a time-limited intervention for insomnia in young autistic children.

Keywords: Autism; Autism spectrum disorder; Bedtime problems; Behavioral intervention; Clinical Global Impression; Composite Sleep Index; Improvement scale; Insomnia; Modified Simonds & Parraga Sleep Questionnaire; Parent training; Randomized controlled trial (RCT); Sleep; Sleep disturbances; Sleep problems.