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Behavioural treatment for sleep problems in children with severe learning disabilities and challenging daytime
1University of Oxford Section of Child and Adolescent Psychiatry, Park Hospital for Children, Headington, UK. lucinda.wiggs@psychiatry.oxford.ac.uk
Insights
Behavioral sleep interventions did not specifically reduce challenging behaviors in children with severe learning disabilities. Non-specific effects, like increased sleep duration, benefited behavior in both groups.
Area of Science:
- Developmental Psychology
- Clinical Psychology
- Pediatric Sleep Medicine
Background:
- Children with severe learning disabilities often exhibit challenging daytime behaviors and significant sleep problems.
- Behavioral interventions are commonly used to address sleep issues in children.
- The relationship between sleep problem resolution and daytime behavior requires further investigation.
Purpose of the Study:
- To investigate if behavioral treatment of sleep problems in children with severe learning disabilities reduces challenging daytime behavior.
- To assess the impact of sleep interventions on behavior as reported by mothers and teachers.
- To differentiate specific treatment effects from non-specific study participation effects.
Main Methods:
- A randomized controlled trial involving 30 children with severe learning disabilities, challenging behavior, and sleep problems.
- Intervention group received a tailored behavioral sleep program with therapist support.
- Aberrant Behavior Checklist used for baseline and 1- and 3-month follow-up assessments.
Main Results:
- No specific behavioral changes were observed exclusively in the intervention group.
- Improvements in some behaviors were noted in both intervention and control groups at follow-ups.
- Mothers' and teachers' reports showed agreement on many observed behavioral changes.
Conclusions:
- Non-specific factors, such as increased sleep duration experienced by both groups, may positively influence child behavior.
- The resolution of sleep problems per se might not be the primary driver of behavioral improvement.
- Further research is needed to identify and utilize these non-specific therapeutic factors.
Abstract:
The study aimed to investigate a group of children with severe learning disabilities, challenging daytime behaviour, and severe sleep problems to see if successful behavioural treatment of the children's sleep problems resulted in reduced daytime challenging behaviour as reported by mothers and teachers. A randomised controlled trial of behavioural interventions for the children's sleep problems was conducted (N = 30). The intervention group received an individually tailored behavioural programme and were supported by telephone calls from the therapist. Baseline assessments of the children's behaviour were made using the Aberrant Behavior Checklist and were repeated 1 month and 3 months after the start of intervention. There were no behavioural changes that were specific to children in the treatment group. However, improvements in some behaviours were seen in both the intervention and the control group at the 1-month and 3-month assessments and there was agreement between mothers' and teachers' reports for many of these changes. The results suggest that nonspecific effects of participating in the study (including an increased sleep duration, which was seen in both groups), rather than resolution of sleep problem per se, may have a beneficial effect on child behaviour and these factors need to be identified for therapeutic use.