The relative efficacy of two brief treatments for sleep problems in young learning disabled (mentally retarded)
P Montgomery1, G Stores, L Wiggs
1University of Oxford Section of Child and Adolescent Psychiatry, Park Hospital, Headington, Oxford, UK. paul.montgomery@psych.ox.ac.uk
Insights
A brief behavioral treatment delivered via booklet was as effective as face-to-face therapy for improving sleep problems in children with learning disabilities. This accessible method significantly reduced settling and night waking issues, with lasting results.
Area of Science:
- Pediatric Sleep Medicine
- Developmental Psychology
- Behavioral Therapy
Background:
- Sleep problems like settling difficulties and night waking are common and persistent in children with learning disabilities.
- Access to effective behavioral treatments is limited due to scarce resources.
Purpose of the Study:
- To evaluate the effectiveness of a media-based, brief behavioral sleep treatment for children with learning disabilities.
- To compare face-to-face treatment delivery against a control group.
- To compare booklet-delivered treatment against control groups.
Main Methods:
- A randomized controlled trial involved 66 children (aged 2-8 years) with severe learning disabilities and sleep problems.
- Behavioral interventions were delivered either face-to-face or through an illustrated booklet.
- Sleep diaries were used to create a composite sleep disturbance score.
Main Results:
- Both face-to-face and booklet treatments were nearly equally effective compared to controls.
- Two-thirds of children with significant sleep issues showed marked improvement.
- Improvements in settling and night waking problems were sustained at six-month follow-up.
Conclusions:
- Booklet-delivered behavioral treatments are as effective as traditional face-to-face therapy for most children with learning disabilities experiencing sleep problems.
- Media-based interventions offer a viable and accessible alternative for managing pediatric sleep disturbances.
Background:
Settling and night waking problems are particularly prevalent, persistent, and generally considered difficult to treat in children with a learning disability, although intervention trials are few. Scarce resources, however, limit access to proven behavioural treatments.
Aims:
To investigate the efficacy of a media based brief behavioural treatment of sleep problems in such children by comparing (1) face-to-face delivered treatment versus control and (2) booklet delivered treatment versus controls.
Methods:
The parents of 66 severely learning disabled children aged 2-8 years with settling and/or night waking problems took part in a randomised controlled trial with a wait-list control group. Behavioural treatments were presented either conventionally face-to-face or by means of a 14 page easy to read illustrated booklet. A composite sleep disturbance score was derived from sleep diaries kept by parents.
Results:
Both forms of treatment were almost equally effective compared with controls. Two thirds of children who were taking over 30 minutes to settle five or more times per week and waking at night for over 30 minutes four or more times per week improved on average to having such settling or night waking problems for only a few minutes or only once or twice per week (H = 34.174, df = 2, p<0.001). These improvements were maintained after six months.
Conclusions:
Booklet delivered behavioural treatments for sleep problems were as effective as face-to-face treatment for most children in this population.
