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Testing Sensory and Multisensory Function in Children with Autism Spectrum Disorder
Published on: April 22, 2015
Protocol for targeting insomnia in school-aged children with autism spectrum disorder without intellectual
Christina S McCrae1, Micah O Mazurek2, Ashley F Curtis3,4
1Psychiatry, University of Missouri, Columbia, MO, USA mccraec@health.missouri.edu.
Insights
This study investigates Cognitive Behavioral Therapy for Childhood Insomnia (CBT-CI) in children with autism spectrum disorder (ASD). Findings may improve sleep treatments for ASD and insomnia.
Area of Science:
- Pediatric Sleep Medicine
- Autism Spectrum Disorder Research
- Behavioral Therapy
Background:
- Insomnia affects up to 80% of children with autism spectrum disorder (ASD), leading to decreased quality of life, impaired cognition, and increased parental stress.
- Cognitive Behavioral Treatment for Childhood Insomnia (CBT-CI) is effective but not yet studied in school-aged children with ASD.
- Healthcare access is a challenge for children with ASD, especially in rural areas.
Purpose of the Study:
- To examine the efficacy of CBT-CI adapted for children with ASD and comorbid insomnia.
- To compare two delivery modes: in-person and remote.
- To assess the impact of CBT-CI on child and parent sleep, daytime functioning, and parental stress.
Main Methods:
- A randomized controlled trial involving 180 children aged 6-12 years with ASD and insomnia.
- Participants will be randomized to adapted CBT-CI (in-person or remote) or Sleep Hygiene education.
- Assessments include objective/subjective sleep, daytime functioning, quality of life, physiological arousal, and parental burden at baseline, post-treatment, and 6/12-month follow-ups.
Main Results:
- This is a pre-results abstract; therefore, no results are available.
- Data collection is expected to conclude by 2024.
- Full trial results are planned for publication by 2025.
Conclusions:
- This trial is the first to adapt and examine CBT-CI for school-aged children with ASD and insomnia.
- Findings may inform the development of targeted treatments for childhood insomnia in ASD.
- Investigating remote delivery can improve healthcare access for underserved populations.
Introduction:
Insomnia affects up to 80% of children with autism spectrum disorder (ASD). Negative consequences of insomnia in ASD include decreased quality of life (QOL), impaired learning and cognition, increased stereotypic and challenging behaviours, and increased parental stress. Cognitive behavioural treatment for childhood insomnia (CBT-CI) is a promising treatment for dealing with insomnia and its negative consequences but has not yet been studied in school-aged children with ASD and comorbid insomnia. Access to healthcare is another challenge for children with ASD, particularly in rural and underserved regions. Previous studies indicate that ASD and insomnia share common arousal-based underpinnings, and we hypothesise that CBT-CI will reduce the hyperarousal associated with insomnia and ASD. This trial will be the first to examine CBT-CI adapted for children with ASD and will provide new information about two different modes of delivery across a variety of primary and secondary child and parent sleep and related outcomes. Knowledge obtained from this trial might allow us to develop new or modify current treatments to better target childhood insomnia and ASD.
Methods And Analysis:
Children (N=180) 6-12 years of age with ASD and insomnia will be recruited from an established autism database, a paediatric clinic and community outreach in the Columbia, MO and surrounding areas. Participants will be randomised to CBT-CI adapted for children with ASD (in-person or remote using computers with cameras) or Sleep Hygiene and Related Education. Participants will be assessed at baseline, post-treatment, 6-month and 12-month follow-ups. The following assessments will be completed regarding the children: objective and subjective sleep, daytime functioning (adaptive functioning, attention, challenging behaviours, anxiety), QOL and physiological arousal (heart rate variability) and parents: objective and subjective sleep, daytime functioning (anxiety, depression, fatigue), QOL, physiological arousal and parental burden/stress.
Ethics And Dissemination:
Ethics approval was obtained in January 2020 from the University of Missouri. Ethics approval was obtained in July 2020 from the US Army Medical Research and Development Command, Office of Research Protections and Human Research Protection Office. All data are expected to be collected by 2024. Full trial results are planned to be published by 2025. Secondary analyses of baseline data will be subsequently published.
Trial Registration Number:
NCT04545606; Pre-results.
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