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Optimizing the Better Nights, Better Days for Children with Neurodevelopmental Disorders program for large scale

Alzena Ilie1, Matt Orr1, Shelly Weiss2

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Frontiers in Sleep
|December 22, 2025
PubMed
Summary
This summary is machine-generated.

Parents found the Better Nights, Better Days for Children with Neurodevelopmental Disorders (BNBD-NDD) program helpful, though some needed more support. Optimizing BNBD-NDD can improve its large-scale implementation for pediatric insomnia.

Keywords:
barriers and facilitatorsbehavioral interventionchildreneHealthinsomniainterventionneurodevelopmental disorders (NDDs)transdiagnostic

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Area of Science:

  • Pediatric Sleep Medicine
  • Digital Health Interventions
  • Neurodevelopmental Disorders

Background:

  • Pediatric insomnia is prevalent, particularly in children with neurodevelopmental disorders (NDDs).
  • The Better Nights, Better Days for Children with Neurodevelopmental Disorders (BNBD-NDD) is an eHealth intervention for parents of children (ages 4-12) with NDDs and insomnia.

Purpose of the Study:

  • To identify barriers and facilitators impacting the reach, effectiveness, adoption, implementation, and maintenance of the BNBD-NDD program.
  • To assess differences in these factors based on engagement levels and NDD type (ASD vs. ADHD).

Main Methods:

  • Qualitative interviews were conducted with 20 parents randomized to the BNBD-NDD treatment arm.
  • Rapid analysis using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was employed.

Main Results:

  • Facilitators generally outweighed barriers for Reach, Effectiveness, Implementation, and Maintenance.
  • Engaged parents highlighted program design and behavior change facilitators; unengaged parents desired more support.
  • Parents of children with Autism Spectrum Disorder (ASD) reported more facilitators and barriers than parents of children with Attention-Deficit/Hyperactivity Disorder (ADHD).

Conclusions:

  • Participant feedback provides insights for optimizing BNBD-NDD for wider implementation.
  • Modifications can enhance parent support, strategy implementation, and accessibility of this evidence-based treatment.