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Nighttime fears in children: clinical characterisation and the user needs and preferences for a digital parent-led
Melissa Aji1,2, Amy Datyner3, Julie Gougeon3
1Black Dog Institute, University of New South Wales, Sydney, NSW, Australia. m.aji@blackdog.org.au.
Insights
Nighttime fears in children are common and linked to anxiety and sleep problems. A new digital, parent-led intervention is proposed to help families address these challenges effectively.
Area of Science:
- Pediatric Psychology
- Child Psychiatry
- Digital Health Interventions
Background:
- Nighttime fears are prevalent in children, often leading to sleep disturbances and later anxiety disorders.
- Existing research and treatment options for childhood nighttime fears are limited, leaving families with few accessible, evidence-based interventions.
- This study addresses the need for better understanding and accessible support for children experiencing nighttime fears.
Purpose of the Study:
- To assess the clinical profile of children experiencing nighttime fears.
- To explore parents' needs and preferences for intervention.
- To inform the co-design of a digital, parent-led, exposure-based intervention for nighttime fears.
Main Methods:
- A mixed-methods co-design approach was employed with parents of children aged 7-12 years.
- Online assessment battery included diagnostic instruments for psychiatric disorders and sleep disturbances.
- Semi-structured interviews and a focus group with psychologists provided qualitative insights.
Main Results:
- Separation Anxiety Disorder and Specific Phobia were common diagnoses; 70% experienced pathological sleep disturbances.
- Parents and children reported significant emotional distress, with limited access to care.
- Psychologists highlighted the crucial role of parents and the need for structured support.
Conclusions:
- Children with nighttime fears frequently have co-occurring psychiatric disorders and sleep issues.
- A co-designed, parent-led digital intervention shows promise in addressing a critical need for families.
- This approach may provide accessible, evidence-based support for managing childhood nighttime fears.
Background:
Nighttime fears are highly prevalent and are associated with sleep disturbances and later anxiety disorders. Despite their impact, research and treatment options remain limited. Few studies have examined the clinical profile of this population. Families have few intervention options, especially those that are accessible and evidence-based. This mixed-methods study aimed to [1] assess the clinical profile of children experiencing nighttime fears, and [2] explore parents' needs and preferences to inform the co-design of a digital, parent-led exposure-based intervention.
Methods:
A co-design approach (N = 44) was used involving an online assessment battery with parents of children aged 7-12 years experiencing nighttime fears (n = 34; M child age = 9.6 years; 56% female), two phases of semi-structured interviews with a separate group of parents (n = 5; median child age = 10.7 years; 60% female), and a focus group with psychologists (n = 5; median age: 31.0; 60% female). The assessment battery included a diagnostic instrument assessing DSM-5 psychiatric disorders, and a measure of sleep disturbances. Interviews explored both parents' experiences and their feedback on a prototype intervention. Psychologists discussed clinical insights and treatment approaches. Quantitative data were analysed descriptively; qualitative data were analysed using framework analysis.
Results:
Separation Anxiety Disorder (24%) and Specific Phobia - Natural/Environment type (23%) were the most common primary diagnoses. Sleep disturbances were prevalent, with 70% scoring in the pathological range for initiating and maintaining sleep. Qualitative findings revealed significant emotional distress for both children and parents, limited access to care and the need for clear guidance. Psychologists emphasised the central role of parents and the need for structured support.
Conclusions:
Children with nighttime fears often meet criteria for psychiatric disorders and experience significant sleep issues. A co-designed and parent-led digital intervention may address a critical gap for families.
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