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Treatment of multiple sleep problems in children with developmental disabilities: faded bedtime with response cost
C C Piazza1, W W Fisher, M Sherer
1Neurobehavioral Unit, Kennedy Krieger Institute, Baltimore, MD 21205, USA.
Insights
Faded bedtime with response cost (FBRC) significantly improved sleep in children with developmental disabilities. This behavioral intervention offers a validated option for addressing common sleep problems in this population.
Area of Science:
- Behavioral psychology
- Developmental disabilities research
- Sleep science
Background:
- Sleep problems are prevalent in individuals with developmental disabilities and severe behavior issues.
- Empirically validated treatments for these sleep disturbances are limited.
Purpose of the Study:
- To compare the efficacy of faded bedtime with response cost (FBRC) against a standard bedtime scheduling procedure.
- To treat multiple sleep problems in children with developmental disabilities and severe behavior problems.
Main Methods:
- Faded bedtime with response cost (FBRC): systematic bedtime delay, response cost for delayed sleep onset, and gradual bedtime advancement.
- Bedtime scheduling: consistent sleep/wake times and prevention of daytime napping.
- Comparison of sleep improvements between two groups of children with developmental disabilities.
Main Results:
- Children in the FBRC group showed significantly greater sleep improvement compared to the bedtime scheduling group.
- FBRC demonstrated superior efficacy in addressing multiple sleep problems.
Conclusions:
- Faded bedtime with response cost is an effective behavioral intervention for sleep problems in children with developmental disabilities.
- Further research into behavioral and biological mechanisms underlying FBRC efficacy is warranted.
Abstract:
Sleep problems are a common concern for persons with mental retardation and severe behavior problems, yet few empirically validated treatment options exist. In the current investigation, the efficacy of a faded bedtime with response cost treatment was compared with a bedtime scheduling procedure in treating the multiple sleep problems of two groups of children with mental retardation, sleep problems, and other severe behavior problems. Faded bedtime with response cost (FBRC) consisted of systematic delay of bedtime, removal from bed if sleep was not initiated within 15 minutes (response cost), and a fading procedure to gradually advance the bedtime. The bedtime scheduling procedure consisted of a consistent sleep and wake time and prevention of daytime sleep. The sleep of children in the FBRC group improved significantly more than the sleep of children in the bedtime scheduling group. Results are discussed in terms of behavioral and biological mechanisms which may contribute to the efficacy of FBRC.