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Behavioural treatment for sleep problems in children with severe learning disabilities and challenging daytime
1University of Oxford Section of Child and Adolescent Psychiatry, Park Hospital for Children, Headington, UK. lucinda.wiggs@psychiatry.oxford.ac.uk
Insights
Behavioral interventions improved sleep for children with severe disabilities, benefiting mothers too. Treatment effects may be indirect, impacting clinical practice for these families.
Area of Science:
- Pediatric Sleep Medicine
- Developmental Disabilities
- Behavioral Therapy
Background:
- Children with severe learning disabilities often experience significant sleep problems.
- These sleep issues are frequently associated with behavioral disturbances and management challenges for parents.
- Understanding effective interventions for this population is crucial for improving quality of life.
Purpose of the Study:
- To investigate the efficacy of behavioral interventions for severe sleep problems in children with severe learning disabilities.
- To explore the mechanisms through which these behavioral treatments impact sleep in this specific group.
- To assess the effects on both the children's sleep and maternal well-being.
Main Methods:
- A randomized controlled trial comparing 15 families receiving behavioral advice for childhood sleep problems with 15 matched controls.
- Sleep assessments included parental reports and actometry for both children and mothers.
- Interventions focused on behavioral advice for the child's sleep issues.
Main Results:
- Objective measures (actometry) did not show significant changes in children's sleep quality or quantity.
- Mothers in the intervention group reported improvements in their children's sleep problems.
- Mothers in the intervention group also reported increased personal sleeping time.
Conclusions:
- Behavioral interventions can successfully address sleep problems in children with severe learning disabilities.
- The mechanisms of treatment may be indirect, influencing parental perception and maternal sleep.
- Findings have implications for clinical practice and understanding sleep in children with developmental challenges.
Abstract:
Children with sleep problems present serious management problems to their parents. Such children are also more likely to have additional problems, behavioural disturbance being particularly common. This randomized controlled trial of behavioural interventions for the children's sleep problems was conducted to explore the efficacy and mechanisms of treatment in children with the most extreme forms of problems: severe learning disabilities, severe sleep problems and severe daytime challenging behaviour. Fifteen index families received behavioural advice for the child's sleep problem and compared with 15 matched controls who received no such advice. Repeat assessments of the children's and mothers' sleep were made by parental report as well as actometry. Objective changes in the children's sleep quality and quantity were not seen after treatment. However, mothers in the treatment group reported improvements in the children's sleep problems and had an increased sleeping time themselves following treatment. The results indicate that sleep problems can be successfully treated in this group of children, although the mechanisms of treatment may not be as direct as supposed. This has implications for understanding of sleep problems in children with learning disabilities and also for clinical practice, when considering ways of offering help to these highly 'challenged' families.