Telehealth cognitive behavioral therapy for insomnia in children with autism spectrum disorder: A pilot examining feasibility, satisfaction, and preliminary findings

被引：45

作者：

McCrae, Christina S. ^{[1
]}

Chan, Wai Sze ^{[2
]}

Curtis, Ashley F. ^{[1
]}

Nair, Neetu ^{[1
]}

Deroche, Chelsea B. ^{[1
]}

Munoz, Melissa ^{[1
]}

Takamatsu, Stephanie ^{[1
]}

McLean, Deija ^{[1
]}

Davenport, Mattina ^{[1
]}

Muckerman, Julie E. ^{[1
]}

Takahashi, Nicole ^{[1
]}

McCann, Dillon ^{[1
]}

McGovney, Kevin ^{[1
]}

Sahota, Pradeep ^{[1
]}

Mazurek, Micah O. ^{[3
]}

机构：

[1] Univ Missouri, Columbia, MO 65212 USA

[2] Univ Hong Kong, Hong Kong, Peoples R China

[3] Univ Virginia, Charlottesville, VA 22903 USA

来源：

AUTISM | 2021年 / 25卷 / 03期

关键词：

autism; child; cognitive behavioral therapy; insomnia; parent; telehealth; PERVASIVE DEVELOPMENTAL DISORDERS; RANDOMIZED CONTROLLED-TRIAL; SCHOOL-AGE-CHILDREN; SLEEP PROBLEMS; YOUNG-CHILDREN; INTERVENTION; QUESTIONNAIRE; ADOLESCENTS; ASSOCIATIONS; DISABILITIES;

D O I：

10.1177/1362361320949078

中图分类号：

B844 [发展心理学（人类心理学）];

学科分类号：

040202 ;

摘要：

Insomnia is common in children with autism. Cognitive behavioral treatment for childhood insomnia may improve sleep and functioning in children with autism and their parents, but delivery involving multiple office visits limits accessibility. This single-arm pilot study tested telehealth delivery of eight-session cognitive behavioral treatment for childhood insomnia in 17 children (6-12 years) with autism spectrum disorder and insomnia and their parent(s). Treatment integrity was assessed each session (delivery, by therapist;receipt, participant understanding; andenactment, home practice). Treatment satisfaction was assessed after treatment. Children and parents wore actigraphs and completed electronic diaries for 2 weeks, children completed 5-min Holter Monitoring (assessed heart rate variability, physiological arousal indicator), and parents completed Aberrant Behavior Checklist before and after 1 month. Average integrity scores were high (98%,delivery; 93%,receipt; and 82%,enactment). Parents found cognitive behavioral treatment for childhood insomnia helpful, age-appropriate, and autism-friendly. Paired-samplest-tests (family-wise error controlled) indicated telehealth cognitive behavioral treatment for childhood insomnia improved childandparent sleep (objectiveandsubjective) and functioning (child-decreased irritability, lethargy, stereotypy, hyperactivity; parent-decreased fatigue). At 1 month, inappropriate speech also decreased, but hyperactivity was no longer decreased. Other gains were maintained. Most children demonstrated reduced arousal following treatment. This pilot shows telehealth cognitive behavioral treatment for childhood insomnia is feasible and may improve child and parent sleep, child behavior and arousal, and parent fatigue. A randomized controlled trial of telehealth cognitive behavioral treatment for childhood insomnia for children with autism is needed. Lay abstract Insomnia is common in children with autism. Cognitive behavioral treatment for childhood insomnia (CBT-CI) may improve sleep and functioning in children with autism and their parents, but typical delivery involving multiple office visits can make it difficult for some children to get this treatment. This pilot study tested telehealth delivery of CBT-CI using computers, which allowed children and their parents to get the treatment at home. This pilot shows therapists that parents and children were able to use telehealth CBT-CI to improve child and parent sleep, child behavior and arousal, and parent fatigue. Parents found telehealth CBT-CI helpful, age-appropriate, and autism-friendly. Telehealth CBT-CI holds promise for treating insomnia in school-aged children with autism and deserves further testing.

引用

页码：667 / 680

页数：14

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