Authors (including presenting author) :
Ip YT(1), Lee SL(2), Li SX(3)
Affiliation :
(1)Department of Clinical Psychology, DKCH, (2)Department of Paediatrics & Adolescent Medicine, QMH, (3)Department of Psychology, HKU
Introduction :
Childhood insomnia is highly prevalent in preschool children with Autism Spectrum Disorder (ASD), with a prevalence rate up to 72%. Whilst there has been some evidence supporting the efficacy of parent-based sleep intervention, there remained several barriers (e.g. parents’ limitation on travel time) in increasing accessibility of the treatment for those in need. There is an imperative need to examine the delivery of the intervention in alternative modality, especially in the context of ongoing pandemic.
Objectives :
(1) to examine the efficacy of a Parent-based Sleep Intervention Telehealth Program, as compared to Treatment-As-Usual (TAU) control, in reducing behavioral sleeping problems in preschool children with ASD;(2) to examine whether this program could improve the child’s executive functions, behavioral/emotional problems, and their parents’ sleep quality and mood.
Methodology :
The current study was a randomized controlled trial (RCT). Parents/caregivers (>=18 years) of preschool children (aged 3-6 years) with a clinical diagnosis of ASD with comorbid insomnia were recruited. Eligible participants were randomly assigned into either Intervention Group or TAU Control. Participants in the Intervention Group received a Parent-based Behavioural Sleep Intervention conducted by a Clinical Psychologist (three weekly 90-minute group sessions on Zoom, and four bi-weekly individual 15-minute telephone sessions). Primary outcome was child’s sleep problems, especially insomnia symptoms. Secondary outcomes were children’s executive functions, behavioral/emotional problems, parental sleep, mood and stress level.
Result & Outcome :
The final sample in the analysis consisted of 62 participants (Intervention Group: n=30; TAU Control: n=32; overall drop-out rate: 17.3%). The intervention resulted in significant improvements in overall sleep problems ( p<.05; partial eta square=.084), and insomnia symptoms such as Bedtime Resistance and Sleep Onset Delay (p<.05; partial eta square=.076-.084) with medium to large effect sizes, as compared with the TAU control. There were also significant improvements in the child’s overall behavioral/emotional problems and externalizing problems (p<.05; partial eta square=.090-.101), as well as parents’ general stress level (p<.05; partial eta square=.081) in intervention group. This was the first RCT to examine the effects of a brief parent-based intervention program targeting behavioral insomnia in preschool children with ASD, using a telehealth service model. The findings were promising and supported the feasibility and effectiveness of adopting this mode of service delivery to manage sleep problems in children with ASD. A revised version of this Parent-based Sleep Intervention Telehealth Program is now endorsed as one of the protocol-driven telehealth programs endorsed by COC(CP), for which can be applied across clusters.
