Parent Perceptions of Efficacy for Strategies used to Facilitate Sleep in Children with Autism

Autism is a relatively common developmental disability that has neurobiological origins and is characterized by pervasive deficits in social interaction, communication and range of interests. In a previously published article, the authors described commonly occurring sleep problems in children with autism [Williams, P. G., Sears, L. L., and Allard, A. (2004). J. Sleep Res. 13: 265–268.] Current estimates of sleep disorders in this population range from 44 to 83% [Richdale, A. (1999). Develop. Med. Child Neurol. 41: 60–66]. Parents often have to devise their own strategies for dealing with sleep problems. This study surveyed interventions being used by families of children with autism. Likert-based surveys were sent out to 500 families of autistic children with 210 returned. Based on records of psychological testing, survey responses for these children were categorized into mental retardation (MR) or not mental retardation (not MR) groups. Among the most frequently used behavior interventions for both groups were establishing a regular bedtime and waking time, providing a darkened room, reading to the child, and providing toys to play with in bed. Behavioral strategies considered most effective included establishing a regular bedtime, bringing the child into the parents’ bed, wrapping the child, using a noise masker, and allowing the child to have toys in his bed. When surveys were divided into MR/not MR groups, some differences in perceived effectiveness of behavioral interventions for sleep were noted. Reading a story and using a nightlight were perceived as much less effective for the MR group as compared to those in the not MR group. In general, medications were used much less frequently than behavioral interventions to help with sleep. When comparisons between the MR/not MR groups were made, no statistically significant differences were seen for perceived effectiveness of medications. This study points to the need for more systematic study of sleep problems and interventions for children with autism.