Sleep problems in children with disabilities : behavioural family interventions.
Degree GrantorUniversity of Canterbury
Degree NameMaster of Education
Sleep problems are frequently reported in children and studies indicate that approximately 15 to 30% of children experience some form of sleep difficulty (Partinen & Hublin, 2000; Richman, 1981; Zuckerman, Stevenson, & Bailey, 1987). Children's sleep problems often impact on family members, in particular parents, causing a considerable amount of stress and frustration. Difficulties with sleep are a common problem for typically developing children; however, research indicates that the incidence of sleep problems is even higher in the disabilities population (Didden, Korzillius, van Aperlo, Overloop, & de Vries, 2002; Espie & Tweedie, 1991; Richdale, Francis, Gavidia-Payne, & Cotton, 2000; Saxby & Morgan, 1983). This has implications for families already under considerable amounts of stress and pressure of having a child with a disability. The present study aimed to treat persistent sleep problems in children with disabilities using family behavioural intervention methods. A range of behavioural strategies was utilised to reduce sleep problems such as bed refusal, sleep onset delay, night waking, co-sleeping, and nightmares. Techniques such as a positive bedtime routine, reward systems, the parental presence programme, standard and modified extinction were used. In one case, a short-term decremental dose of a mild sedative (trimeprazine tartrate) was used in the initial stages of implementing a behavioural intervention to reduce child and parent distress. A "fear busting and monster taming" programme (White, 1985) was employed in conjunction with other behavioural techniques to reduce the occurrence of nightmares in another child. The results indicate that behavioural family interventions are effective in treating sleep problems in children with disabilities. The majority of the sleep behaviours targeted for intervention were eliminated or reduced to low levels of occurrence with 9 out of 11 target behaviours rated as showing a substantial improvement. These positives changes were maintained at follow-up with the exception of co-sleeping in Case Study Two. The social validity for the programmes was high and caregivers reported satisfaction.