Authors: (including presenting author): :
Lau FLF(1), Li SX(2)
Affiliation: :
(1) Clinical Psychology, Castle Peak Hospital, (2) Department of Psychology, The University of Hong Kong
Keyword 1: :
Sleep intervention
Keyword 2: :
Paediatric sleep
Introduction: :
Children with special educational needs (SEN), including Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD), often experience high rates of insomnia and associated mood disturbances and functioning impairments, which negatively impact both the children and their families. Although behavioural sleep interventions are recognised as the first-line treatment, many families face barriers to access treatment. Digital, parent-mediated intervention programmes, supplemented with therapist support, may offer a promising alternative, but rigorous evaluation of their efficacy in the SEN populations remains limited.
Objectives: :
This randomised controlled trial examined the effects of a parent-based sleep intervention delivered via a mobile app, with and without personalised telephone support, on sleep and daytime functioning outcomes in children with SEN and sleep problems, as well as their parents.
Methodology: :
109 parents of children (aged 6–12) with ASD/ADHD and sleep disturbances (Children’s Sleep Habits Questionnaire total score ≥ 41) were randomised and included in the intention-to-treat (ITT) analysis (adjunct telephone support group: n = 37; no-support group: n = 35; treatment-as-usual (TAU): n = 37).
Result & Outcome: :
The adjunct telephone support group showed a significant improvement in CSHQ total score relative to TAU (p = .016), but there was no significant difference between the no-support group and TAU (p = .100). Relative to TAU, there were significant improvements in CSHQ sleep onset delay in both interventions (adjunct telephone support: p < .001; no-support: p < .001), CSHQ night wakings in the no-support group (p < .001), and a marginally significant improvement in CSHQ bedtime resistance in the adjunct telephone support group (p = .056). Relative to TAU, the adjunct telephone support group also demonstrated significant improvements in daytime sleepiness (p = .005), parental sleep (p = .002), and parent-perceived child regulation problems (p = .008), whilst the no-support group showed a significant improvement in internalising symptoms (p = .015). The findings demonstrated the efficacy of a brief, low-intensity app-based intervention in reducing sleep disturbances in children with SEN, with effect sizes comparable to, or exceeding, those reported for traditional face-to-face and telehealth models, whilst also enhancing accessibility. Preliminary evidence suggested that additional therapist support might confer further benefits for certain child and parent related outcomes.
