行为家长训练解决自闭症谱系障碍幼儿睡眠障碍：一项初步试验。
Behavioral parent training to address sleep disturbances in young children with autism spectrum disorder: a pilot trial.
机构信息
University of Pittsburgh School of Medicine, Autism Center, 3420 Fifth Avenue, Pittsburgh, PA 15213, United States.
出版信息
Sleep Med. 2013 Oct;14(10):995-1004. doi: 10.1016/j.sleep.2013.05.013. Epub 2013 Aug 27.
OBJECTIVES
A large percentage of children with autism spectrum disorders (ASD) have bedtime and sleep disturbances. However, the treatment of these disturbances has been understudied. The purpose of our study was to develop a manualized behavioral parent training (BPT) program for parents of young children with ASD and sleep disturbances and to test the feasibility, fidelity, and initial efficacy of the treatment in a small randomized controlled trial (RCT).
PARTICIPANTS AND METHODS
Parents of a sample of 40 young children diagnosed with ASD with an average age of 3.5years were enrolled in our study. Participants were randomized to either the BPT program group or a comparison group who were given nonsleep-related parent education. Each participant was individually administered a 5-session program delivered over the 8-week study. Outcome measures of feasibility, fidelity, and efficacy were collected at weeks 4 and 8 after the baseline time point. Children's sleep was assessed by parent report and objectively by actigraphy.
RESULTS
Of the 20 participants in each group, data were available for 15 participants randomized to BPT and 18 participants randomized to the comparison condition. Results supported the feasibility of the manualized parent training program and the comparison program. Treatment fidelity was high for both groups. The BPT program group significantly improved more than the comparison group based on the primary sleep outcome of parent report. There were no objective changes in sleep detected by actigraphy.
CONCLUSIONS
Our study is one of few RCTs of a BPT program to specifically target sleep disturbances in a well-characterized sample of young children with ASD and to demonstrate the feasibility of the approach. Initial efficacy favored the BPT program over the comparison group and suggested that this manualized parent training approach is worthy of further examination of the efficacy within a larger RCT.
目的
很大比例的自闭症谱系障碍（ASD）儿童存在就寝和睡眠问题。然而，这些问题的治疗研究还很不足。我们的研究目的是为有睡眠问题的 ASD 幼儿的家长制定行为家长培训（BPT）手册，并在小规模随机对照试验（RCT）中测试该治疗的可行性、忠实性和初步疗效。
参与者和方法
本研究纳入了平均年龄为 3.5 岁的 40 名被诊断为 ASD 的幼儿的家长作为样本。参与者被随机分配到 BPT 程序组或接受非睡眠相关家长教育的对照组。每个参与者都接受了为期 8 周的 5 次课程。在基线后第 4 周和第 8 周收集可行性、忠实性和疗效的结果测量。通过家长报告和活动记录仪客观评估儿童睡眠。
结果
在每组 20 名参与者中，有 15 名随机分配到 BPT 组和 18 名随机分配到对照组的参与者的数据可用。结果支持了手册化家长培训程序和对照组程序的可行性。两组的治疗忠实性都很高。基于家长报告的主要睡眠结果，BPT 程序组的改善明显多于对照组。活动记录仪没有检测到客观的睡眠变化。
结论
我们的研究是少数针对 ASD 幼儿睡眠问题的 BPT 方案的 RCT 之一，该研究对特征明确的 ASD 幼儿样本进行了特定的治疗，并证明了该方法的可行性。初步疗效表明 BPT 方案优于对照组，这表明这种手册化的家长培训方法值得在更大规模的 RCT 中进一步检验其疗效。
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