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自闭症睡眠障碍的功能性行为评估指导治疗方案的序贯实施:案例研究。

Sequential Implementation of Functional Behavior Assessment-Informed Treatment Components for Sleep Disturbance in Autism: A Case Study.

机构信息

College of Education, Health and Human Development, University of Canterbury, Christchurch, New Zealand.

School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand.

出版信息

Behav Sleep Med. 2021 May-Jun;19(3):333-351. doi: 10.1080/15402002.2020.1758701. Epub 2020 May 12.

Abstract

: Sleep disturbances are a significant problem for people with autism spectrum disorder (ASD). Existing research supports the use of parent-implemented, functional behavior assessment (FBA)-informed interventions for sleep problems in children with ASD. There is also emerging evidence for combined parent- and young person-implemented behavioral sleep interventions for older children and adolescents with ASD. However, the active treatment components of such interventions have not been identified in previous studies, as components have not been evaluated independently of one another.: The current study sequentially implemented FBA-informed treatment components (in the order of least to most restrictive and time intensive) within a single-case AB design, to evaluate at which point treatment resulted in a statistically and clinically substantive reduction in target sleep variables. Combined parent- and young person-implemented intervention components consisted of: (a) white noise; (b) white noise and relaxation instruction; and (c) white noise, relaxation instruction, and stimulus control.: The participant was a 9-year-old girl with autism and selective mutism.: The combined use of white noise, relaxation instruction, and stimulus control resolved the participant's sleep problems. Other more restrictive and/or time intensive interventions were unnecessary. Treatment effects were maintained at 10-week follow-up.: The current study illustrates the feasibility of administering FBA-informed treatment components sequentially, to ensure application of minimally sufficient interventions.

摘要

睡眠障碍是自闭症谱系障碍(ASD)患者的一个重大问题。现有研究支持采用家长实施的、基于功能行为评估(FBA)的干预措施来解决 ASD 儿童的睡眠问题。对于年龄较大的 ASD 儿童和青少年,联合家长和年轻人实施的行为睡眠干预措施也有新的证据支持。然而,在以前的研究中,这些干预措施的积极治疗成分尚未确定,因为这些成分没有相互独立进行评估。

本研究在单一案例 AB 设计中依次实施了基于 FBA 的治疗成分(从最不严格和最耗时到最严格和最耗时),以评估治疗在何时导致目标睡眠变量在统计学和临床上有实质性减少。联合家长和年轻人实施的干预成分包括:(a)白噪声;(b)白噪声和放松指导;以及(c)白噪声、放松指导和刺激控制。

参与者是一名 9 岁患有自闭症和选择性缄默症的女孩。

联合使用白噪声、放松指导和刺激控制解决了参与者的睡眠问题。其他更严格和/或耗时的干预措施是不必要的。在 10 周的随访中,治疗效果得到了维持。

本研究说明了依次实施基于 FBA 的治疗成分的可行性,以确保应用最适度的干预措施。

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