Warner Morganne, Gillenson Caroline J, Parent Justin, Comer Jonathan S, Bagner Daniel M
Department of Psychology, Center for Children and Families, Florida International University, Miami, FL; and.
Department of Psychology, Clinical Psychology, University of Rhode Island, South Kingstown, RI.
J Dev Behav Pediatr. 2025 Apr 2;46(3):e269-e274. doi: 10.1097/DBP.0000000000001361.
Sleep problems are frequently reported and associated with externalizing behavior problems in young children, especially those with developmental delay (DD). Parent-child interaction therapy (PCIT) led to improved sleep in young children with DD, but research has not examined the effect of internet-delivered PCIT (iPCIT) on sleep quality or changes in bedtime resistance behaviors as a mediator. This study examined iPCIT's effect on sleep quality in young children with DD through its impact on bedtime resistance behaviors.
Participants were from a previously completed randomized controlled trial and included 150 children with DD ( M age = 36.2 months, SD = 1.0 months) and their caregivers who were randomized to iPCIT or referrals as usual (RAU). Path analyses examined links between treatment condition, post-treatment bedtime resistance, and sleep quality reported at 6-month follow-up.
Treatment condition significantly influenced bedtime resistance behaviors (β = 0.17, 90% CI, [0.04, 0.29], p = 0.01), and these changes, in turn, significantly affected sleep quality reported at 6-month follow-up (β = 0.18, 90% CI, [0.03, 0.33], p = 0.02). Caregivers receiving iPCIT reported fewer bedtime resistance behaviors after treatment and improved child sleep quality at 6-month follow-up than caregivers receiving RAU.
Although effects were smaller than in other studies examining PCIT's effect on sleep, these results highlight how iPCIT led to improved sleep quality in children with DD through changes in bedtime resistance. Further research is needed to explore differences in the effectiveness of in-person versus iPCIT, as well as other mechanisms (such as parenting behaviors) through which iPCIT affects child sleep quality.
睡眠问题在幼儿中经常被报告，并且与外化行为问题相关，尤其是那些有发育迟缓（DD）的幼儿。亲子互动疗法（PCIT）能改善患有DD的幼儿的睡眠，但研究尚未考察互联网提供的PCIT（iPCIT）对睡眠质量的影响，或作为中介的就寝抗拒行为的变化。本研究通过iPCIT对就寝抗拒行为的影响，考察其对患有DD的幼儿睡眠质量的影响。
参与者来自之前完成的一项随机对照试验，包括150名患有DD的儿童（平均年龄 = 36.2个月，标准差 = 1.0个月）及其照顾者，他们被随机分配到iPCIT组或常规转介组（RAU）。路径分析考察了治疗条件、治疗后就寝抗拒与6个月随访时报告的睡眠质量之间的联系。
治疗条件显著影响就寝抗拒行为（β = 0.17，90%置信区间，[0.04, 0.29]，p = 0.01），而这些变化反过来又显著影响6个月随访时报告的睡眠质量（β = 0.18，90%置信区间，[0.03, 0.33]，p = 0.02）。接受iPCIT的照顾者在治疗后报告的就寝抗拒行为较少，且在6个月随访时儿童睡眠质量比接受RAU的照顾者有所改善。
尽管效果比其他考察PCIT对睡眠影响的研究要小，但这些结果凸显了iPCIT如何通过改变就寝抗拒行为来改善患有DD的儿童的睡眠质量。需要进一步研究以探索面对面PCIT与iPCIT有效性的差异，以及iPCIT影响儿童睡眠质量的其他机制（如养育行为）。
