Piazza C C, Fisher W W, Sherer M
Neurobehavioral Unit, Kennedy Krieger Institute, Baltimore, MD 21205, USA.
Dev Med Child Neurol. 1997 Jun;39(6):414-8. doi: 10.1111/j.1469-8749.1997.tb07456.x.
Sleep problems are a common concern for persons with mental retardation and severe behavior problems, yet few empirically validated treatment options exist. In the current investigation, the efficacy of a faded bedtime with response cost treatment was compared with a bedtime scheduling procedure in treating the multiple sleep problems of two groups of children with mental retardation, sleep problems, and other severe behavior problems. Faded bedtime with response cost (FBRC) consisted of systematic delay of bedtime, removal from bed if sleep was not initiated within 15 minutes (response cost), and a fading procedure to gradually advance the bedtime. The bedtime scheduling procedure consisted of a consistent sleep and wake time and prevention of daytime sleep. The sleep of children in the FBRC group improved significantly more than the sleep of children in the bedtime scheduling group. Results are discussed in terms of behavioral and biological mechanisms which may contribute to the efficacy of FBRC.
睡眠问题是智力迟钝和严重行为问题患者普遍关注的问题，但经过实证验证的治疗方案却很少。在当前的调查中，将逐渐推迟就寝时间并结合反应代价的治疗方法与就寝时间安排程序在治疗两组患有智力迟钝、睡眠问题及其他严重行为问题的儿童的多种睡眠问题方面的疗效进行了比较。逐渐推迟就寝时间并结合反应代价（FBRC）包括系统地推迟就寝时间、如果在15分钟内未入睡则将其带离床铺（反应代价）以及逐渐提前就寝时间的递减程序。就寝时间安排程序包括固定的睡眠和起床时间以及防止白天睡觉。FBRC组儿童的睡眠改善明显多于就寝时间安排组儿童。从可能有助于FBRC疗效的行为和生物学机制方面对结果进行了讨论。
