Treatment of Sleep Disturbances in Young Children with Autism

描述（由申请人提供）：自闭症谱系障碍（自闭症障碍，广泛性发育障碍，亚斯伯格障碍）是儿童早期发病的严重发育障碍，影响多达150名儿童中的1名（疾病控制与预防中心，2007）。他们的特点是社会互动和沟通的缺陷，以及重复的行为和有限的兴趣（APA, 2000）。鉴于其严重性和普遍性，自闭症是一个重大的公共卫生问题。近年来，自闭症的患病率有所上升，早期诊断这种疾病的能力也有所提高（formbonne, 2003）。人们普遍认为，强化干预最有可能改善儿童早期的长期预后（国家研究委员会，2001年）。虽然不是自闭症的核心特征，但人们普遍认为，很大比例的自闭症谱系障碍儿童存在严重的睡眠问题（Honomichl, Goodlin-Jones, Burnham, Gaylor & Anders, 2002; Johnson, 1996; Wiggs & Stores, 2004）。众所周知，正常发育儿童的睡眠问题会对白天功能、学习习得以及养育子女和家庭功能产生不利影响（Dahl, 1996; Ebert & Drake, 2004; Sadeh, Gruber, & Raviv; 2002; Sadeh, Raviv, & Gruber, 2000）。对于患有自闭症的幼儿来说，他们的发育已经受到一系列缺陷的影响，睡眠障碍的有害影响可能更为严重。然而，在行为和教育干预中，睡眠障碍对最佳表现的影响尚未得到系统的探讨。作为对项目公告（PA-07-343 -自闭症谱系障碍的社会心理/行为干预和服务研究）的回应，本申请描述了一项试点研究，该研究旨在开展一项随机临床试验，以评估行为父母培训项目在改善自闭症幼儿睡眠障碍方面的效果。本研究将用于研究自闭症儿童睡眠障碍行为训练方案的可行性、可接受性和有效性。它代表了一种低成本和快速的临床方法来解决这个年轻群体的问题。

DESCRIPTION (provided by applicant): Autism Spectrum Disorders (Autistic Disorder, Pervasive Developmental Disorder, Asperger Disorder) are severe developmental disorders of early childhood onset affecting as many as 1 in 150 children (Center for Disease Control & Prevention, 2007). They characterized by deficits in social interaction and communication, as well as repetitive behavior and restricted interests (APA, 2000). Given the severity and the prevalence, autism is a significant public health issue. Recent years have seen both an increase in the prevalence of autism and an improved ability to diagnose the disorder much earlier (Fombonne, 2003). It is during the child's early years when it is generally agreed that intensive interventions are most likely to improve long term prognosis (National Research Council, 2001). While not a core feature of autism, it is widely accepted that a large percentage children with autism spectrum disorders (autism) present with significant sleep issues (Honomichl, Goodlin-Jones, Burnham, Gaylor & Anders, 2002; Johnson, 1996; Wiggs & Stores, 2004). Sleep problems in typically developing children are known to adversely impact daytime functioning, learning acquisition, as well as parenting and family functioning (Dahl, 1996; Ebert & Drake, 2004; Sadeh, Gruber, & Raviv; 2002; Sadeh, Raviv, & Gruber, 2000). For young children with autism whose development is already compromised by a range of deficits, the detrimental impact of sleep disturbances may be even more significant. However, the impact of sleep disturbances on optimal performance in behavioral and education interventions has not been systematically explored. In response to the Program Announcement (PA-07-343 - Psychosocial / Behavioral Intervention and Services Research in Autism Spectrum Disorders), this application describes a pilot study to conduct a randomized clinical trial to evaluate the efficacy of a behavioral parent training program in the amelioration of sleep disturbances in young children with autism. This work will be used to examine the feasibility, acceptability and efficacy of a behavior training program for sleep disturbance in children with autism. It represents a low cost and rapid clinical approach to the problem in this younger age group. PUBLIC HEALTH RELEVANCE: This pilot project will evaluate the efficacy of a behavioral parent training program for sleep disturbance in young children with autism compared to a parent education program. Children between the ages of 2 and 5 years diagnosed with an autism spectrum disorder who also have significant sleep disturbance will be recruited for this 2 month study.