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Abstract
Children diagnosed with autism or autism spectrum disorders (ASD) are more likely than other children to exhibit behaviors characteristic of a feeding or sleeping disorder. Parents of children with these disorders may be extremely concerned about the health and safety of their child. Sleeping and feeding problems can cause a great deal of stress to parents and other family members. Behavioral assessment and treatment procedures have been developed to address behavior problems related to sleeping and feeding disorders. This article ...
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Abstract
Parenting a child with autism has been associated with maternal stress. The present investigation examined children's sleep difficulties and severity of autism along with mothers' sleep problems in relation to stress levels reported by mothers ( N = 72). Mothers' reports of their children's sleep problems were related to mothers' reports of their own sleep difficulties and to the severity of children's autistic symptoms. Severity of autism was predictive of mothers' stress. After controlling for child age and gender, mothers' sleep, ...
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Abstract
Sleep disturbances are common in patients with Asperger disorder. Although these sleep problems are often persistent and may significantly impair the child's daytime well-being, no treatment studies have been reported. In this open clinical trial, the effectiveness of melatonin was studied in a sample of 15 children with Asperger disorder (13 boys, 2 girls) aged 6-17 years using several questionnaires and actigraph measurements. They included assessments of sleep quality, tiredness, and behavior. Melatonin (3 mg/day) was used for 14 days. All ...
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Abstract
Sleep disturbances are a significant problem for persons with developmental disabilities. These problems occur at a higher rate than what is observed in the typically developing population, and persons with Autism Spectrum Disorders (ASD) appear to be at a higher risk than individuals with other developmental disabilities. However, another major risk is intellectual disability (ID). These two groups of disorders overlap to a substantial degree. Thus, persons with ASD and ID appear to be particularly susceptible to sleep disturbances. These sleep ...
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Abstract
There is increased awareness of sleep disorders and their complexity in developmental disorders, including autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD). This review is focused on the latest reports of research on sleep disorders in these two developmental disorders. Sleep disruptions such as prolonged sleep onset latency, sleep fragmentation, and increased daytime sleepiness are repeatedly described in both ASD and ADHD. Parasomnias are common in ASD, but rarely studied in ADHD. Sleep disordered breathing and restless legs syndrome ...
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Abstract
Like children with other developmental disabilities, children with autism spectrum disorders suffer from sleep problems at a greater rate than typically developing children. It is increasingly recognized that addressing these sleep problems may improve daytime functioning and decrease family stress. The sleep problems experienced by children with autism spectrum disorders are presented in this article. ...
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Abstract
Sleep problems are commonly reported in children with autistic disorders. Most studies are based on sleep questionnaires and sleep diaries, but polysomnographic and actigraphic data have also been used. In this study we investigated sleep in older individuals (aged 15-25 years) with autism and Asperger syndrome, using sleep questionnaires, sleep diaries and actigraphy. Although the sleep questionnaires completed by parents and caretakers revealed only a moderate degree of sleep problems, greater sleep disturbance was recorded with actigraphy. ...
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Autism : the international journal of research and practice, Vol. 5, No. 2. (June 2001), pp. 209-221
Abstract
This article presents a case study which is part of a larger project on sleep problems in children with autism. The successful treatment of sleep problems (night settling, night waking, and co-sleeping) in a boy of 5 years 4 months with autism is described. The intervention was based on behavioural principles and involved the parents attending an individually-run parent training programme. The programme consisted of an interview, three weekly training sessions and a review session. The parents learned how to use ...
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Journal of child neurology, Vol. 16, No. 8. (August 2001), pp. 581-584
Abstract
This study explored the safety and efficacy of synthetic melatonin in the treatment of sleep problems in 20 children with developmental disabilities, in a randomized, double-blind, placebo-controlled 6-week trial of melatonin versus placebo. All but 2 children fell asleep more quickly when receiving melatonin than placebo. Overall, the greater the sleep latency (time to fall asleep) was at baseline or when receiving placebo, the more pronounced was the decrease in sleep latency with melatonin. The effect of melatonin on sleep latency ...
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Abstract
We describe our experience in using melatonin to treat insomnia, a common sleep concern, in children with autism spectrum disorders. One hundred seven children (2-18 years of age) with a confirmed diagnosis of autism spectrum disorders who received melatonin were identified by reviewing the electronic medical records of a single pediatrician. All parents were counseled on sleep hygiene techniques. Clinical response to melatonin, based on parental report, was categorized as (1) sleep no longer a concern, (2) improved sleep but continued ...
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Journal of Developmental and Physical Disabilities, Vol. 8, No. 4. (December 1996), pp. 407-413, doi:10.1007/bf02578404
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Neuroreport, Vol. 11, No. 1. (17 January 2000), pp. 127-130
Abstract
Asperger's syndrome (AS) is a pervasive developmental disorder that may fall along the autistic spectrum. We compared the sleep of eight patients with AS with that of participants matched for age and gender. Patients with AS showed decreased sleep time in the first two-thirds of the night, increased number of shifts into REM sleep from a waking epoch, and all but one patient showed signs of REM sleep disruption. EEG sleep spindles were significantly decreased while K complexes and REM sleep ...
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Sleep, Vol. 32, No. 12. (1 December 2009), pp. 1566-1578
Abstract
STUDY OBJECTIVES: (1) Compare sleep behaviors of children with autism spectrum disorders (ASD) with sleep behaviors of typically developing (TD) children using the Children's Sleep Habits Questionnaire (CSHQ); (2) compare sleep quality--defined as mean activity, sleep latency, number of awakenings, sleep efficiency and total sleep time--of the cohort of children with ASD and TD, as measured by 10 nights of actigraphy; and (3) estimate the prevalence of sleep disturbances in the ASD and TD cohorts. DESIGN: Descriptive cross-sectional study. SETTING: The ...
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Abstract
Autism spectrum disorders (ASDs) are a group of a neurodevelopmental disorders affecting social, communicative, and behavioral functioning. ASD is a heterogeneous group of disorders, often accompanied by associated medical issues. Thus, the development of effective treatments is a complex task requiring consideration of diverse etiologic and phenotypic characteristics. Recent attention to the diagnosis and treatment of medical conditions in ASD children has led to the formation of a new international collaboration to improve autism care, the Autism Treatment Network (ATN. Numerous ...
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Journal of child psychology and psychiatry, and allied disciplines, Vol. 37, No. 8. (November 1996), pp. 907-925
Abstract
Sleep disorders in children are diverse in type, common, often serious in their effects yet neglected in professional education. They complicate many psychiatric disorders and can cause various cognitive and behavioural problems as well as more widespread difficulties in the family as a whole. Accurate assessment allows an appropriate choice from the various types of treatments that are now available but often under used. Diagnostic points and treatment approaches are outlined for the three main categories of childhood sleep disorder: sleeplessness; ...
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Abstract
Some children with autism have excessive daytime sleep but intervention research for this problem has not been conducted. The present study evaluated procedures with a 13 year old boy who had autism and slept for prolonged periods during the day. Classroom staff at a specialized school implemented procedures with the boy according to an ABAB experimental design. Intervention eliminated daytime sleep through a 6-month follow-up assessment. The study adds to the literature concerning sleep problems in children with autism and extends ...
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Abstract
The aim of this study was to report preliminary data on the effectiveness and tolerability of ramelteon for the treatment of insomnia in youth with autistic disorder (autism). Two youths, ages 7 and 18 years, with autism and significant insomnia characterized by problems with sleep onset and maintenance received an open-label trial of ramelteon (4-8 mg) over a duration of 16-18 weeks. Target symptoms of delayed sleep onset and/or frequent nocturnal awakening improved significantly, as determined by Clinical Global Impressions-Improvement (CGI-I) ...
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Research in developmental disabilities, Vol. 22, No. 4. (g 2001), pp. 255-272
Abstract
This paper describes research on the prevalence, correlates, and treatment of sleep disorders in individuals with developmental disabilities. A significant number of individuals with developmental disabilities have disordered sleep, although prevalence estimates vary from 13% to 86%. Constitutional variables, including age, presence of physical and sensory impairments, and certain genetic syndromes and medical conditions appear to be related to sleep disturbance, but the evidence is mainly correlational and therefore cannot be said to show a causal relation. While a number of ...
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Abstract
In addition to abnormalities in social and communication development, a 'need for sameness' and 'resistance to change' are features of autistic spectrum disorders first identified by Kanner in 1943. Our ability to react to change is modulated by the hypothalamic-pituitary-adrenal (HPA) axis, a feature of which is a dramatic increase in cortisol upon waking, the Cortisol Awakening Response (CAR). This study examined whether the CAR was evident in 20 adolescent males with Asperger Syndrome (AS) and 18 age-matched typically developing (TD) ...
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Brain & development, Vol. 23, No. 2. (March 2001), pp. 135-137
Abstract
An 8 year-old boy with Asperger's syndrome had difficulties in communicating with his teachers and classmates. He occasionally stole out of the classroom. He could not sleep at night recalling his awful experience and kept crying every night and refused to go to school. The treatment with fluvoxamine was started at the dose of 25 mg daily. Four weeks after the treatment, his repetitive behavior and hyperactivity decreased and night crying diminished. Although he still has difficulties in communicating with others, ...
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Journal of paediatrics and child health, Vol. 34, No. 6. (December 1998), pp. 528-533
Abstract
The aim of the study was to investigate the specificity of sleep problems in children with autism and further explore the currently unclear association between sleep problems and daytime behaviour. The Pervasive Developmental Disorder (PDD) group consisted of 31 children with autism and 7 children with Asperger's Disorder ranging in age from 44 to 152 months. The control group consisted of 36 children ranging in age from 63 to 171 months. The children were matched on age and gender, and group-matched ...
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Abstract
This study investigated sleep of children with autism and developmental regression and the possible relationship with epilepsy and epileptiform abnormalities. Participants were 104 children with autism (70 non-regressed, 34 regressed) and 162 typically developing children (TD). Results suggested that the regressed group had higher incidence of circadian rhythm disorders than non-regressed children. The regressed group showed higher Children's Sleep Habits Questionnaire Bedtime Resistance, Sleep Onset Delay, Sleep Duration and Night-Wakings scores. Epilepsy and frequent epileptiform EEG abnormalities were more frequent in ...
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Abstract
A growing body of evidence indicates that people with autism frequently experience sleep disorders and exhibit atypical sleep architecture. In order to establish whether sleep disorders truly belong to the autism spectrum disorder (ASD) phenotype, we conducted a subjective and objective study of sleep in a group of high-functioning adults with ASD but without sleep complaints, psychiatric disorders or neurological comorbidity. We compared the subjective data of 27 ASD participants with those of 78 healthy controls matched for chronological age and ...
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Abstract
With health maintenance organizations and insurance companies requiring proof of treatment efficacy, clinicians must determine whether research supports commonly used treatment methods. To determine the effectiveness of applied behavior analysis (ABA) for treating sleep problems in children with autism, a computer search of all relevant literature was conducted. The resulting articles revealed four basic themes of behavioral techniques for treating sleep disorders for children with autism: bedtime routines, extinction, stimulus fading, and faded bedtimes. Research on each technique was evaluated based ...
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International Journal of Behavioral and Consultation Therapy, Vol. 1, No. 3. (2005), pp. 165-190
Abstract
This paper reviews behavioral treatments for sleep problems in children with a developmental disorder (DD). Sleep problems are common in children with a DD and children’s sleep problems may be associated with adverse consequences including behaviour problems, compromised daytime functioning and family stress. However, the sleep intervention literature for these children is seriously lacking, with only extinction and graduated extinction approaches meeting criteria for a probably efficacious treatment for common sleeplessness problems. The investigation of behavioral treatments for other sleep difficulties remains in its infancy. The impact ...
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Abstract
Young people with physical, psychological or intellectual disabilities or disorders are reported to have more frequent and persistent problems with sleep than their peers without <<<<special needs>>>>. Sleep disorders affecting the quantity or quality of sleep have effects on a child's daytime functioning and the functioning of their families. Many children with special needs have learning and behaviour problems and their parents (particularly mothers) have increased levels of stress and poorer mental health. This relationship between sleep disorders and learning, and ...
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Abstract
To examine sleep quality and sleep-wake patterns in parents of children with autism spectrum disorders (ASDs) and parents of typically developing (TD) children. Thirty-five mothers and 22 fathers completed the Pittsburgh Sleep Quality Index, a 7-day sleep diary, and wore an actigraph for 1 week. Parents of children with ASDs reported poorer sleep quality compared to the TD group. In addition, parents of children with ASDs had objectively different sleep patterns, with an earlier wake time and shorter total sleep time ...
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Abstract
A growing body of research has identified significant sleep problems in children with autism. Disturbed sleep-wake patterns and abnormal hormone profiles in children with autism suggest an underlying impairment of the circadian timing system. Reviewing normal and dysfunctional relationships between sleep and circadian rhythms will enable comparisons to sleep problems in children with autism, prompt a reexamination of existing literature and offer suggestions for future inquiry. In addition, sleep and circadian rhythms continue to change over the course of development even ...
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Abstract
The two-process model is a scheme for the timing of sleep that consists of homeostatic (Process S) and circadian (Process C) variables. The two-process model exhibits abnormal sleep patterns such as internal desynchronization or sleep fragmentation. Early infants with autism often experience sleep difficulties. Large day-by-day changes are found in the sleep onset and waking times in autistic children. Frequent night waking is a prominent property of their sleep. Further, the sleep duration of autistic children is often fragmented. These sleep ...
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Social science & medicine (1982), Vol. 56, No. 3. (February 2003), pp. 631-642
Abstract
Gender is a concept that is frequently discussed in the literature on stress, coping and illness. Research has reported that women are more vulnerable than men are to stressful events and use different strategies to cope with them. Furthermore, it is often asserted that these gender-based differences in coping may partially explain the differential impact of stressful events on men and women. Unfortunately, much of this research has equated gender with sex and failed to contextualise the experience of illness and ...
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Abstract
Sleep disorders can affect daytime functioning in a variety of neurologic conditions, including autism spectrum disorder. This report describes improvements in sleep, social communication, attention, repetitive behaviors, and hypersensitivity after adenotonsillectomy for obstructive sleep apnea in a 5-year-old female with an autism spectrum disorder. Improvements were documented via pre- and postsurgical measures of parent report, polysomnography, validated sleep and behavior scales, and the Autism Diagnostic Observation Schedule. Identification and treatment of sleep disorders, including obstructive sleep apnea, may improve daytime behavior ...
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Abstract
Asperger syndrome (AS) is a neurodevelopmental disorder belonging to autism spectrum disorders with prevalence rate of 0,35% in school-age children. It has been most extensively studied in childhood while there is scarcity of reports concerning adulthood of AS subjects despite the lifelong nature of this syndrome. In children with Asperger syndrome the initiation and continuity of sleep is disturbed because of the neuropsychiatric deficits inherent of AS. It is probable that sleep difficulties are present in adulthood as well. Our hypothesis ...
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Abstract
We developed an Internet survey to identify treatments used by parents of children with autism. The survey listed 111 treatments and was distributed via colleagues and through chapters of the Autism Society of America and Autism Organizations Worldwide. A total of 552 parents submitted usable returns during the 3-month survey period. On average the parents reported using seven different treatments. The number of treatments used varied as a function of the child's age and type/severity of disability within the autism spectrum. ...
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Swiss medical weekly, Vol. 139, No. 19-20. (16 May 2009), pp. 293-296
Abstract
Melatonin may be used to treat sleep disorders in both children and adults with intellectual disability. The evidence for its efficacy, potential adverse effects and drug interactions are reviewed in the context of prescription of melatonin to patients with autism. This study presents the use of melatonin to treat severe circadian sleep-wake disturbances in 6 adults with autism. Melatonin was initiated at a daily dose of 3 mg at nocturnal bedtime. If this proved ineffective, the melatonin dose was titrated over ...
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Abstract
Parents of children in the autism spectrum wrote an open-ended answer via an online questionnaire to the question, “How has your child in the autism spectrum affected your life and your family's life?” ( N = 493). Using a qualitative content analysis, 15 negative themes and 9 positive themes were identified. Themes are subsumed into five clusters: Stress; Child's behavior; Parents’ personal well being, work, and marital relationship; Impact on the whole family; and Social isolation. The mix of negative and positive ...
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Abstract
This study investigated the association between preschool children's sleep patterns measured by actigraphy and parent-reported hyperactivity symptoms. Many previous studies have reported sleep problems in children with attention deficit hyperactivity disorder (ADHD)-like symptoms. This study examined a cross-sectional sample of 186 preschoolers age 2-5 years in three groups: children with autism, children with developmental delay without autism, and typically developing children recruited from the general population. One week of actigraphic sleep data plus a parent report of the presence or absence ...
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Journal of autism and developmental disorders, Vol. 30, No. 2. (April 2000), pp. 127-135
Abstract
This research evaluated parent reports of sleep behaviors of four groups of children: those with Autism or Pervasive Developmental Disorders, those with General Mental Retardation alone, those attending Special Education classes (with no MR diagnosis), and a control group of similar aged children without a developmental diagnosis. Diagnostic classification and demographic information were determined through parent report, report of classroom registration, and the Gilliam Autism Rating Scale (Gilliam, 1995). To evaluate sleeping behavior the study used a 28-item, five-factor scale (Behavioral ...
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Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 31, No. 4. (July 1992), pp. 735-738
Abstract
Two individuals with Asperger's syndrome, a rare pervasive developmental disorder, developed recurrent episodes of hypersomnia and abnormal behavior (Kleine-Levin syndrome) during adolescence. The possible etiological role of developmental structural brain anomalies and the differential diagnosis of recurrent hypersomnia and abnormal behavior in patients with pervasive developmental disorders are discussed. ...
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Child psychiatry and human development, Vol. 33, No. 2. (2002), pp. 107-123
Abstract
The objectives of this pilot study were 1) to examine possible effects of secretin infusions on sleep-wake state organization in children with autism, and 2) to assess the feasibility of home recordings using time-lapse videosomnography in children with autism. Participants were a subset of subjects from two double blind, placebo-control, multi-center clinical trials. One trial, the UC Irvine study, assessed the effects of porcine secretin vs. saline infusions on children's behavior, language and IQ. The UC Davis trial assessed the effects ...
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Abstract
This study examined the persistence of sleep problems in preschool children with autism and two matched comparison groups: children with developmental delay without autism and typically developing children. Sleep problems were defined subjectively by parent report, by the Children's Sleep Habits Questionnaire (CSHQ), and objectively by quantitative Research Diagnostic Criteria (RDC) derived from actigraphic recordings. Children were studied on three occasions, each separated by a 3-month interval. At each assessment, the children were recorded actigraphically for 1 week, and parents completed ...
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Abstract
Sleep disturbances are highly prevalent among children with psychiatric disorders, making recognition and management of pediatric sleep disorders an important step in improving treatment outcome and preventing relapse of mental illness. This chapter will review the research data on the epidemiology, clinical presentation and treatment approaches for sleep disorders frequently seen in the context of common psychiatric conditions in children and adolescents. Readers will learn about interaction between sleep related problems and symptoms of Attention Deficit/Hyperactivity Disorder, Anxiety and Mood Disorders ...
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Abstract
The amount of research conducted on sleep in children and adolescents has increased dramatically over the past decade due to the recognition that many children have significant sleep problems leading to daytime dysfunction. Approximately one third of typically developing children have sleep difficulties at some point, and a similar percentage of adolescents have impaired or insufficient sleep leading to daytime impairments. Sleep problems are known to occur at even greater rates in children with special needs, such as those with developmental ...
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Research in developmental disabilities, Vol. 25, No. 1. (b 2004), pp. 57-66
Abstract
Researchers have been placing an increased importance on discovering what variables contribute to better prognosis during behavioral interventions for children with autism. This article preliminarily identifies sleep problems that may exacerbate symptoms of autism; thus, possibly influencing effectiveness of daytime interventions. A data-base of parent report of sleep problems of children with autism (N=55), ranging from 5 to 12 years of age (M=8.2 years) was evaluated. Results suggested that fewer hours of sleep per night predicted overall autism scores and social ...
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Developmental medicine and child neurology, Vol. 41, No. 1. (January 1999), pp. 60-66
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Journal of behavior therapy and experimental psychiatry, Vol. 33, No. 1. (March 2002), pp. 49-58
Abstract
Sleep problems such as settling problems, frequent night waking, and early waking are prevalent as well as persistent with children and young adults with developmental disabilities who live at home. In this study, results of pretreatment functional assessment suggested that parental attention may have shaped and maintained the sleep problems with four participants. Effectiveness of extinction of parental attention, that is planned ignoring, was assessed on number of minutes of nighttime disruptive behaviors. Treatment resulted in a normalized sleep pattern in ...
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Child: care, health and development, Vol. 30, No. 2. (March 2004), pp. 139-150
Abstract
Sleep problems are common in children with an intellectual disability (ID), often lasting for many years. Many parents do not perceive their child to have a sleep problem, do not believe treatment is possible and do not seek treatment. This paper examined prevalence and duration of sleep problems in children with an ID and considered parental perceptions of sleep problems and views towards treatment. The paper reports on two studies (n = 149 and 243 respectively) of children between 3 and ...
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