Case study: A case-series evaluation of a behavioral sleep intervention for three children with autism and primary insomnia.

OBJECTIVE To assess the effectiveness of a manualized multi-component behavioral sleep intervention for children with autism spectrum disorder (ASD) and primary insomnia. METHODS Three children (2 males and 1 female, aged 8-9 years) participated. The intervention consisted of a treatment handbook for parents; a distance treatment approach was used in which parents had weekly telephone contact with a therapist. The main behavioral strategies employed were Faded Bedtime with Response Cost and positive reinforcement. Within a case-series design, both subjective (parent-report questionnaires and sleep diaries) and objective (actigraphy) measures were used to record changes in children's sleep and daytime behavior. RESULTS For all 3 children, mean sleep onset latency was reduced following the intervention. These improvements were generally maintained at follow-up 12 weeks later. CONCLUSIONS The current study provides preliminary evidence for the effectiveness of a manualized behavioral sleep intervention program for improving insomnia in children with ASD.