ABSTRACT
Chronic insomnia (>3 months) is common in children with autism. Cognitive behavioral treatment for insomnia in children (CBT-CI) holds promise for improving sleep and daytime functioning in school-aged children with autism and their parents, but typical delivery involving multiple in-person office visits limits accessibility. This case study describes telehealth delivery of CBT-CI (teleCBT-CI) with a 7-year 4-month-old biracial boy with autism spectrum disorder (ASD) and insomnia and his parents. He and his mother wore actigraphs and completed electronic sleep diaries for 2 weeks, and his mother completed the Aberrant Behavior Checklist at pre/post/1-month follow-up. He and both of his parents completed eight telehealth treatment sessions. TeleCBT-CI improved the boy's sleep (objective, subjective) and decreased irritability, lethargy, stereotypy, and hyperactivity. This case study shows that teleCBT-CI is feasible and can improve child sleep and functioning.
Subject(s)
Autism Spectrum Disorder , Sleep Initiation and Maintenance Disorders , Telemedicine , Autism Spectrum Disorder/complications , Autism Spectrum Disorder/therapy , Child , Cognition , Female , Humans , Infant , Male , Mothers , Sleep Initiation and Maintenance Disorders/therapyABSTRACT
This study validated a short form of the Children's Evaluation of Everyday Social Encounters Questionnaire (ChEESE-Q). Fifth- to eighth-grade children (N = 241) completed a two-vignette version of the ChEESE-Q (i.e., ChEESE-Q SF), along with measures of adjustment and affect. The ChEESE-Q SF fit the same three-factor structure as the original ChEESE-Q, with each factor-based subscale being invariant across grade and gender. Results also indicated that the ChEESE-Q could not only be shortened at the vignette level, but at the item level as well, maintaining excellent model fit with the same three factor structure. ChEESE-Q SF subscale scores demonstrated acceptable internal consistency and correlated with related constructs in expected directions. Negative information processing was associated with higher anxious and depressive symptomology and negative affect. Positive information processing was associated with lower depressive symptomology, and higher positive affect. Analysis of a secondary sample of third- to sixth-grade youth (N = 252) also demonstrated adequate test-retest reliability. This study provided validation for a shortened version of the ChEESE-Q, and more support for specific styles of information processing. Validation of a short form enables researchers to assess social information processing in a multifaceted and comprehensive, yet resource-efficient way. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Subject(s)
Mental Processes , Social Interaction , Surveys and Questionnaires , Adolescent , Anxiety/psychology , Child , Depression/psychology , Female , Humans , Male , Reproducibility of ResultsABSTRACT
Sleep and opioid medications used to treat insomnia and chronic pain are associated with adverse side effects (falls and cognitive disturbance). Although behavioural treatments such as cognitive behavioral therapy for insomnia (CBT-I) and pain (CBT-P) improve sleep and clinical pain, their effects on sleep and opioid medication use are unclear. In this secondary analysis of published trial data, we investigated whether CBT-I and CBT-P reduced reliance on sleep/opioid medication in patients with fibromyalgia and insomnia (FMI). Patients with FMI (n = 113, Mage = 53.0, SD = 10.9) completed 8 weeks of CBT-I (n = 39), CBT-P (n = 37) or waitlist control (WLC; n = 37). Participants completed 14 daily diaries at baseline, post-treatment and 6-month follow-up, assessing sleep and opioid medication usage. Multilevel modelling examined group by time effects on days of medication use. A significant interaction revealed CBT-P reduced the number of days of sleep medication use at post-treatment, but usage returned to baseline levels at follow-up. There were no other significant within- or between-group effects. CBT-P led to immediate reductions in sleep medication usage, despite lack of explicit content regarding sleep medication. CBT-I and CBT-P may be ineffective as stand-alone treatments for altering opioid use in FMI. Future work should explore CBT as an adjunct to other behavioural techniques for opioid reduction.
