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 a bedtime routine, reinforcement, effective instructions, partner support strategies and extinction procedures. Once the techniques were implemented, the child learned how to settle himself to bed and how to sleep alone for the entire night. For this child, the results of the sleep programme were clinically significant as measured by a scale of goal achievement, and were maintained at a 3 month and a 12 month follow-up.
Subject(s)
Autistic Disorder/therapy , Behavior Therapy , Sleep Wake Disorders/therapy , Autistic Disorder/psychology , Behavior Therapy/education , Child, Preschool , Extinction, Psychological , Follow-Up Studies , Humans , Male , Parenting/psychology , Parents/education , Sleep Wake Disorders/psychologyABSTRACT
Cranial irradiation therapy (CRT) and chemotherapy are associated with neurobehavioural deficits. Many studies have investigated late effects of these treatments, but few have evaluated changes in abilities over time. This study employed a longitudinal design to map abilities following these treatments. Three groups of children were studied: Group 1 (n = 35): children treated with CRT (18 Gy) + chemotherapy, aged 5 years or less at time of diagnosis; Group 2 (n = 19): children treated with chemotherapy alone, aged 5 years or less at time of diagnosis; Group 3 (n = 35): healthy children. All children were aged 7-13 years at time of initial assessment, with no pre-diagnosis history of neurologic, developmental, or psychiatric disorder. Intellectual and educational abilities were evaluated twice: T1, not less than 2 years post-treatment, and T2, 3 years later. Group 1 achieved poorest results at T1, with comparison groups performing similarly. At T2 group differences were maintained. For verbal skills differences remained stable. Group 1 exhibited deterioration on non-verbal and processing tasks, while comparison groups showed improved abilities. Group 1 exhibited increases in literacy skills, with educational intervention predicting progress. Results suggest cumulative deficits in non-verbal and information processing skills for children treated with CRT + chemotherapy, with other deficits remaining relatively stable over time. Improved literacy skills suggest that gains can occur with remediation.
