Telehealth Sleeping Sound ASD: A pilot study evaluating the telehealth delivery of a brief behavioural sleep intervention for autistic children.

INTERVENTION: The Sleeping Sound intervention involves two 50‐minute face‐to‐face sessions and a follow‐up phone call at 2 week intervals delivered by a clinician (e.g., Paediatrician or Psychologist), experienced in working with children with ASD. The first session will focus on assessing specific sleep difficulties that the child is experiencing and setting goals in relation to the specific sleep problems. Families will be provided with psychoeducation in relation to sleep hygiene and normal sleep patterns, and a tailored sleep management plan that includes their agreed upon goals and tailored sleep management techniques. Examples of the behavioural sleep management techniques that may be individually tailored to participants include bedtime fading to treat delayed sleep phase and early morning rising, relaxation techniques for sleep anxiety, primary caregivers ‘camping out’ for sleep onset association disorder, and parent management techniques (such as enforcing boundaries) that may be coupled with a reward system for bedtime resistance. Sleep management strategies may be delivered using a range of study designed visual tools (e.g., visual sleep schedules, social scripts etc.) to reinforce learning. Families will be given a sleep diary and asked to record bed time, sleep time, wake time and any night time awakenings for the two weeks following the first face‐to‐face session. Clinicians will keep a study consultation form of the session to document precipitating, predisposing, and perpetuating factors impacting the child’s sleep problems, which includes bedtime routines, sleep environment, medications and co‐morbid psychological disorders. The second session is held two weeks later and will be used to reinforce sleep strategies, monitor sleep patterns (by reviewing a sleep diary), CONDITION: Autism Spectrum Disorder;Sleep problems; ; Autism Spectrum Disorder ; Sleep problems Mental Health ‐ Autistic spectrum disorders Public Health ‐ Other public health PRIMARY OUTCOME: Feasability and acceptability of the Telehealth Sleeping Sound ASD intervention. This will be assessed using parent reports of the helpfulness/usefulness of the intervention and use of program strategies using a study‐designed questionnaire provided to families in the intervention group three months post randomisation. [3 months post randomisation] SECONDARY OUTCOME: Children's level of emotional and behavioural functioning measured using the developmental behavioural checklist 2 (DBC2) (composite secondary outcome)[3 and 6 months post randomisation] Children's quality of life measured using the Child Health Utility‐ 9D (CHU‐9D)[3 and 6 months post randomisation] Children's sleep hygiene measured using a 7‐item sleep hygiene scale[3 and 6 months post randomisation] Children's sleep problems measured using the Children's sleep habits questionnaire.[3 and 6 months post randomisation] Parent/caregiver mental health measured using the Kessler 10 (K10)[3 and 6 months post randomisation] Parent/caregiver quality of life measure using the AQol4D[3 and 6 months post randomisation] INCLUSION CRITERIA: Eligibility requirements for child: • Multidisciplinary diagnosis of DSM‐IV Autistic Disorder, Asperger’s Disorder or DSM‐5 ASD, as indicated by paediatrician or a confirmed diagnosis as cited in a clinical report AND • Aged 5‐12 years AND • A score above the clinical cut off (11 or more) on the Social Communication Questionnaire Lifetime form (10 minutes completion time) AND • Child has not been diagnosed with an intellectual disability on parent report • Living in Victoria, Australia Participants currently taking melatonin as well as an • Having a moderate or severe sleep problem by parent report and need to meet criteria for at least one of the following behavioural sleep problems as defined by the American Academy of Sleep Medicine diagnostic criteria: chronic insomnia (due to problems of sleep onset association, limit setting, prolonged night time waking, primary insomnia, early waking, or anxiety) or delayed sleep phase disorder AND