An evaluation of the collateral child and parent outcomes of telehealth-delivered behavioral sleep intervention for Autistic children

Abstract

Purpose

This research follows two studies that examined the efficacy and acceptability of a stepped-care model of behavioral sleep intervention (BSI) delivered to parents of Autistic children via telehealth (Clarke et al., 2024a, 2024b). The current study investigated the collateral benefits of these interventions on Autistic children’s internalizing and externalizing behaviors, health-related quality of life, and parent ratings of relationship quality, depression, anxiety, stress, and personal sleep quality.

Methods and Results

Data were available for 17 Autistic children (aged 3–17 years) and 22 parent participants (16 mothers, six fathers) who had received a telehealth-delivered behavioral sleep intervention (TDBSI). Parents completed a range of psychometric assessments at baseline and within six weeks of completing the program. Alongside reduced sleep problem severity (SPS), significant improvements, as indexed by non-negligible Cohen’s d values whose 95 % confidence intervals did not cross zero, were observed in children’s emotional and behavioral difficulties and health-related quality of life. Parents also reported that improvement in their child’s sleep positively influenced their own sleep quality and emotional well-being. There were no significant changes in parental relationship quality post-intervention, probably a ceiling effect.

Conclusion

TDBSIs have the potential to generate collateral benefits for Autistic children and their families. This finding is consistent with the limited existent research, suggesting that improved sleep may enhance child and parent well-being. Future research should focus on understanding the mechanisms underlying collateral change, including variations in effects among children and parents, and the durability across different telehealth modalities (i.e., self-directed versus therapist-guided) and follow-up intervals.