Brief sleep intervention to enhance behavioral parent training for noncompliance: Preliminary findings from a practice-based study.

Abstract

The purpose of this study was to conduct a preliminary evaluation of a brief behavioral sleep protocol for enhancing standard behavioral treatment for child noncompliance among children with behavior problems. Data were drawn from an archival analysis of pediatric cases treated for noncompliance or disruptive behavior problems in an outpatient behavioral health clinic. A total of 50 cases (mean age ϭ 7.6 years) were identified in which the brief behavioral sleep protocol was delivered prior to behavioral parent training, and weekly parent ratings of child sleep and compliance were collected. Repeated-measures analyses indicated a significant immediate improvement in both child sleep and compliance ratings following the brief behavioral sleep protocol and prior to initiating behavioral parent training. Analyses examining changes from pretreatment to the end of all treatment (including both sleep and behavioral parent training) indicated large improvements in parent ratings of child compliance, with an effect size much larger than typical effect sizes in the literature for behavioral parent training alone. Treatment effects did not significantly differ across 3 clinicians delivering the interventions. Results of this preliminary evaluation suggest that the addition of a brief behavioral sleep protocol at the beginning of standard behavioral treatment for child noncompliance can substantially improve treatment outcomes. Further evaluation using rigorous clinical trial methods and norm-referenced measures is needed, but this study suggests that addressing sleep problems may be an important component of optimal treatment for child behavior problems.

Longitudinal sleep problem trajectories are associated with multiple impairments in child well‐being

“…Concurrently treating insomnia and depressed mood in adolescents has also yielded positive results (Clarke et al, 2015). Additionally, an open trial of caregiver training enhanced with behavioural sleep strategies was associated with large improvements in disruptive behaviours (Nelson, Van Dyk, McGinnis, Nguyen, & Long, 2016). Future research should examine whether these approaches are feasible for children with different severities of sleep problems and comorbid conditions, and on methods for sequencing these treatment components.…”

Child Executive Control as a Moderator of the Longitudinal Association Between Sleep Problems and Subsequent Attention-Deficit/Hyperactivity Disorder Symptoms

“…First, for young children presenting with sleep problems, practitioners can provide behavioral sleep treatments such as techniques for managing bedtime resistance and education on sleep hygiene. Research has begun to demonstrate that treating sleep problems as part of routine clinical care reduces ADHD symptoms and associated problems (Hiscock et al, 2015;Keshavarzi et al, 2014;Nelson, Van Dyk, McGinnis, Nguyen, & Long, 2016). Second, health-care providers are encouraged to assess for EC difficulties starting in preschool.…”

Coordinated special issues on sleep in pediatric and developmental conditions: Introduction to the Clinical Practice in Pediatric Psychology (CPPP) special issue—The clinical practice of pediatric sleep.

“…In this CPPP special issue, Nelson, Van Dyk, McGinnis, Nguyen, and Long (2016) examined a real-world behavioral sleep intervention within an outpatient psychology clinic where families presented for behavioral services for child noncompliance and/or disruptive behavior problems. As part of their standard clinical protocol, children who presented with suboptimal sleep received a brief behavioral intervention over one to two sessions, followed by a standard behavioral parent training intervention.…”