Clinical Assessment of Child and Adolescent Sleep Disturbance

Kuhn, Brett R.; Mayfield, Joan W.; Kuhn, Robert H.

doi:10.1002/j.1556-6676.1999.tb02460.x

Cited by 5 publications

(9 citation statements)

References 59 publications

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“…Behavioral interventions that have received empirical support include extinction and its variants, positive bedtime routines, scheduled awakenings, and disassociating feeding from sleep-wake transitions. Readers are reminded that while this review describes standardized treatment protocols, these interventions are no replacements for a thorough functional assessment of interpersonal or environmental factors that may cue, motivate, or reinforce a specific child's sleep disturbance (Didden, Curfs, Sikkema, & de Moor, 1998;Kuhn, Mayfield, & Kuhn, 1999).…”

Section: Behavioral Approachesmentioning

confidence: 99%

Interventions for Infant and Toddler Sleep Disturbance: A Review

Kuhn¹,

Weidinger

2000

Child & Family Behavior Therapy

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Sleep disturbance affects nearly 25% of infants and toddlers, resulting in fatigue, stress, and family dissatisfaction. This review describes empirically-based treatments for infant and toddler sleep disturbance involving difficulty settling and night waking, including behavioral and pharmacological approaches. Pharmacological interventions included antihistamines, chloral hydrate, benzodiazepines, and melatonin. Behavioral interventions included extinction and its many variants, positive bedtime routines, scheduled awakenings, and disassociating feeding from sleep-wake transitions. Advantages and disadvantages of each approach are discussed and suggestions offered for future research. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: Website ]

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Section: Behavioral Approachesmentioning

confidence: 99%

Interventions for Infant and Toddler Sleep Disturbance: A Review

Kuhn¹,

Weidinger

2000

Child & Family Behavior Therapy

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“…VOLUME 4 -NUMBER 2 512 compromised mood regulation, and a decrease in positive affect (Dahl, 1996;Kuhn, Mayfield & Kuhn, 1999;Owens, 2004). Chronic sleep problems may also have deleterious effects on the cardiovascular, immune, and metabolic systems Owens, 2004).…”

Section: Jeibimentioning

confidence: 99%

Behavioral parent-training approaches for the treatment of bedtime noncompliance in young children.

Ortiz

McCormick²

2007

Journal of Early and Intensive Behavior Intervention

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Bedtime noncompliance is one of the most common and treatable types of child sleep problems. Children who are noncompliant at bedtime are more likely to exhibit daytime somnolescence, which may in turn lead children to exhibit daytime misbehavior, impaired social functioning and poorer school achievement. In addition, these bedtime problems can have a number of negative consequences for members of the child's family, including parental sleep deprivation and depression. Behavioral parent-training approaches are considered the treatments of choice for bedtime noncompliance in young children. In this paper, we describe the evidence supporting a number of such approaches. We highlight several gaps in the treatment literature and we make recommendations for future research. Keywords: Bedtime Noncompliance, Parent Training, Sleep Problems Bedtime noncompliance in preschool and elementary-school school aged children is typically characterized by stalling, whining, or tantruming when bedtime approaches. Almost all children will exhibit these behaviors at some point in their young lives. Most parents have the skills to handle milder forms of bedtime noncompliance. However, when the intensity, duration, or frequency of these behaviors leads to disruptions in a family's functioning, mental health professionals can offer substantial help. These bedtime behaviors are best classified diagnostically as Behavioral Insomnia of Childhood, Limitsetting Type (2005 revision of the International Classification of Sleep Disorders; American Academy of Sleep Medicine). In this paper we will use the less awkward term "bedtime noncompliance" to describe this set of behaviors. Although some of the studies we will mention include infants, we will focus primarily on preschool and school aged children. For an excellent review of the entire class of sleep problems in children, including parasomnias, fears, and nightmare disorders see Sadeh (2005).There is evidence that bedtime noncompliance is one of the most common childhood behavior problems. While many surveys of sleep problems in children lump sleep problems together, a few studies have examined prevalence rates of bedtime noncompliance. Estimates vary widely, but most studies suggest that 5-10% of school-aged children display significant bedtime noncompliance (e.g. Blader, Koplewics, Abikoff, & Foley, 1997, Mindell, 1993. Sleep problems as a class account for almost 10% of presenting concerns in child and adolescent outpatient mental health centers (Meisbov, Schroeder, & Wesson, 1993). There is no doubt that many other families experience these problems and do not seek professional help. Research on Effects of Sleep ProblemsThere is an increasing amount of clinical observation and research demonstrating that sleep problems, including bedtime noncompliance, can lead to insufficient sleep in children, which can, if chronic, lead to emotional, physical, behavioral, and cognitive problems (Dahl, 1996; Gais, Philal, Wagner, & Born, 2000;Kuhn, Mayfield & Kuhn, 1999;Lavigne, et al., 199...

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“…Parents were interviewed and asked questions from both the Child Sleep Assessment (Jencius & Rotter, 1998) and the Semistructured Interview of Children's Sleep Disturbance (Kuhn et al, 1999; see Appendix B). They were asked to report on the history of their child's current sleep problems and provide descriptions (e.g., number of nights the child engages in bedtime noncompliance during a typical week, what types of noncompliance behaviors the child exhibits).…”

Section: Methodsmentioning

confidence: 99%

“…Bedtime struggles are some of the most common childhood behavior problems (Kuhn, Mayfield, & Kuhn, 1999). They are worth investigating because they are known to negatively impact children's developmental outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…Because sleep problems can be manifested in a number of ways, for the sake of this study, the researcher focused solely on bedtime refusal behaviors that delay sleep onset such as stalling, making excuses, leaving the bedroom, physical aggression (e.g., throwing objects, hitting), protests (arguing, crying, calling out), and ignoring the parent's instructions to go to sleep, or failing to respond within five seconds of the parent instructing the child to go to bed. Meisbov, Schroeder, and Wesson (1993), and Richman, Stevenson, and Graham (1975), found that sleep related problems make parents "top ten" list of childhood behavior problems (as cited in Kuhn, Mayfield, & Kuhn, 1999). The actual prevalence rate of childhood sleep disturbances varies widely across the literature because sleep problems have been operationalized in numerous ways.…”

Section: Introductionmentioning

confidence: 99%

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Caretaker-Child Interactions At Bedtime: A Bidirectional Analysis of Noncompliant Bedtime Behavior

Espinal¹

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The purpose of this investigation was to (a) use the positive routines procedure to decrease child noncompliance and the time it takes the child to comply (latency) at bedtime, (b) to assess treatment fidelity, and (c) to record objectively parent behavior.Research was conducted with four children and five parents in their homes. The treatment was explained to each parent and introduced to each child after the baseline phase. Positive routines requires the parent to implement a low-stimulation "routine" at the time the child naturally gets sleepy. The routine gradually begins earlier so that by the end of treatment, it is completed at the time the parent originally attempted to establish bedtime. The data reveal that with high treatment fidelity, the treatment was effective in reducing bedtime noncompliance, latency, and parental reinforcing behaviors.The data also supported the notion that parent behavior can be controlled by child behavior.

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Clinical Assessment of Child and Adolescent Sleep Disturbance

Cited by 5 publications

References 59 publications

Interventions for Infant and Toddler Sleep Disturbance: A Review

Interventions for Infant and Toddler Sleep Disturbance: A Review

Behavioral parent-training approaches for the treatment of bedtime noncompliance in young children.

Caretaker-Child Interactions At Bedtime: A Bidirectional Analysis of Noncompliant Bedtime Behavior

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