Professional Development Needs for Educators Working with Children with Autism Spectrum Disorders in Inclusive School Environments

The primary objective of this mixed methods study was to identify educators’ professional development needs to determine how best to support them in providing quality programming for children with Autism Spectrum Disorders (ASD) within an inclusive educational system. Information was collected through focus groups with key school board informants (n = 33) and a survey of educators (n = 225). The results indicate that educators have found it difficult to meet the wide-ranging and varying needs of children with ASD within a strictly defined model of inclusive education. Educators consistently emphasized the need for multileveled and multipronged professional development that is accessible in a timely fashion and available as needs arise. The need for educational programs that work for children with ASD being taught within inclusive education settings is highlighted

Evaluation of an internet-based behavioral intervention to improve psychosocial health outcomes in children with insomnia (Better Nights, Better Days): Protocol for a randomized controlled trial

Background: Up to 25% of 1- to 10-year-old children experience insomnia (ie, resisting bedtime, trouble falling asleep, night awakenings, and waking too early in the morning). Insomnia can be associated with excessive daytime sleepiness and negative effects on daytime functioning across multiple domains (eg, behavior, mood, attention, and learning). Despite robust evidence supporting the effectiveness of behavioral treatments for insomnia in children, very few children with insomnia receive these treatments, primarily due to a shortage of available treatment resources. Objective: The Better Nights, Better Days (BNBD) internet-based program provides a readily accessible electronic health (eHealth) intervention to support parents in providing evidence-based care for insomnia in typically developing children. The purpose of the randomized controlled trial (RCT) is to evaluate the effectiveness of BNBD in treating insomnia in children aged between 1 and 10 years. Methods: BNBD is a fully automated program, developed based on evidence-based interventions previously tested by the investigators, as well as on the extant literature on this topic. We describe the 2-arm RCT in which participants (500 primary caregivers of children with insomnia residing in Canada) are assigned to intervention or usual care. Results: The effects of this behavioral sleep eHealth intervention will be assessed at 4 and 8 months postrandomization. Assessment includes both sleep (actigraphy, sleep diary) and daytime functioning of the children and daytime functioning of their parents. Results will be reported using the standards set out in the Consolidated Standards of Reporting Trials statement. Conclusions: If the intervention is supported by the results of the RCT, we plan to commercialize this program so that it is sustainable and available at a low cost to all families with internet access

Children\u27s Sleep during COVID-19: How Sleep Influences Surviving and Thriving in Families

Objective The COVID-19 pandemic has the potential to disrupt the lives of families and may have implications for children with existing sleep problems. As such, we aimed to: (1) characterize sleep changes during the COVID-19 pandemic in children who had previously been identified as having sleep problems, (2) identify factors contributing to sleep changes due to COVID-19 safety measures, and (3) understand parents and children s needs to support sleep during the pandemic. Methods Eighty-five Canadian parents with children aged 4 14 years participated in this explanatory sequential, mixed-methods study using an online survey of children s and parents sleep, with a subset of 16 parents, selected based on changes in their children s sleep, participating in semi-structured interviews. Families had previously participated in the Better Nights, Better Days (BNBD) randomized controlled trial. Results While some parents perceived their child s sleep quality improved during the COVID-19 pandemic (14.1%, n 12), many parents perceived their child s sleep had worsened (40.0%, n 34). Parents attributed children s worsened sleep to increased screen time, anxiety, and decreased exercise. Findings from semi-structured interviews highlighted the effect of disrupted routines on sleep and stress, and that stress reciprocally influenced children s and parents sleep. Conclusions The sleep of many Canadian children was affected by the first wave of the COVID-19 pandemic, with the disruption of routines influencing children s sleep. eHealth interventions, such as BNBD with modifications that address the COVID-19 context, could help families address these challenges

Attention-deficit/hyperactivity disorder and sleep problems

grantor: University of Toronto'Objective'. This thesis tests two opposing explanations for sleep difficulties in children with ADHD: (1) sleep problems are intrinsic to ADHD; and (2) sleep problems are extrinsic to ADHD. 'Method'. Three research studies were conducted as part of this thesis. The first study was a box-score analysis of previous research that evaluated for consistency in findings across studies and highlighted methodological issues. The second study tested the specificity of sleep problems to ADHD utilizing sleep questionnaires completed by parents of four groups of children (n = 172): unmedicated ADHD, medicated ADHD, clinical, and normal comparison groups. The third study examined six sleep parameters in 50 children (25 ADHD, 25 normal comparison) to verify sleep problems in children with ADHD through the use of multiple measures (i.e., questionnaires, sleep diaries, and actigraphy). 'Results'. The main finding from each study is outlined below. Firstly, it was found that across previous research, there is little consistent evidence for sleep problems in children with ADHD. Secondly, sleep problems were not found to be specific to ADHD, but were also found in a clinical comparison group. Moreover, specific sleep problems were related to stimulant medication use and comorbidity (e.g., oppositional defiant disorder and anxiety disorders). Thirdly, although sleep problems were reported by parents on a retrospective questionnaire, the majority of these sleep problems were not verified through sleep diaries or actigraphy. The only consistent finding across measures were that children with ADHD had longer sleep duration and more bedtime resistance (i.e., challenging behaviours). 'Conclusions'. The majority of the results across the three studies provide support for the notion that many of the commonly reported sleep problems in children with ADHD may be extrinsic in nature. More specifically, challenging behaviours during bedtime routines may account for these sleep problems. Clinically, it would seem that behavioural interventions should be the first line of treatment for sleep problems in children with ADHD.Ph.D

Validating the Children’s Sleep Habits Questionnaire against polysomnography and actigraphy in school-aged children

Sleep is a vital physiological behaviour in children’s development, and as such it is important to be able to efficiently and accurately assess whether children display difficulties with sleep quality and quantity. The Children’s Sleep Habits Questionnaire (CSHQ; (1)) is one of the most commonly used assessment tools for pediatric sleep. However, this instrument has never been validated against the gold standard of sleep measurement (i.e., polysomnography; PSG), and studies comparing it to actigraphy are limited. Therefore, the current study assessed the validity of four subscales of the CSHQ via direct comparison with PSG and actigraphy for 30 typically developing school-aged children (ages 6 to 12). No significant correlations between relevant CSHQ subscales and PSG variables were found. In terms of the actigraphy variables, only the CSHQ Night Wakings subscale achieved significance. In addition, sensitivity and specificity analyses revealed consistently low sensitivity and high specificity. Overall, the CSHQ Sleep Onset Delay, Sleep Duration, Night Wakings, and Sleep Disordered Breathing subscales showed low construct validity and diagnostic validity. These results underscore that caution should be taken when using the CSHQ as the sole screening tool for sleep problems in children

Sleep lab adaptation in children with attentiondeficit/hyperactivity disorder and typically developing children. Sleep Disord (2013) 698957:1–4. doi:10.1155/2013/698957 Conflict of Interest Statement: The authors declare that the research was conducted in

Objectives. Research has shown inconsistencies across studies examining sleep problems in children with attention-deficit/ hyperactivity disorder (ADHD). It is possible that these inconsistencies are due to sleep lab adaptation. The goal of the current study was to investigate the possibility that children with ADHD adapt differently to the sleep lab than do typically developing (TD) children. Patients and Methods. Actigraphy variables were compared between home and the sleep lab. Sleep lab adaptation reports from the parent and child were compared between children with ADHD ( = 25) and TD children ( = 25). Results. Based on actigraphy, both groups had reduced sleep duration and reduced wake after sleep onset in the sleep lab compared to home. The only interaction effect was that TD children had increased sleep efficiency in the sleep lab compared to home. Conclusions. The results of this study do not support the hypothesis that children with ADHD adjust to the sleep lab differently than their typically developing peers. However, both groups of children did sleep differently in the sleep lab compared to home, and this needs to be considered when generalizing research findings from a sleep lab environment to children's sleep in general