Evaluation of a Telehealth Parent Training Program for Parents of Children with Autism Spectrum Disorder and Sleep Difficulties

Many children with autism spectrum disorder (ASD) experience some form of sleep difficulty (e.g., delayed sleep onset, unwanted co-sleeping, prolonged or frequent night wakings). Although research supports parent-implemented behaviour-analytic sleep interventions to address sleep difficulties in children with ASD (e.g., Jin et al., 2013; Linnehan et al., 2022), more research is needed to determine how accurately parents implement behavioural sleep interventions and the effectiveness of parent training and coaching via telehealth. The present study used a concurrent multiple baseline across participants design to evaluate parents’ ability to implement their child’s behaviour-analytic sleep intervention (i.e., treatment fidelity) and a pre-/post-test design to evaluate parents’ ability to monitor and make decisions related to their child’s sleep (i.e., decision-making accuracy). Parent stress levels were evaluated pre- and post-intervention using the Parenting Stress Index 4th Edition Short Form (PSI-4-SF; Abidin, 2012). Child sleep-related outcomes (e.g., sleep onset delay, occurrences of sleep-interfering behaviours, and total sleep duration) were also monitored. Four parent-child dyads participated; mothers were the primary parent participants. Parents received behavioural skills training and nighttime coaching, via telehealth, over a 12-week intervention period. Overall, results indicate that parents’ treatment fidelity remained high throughout intervention (i.e., >80%). Further, parents’ decision-making accuracy increased from pre-test to post-test and remained at post-test levels during intervention. Two of four parents returned the PSI-4-SF. Results indicate that the intervention did not increase or decrease parent stress levels. Additionally, sleep onset delay decreased for two of four child participants. Occurrences of sleep-interfering behaviours remained variable for all child participants. Total sleep duration increased for two of four child participants. All three children who were co-sleeping at the start of the study were sleeping independently by the end of the study. All parents rated the sleep intervention as positive and acceptable. Strengths, limitations, and areas for future research are discussed