Suggestions for Repeated Measurement of Sleep and Behavior for Children with Autism Receiving Behavior Analysis Service
摘要
Prior research on sleep and challenging behavior among children with autism has involved either directly measuring sleep but indirectly measuring behavior (such as via behavior rating scales or caregiver report) or has involved directly measuring behavior but indirectly measuring sleep (such as via caregiver report). In addition, few studies have collected repeated measures of sleep over relatively extended time periods. With the advent of sleep tracking devices, it should be easier for behavior analysts to assist with repeatedly tracking sleep and relating it to possible behavioral changes. As such, the general purpose of this study was to demonstrate methods of repeated measurement for sleep and challenging behavior for autistic children referred to us for combined sleep and behavior challenges. In the first demonstration, we used commercially available sleep tracking devices and found that, according to device output, the participants were chronically sleeping less than recommended levels (and with high variability in sleep duration). In a second demonstration, we collected repeated measures based on both caregiver report and automated measurement. Compared to automated measurement, caregiver reports over-estimated child sleep durations. In a third demonstration, we evaluated behavior rates collected in the children’s (full day) daily clinic sessions in relation to nights of “good” and “bad” sleep. In a fourth demonstration, we collected systematic repeated measurement of challenging behavior during short observation periods, using commonly accepted interobserver agreement methods. Barriers to data interpretation as well as directions for future research and application are discussed.