Increasing Quality of Sleep Utilizing the iLs Dreampad Mini in Children With Autism Spectrum Disorder

PURPOSE: The purpose was to identify if use of iLs Dreampad Mini (DPM) and FitBit Flex (FBF) increased quality of sleep (QOS) and overall function in daily occupation in children with autism spectrum disorder (ASD).

HYPOTHESES: iLs DPM would increase the QOS and quality of life (QOL) for a child with ASD.

RESEARCH QUESTIONS: Would iLs DPM increase QOS and QOL in children with ASD, would FBF qualify the QOS a child received, and is sleep an occupation for which occupational therapists should provide interventions and education?

RATIONALE: Children with ASD frequently experience trouble with sleep preparation and participation, leading to decreased executive functioning, behavior, cognition, emotional regulation, and social interaction (Fung, Wiseman-Hakes, Stergiou-Kita, Nguyen, & Colantonio, 2013; Katz & Malow, 2014; Turnbull, Reid, & Morton, 2013). Function in daily occupation is inhibited, leading to more sleep issues and causing the cycle to continue (Turnbull et al., 2013, p. 1080). The iLs DPM was utilized as an auditory sleep intervention to increase the QOS and function in daily occupations for the participants.

DESIGN: A preexperimental case study was utilized (OXO).

PARTICIPANTS: Two children in the local area with diagnoses of ASD

METHOD: Self-created questionnaire was completed daily by the child’s parent. The FBF provided quantitative and qualitative data.

ANALYSIS: Descriptive statistics determined there was a relationship between sleeping with and without the iLs DPM. Qualitative methods identified themes related to the hypotheses. Inferential statistics will determine the cause-and-effect relationship of using the iLs DPM. Participant B’s data are in progress.

RESULTS: Hours of sleep, attention behaviors, night wakings, and meltdowns between the weeks of using and not using the iLs DPM were compared quantitatively.

Qualitatively, themes included sleep quality, focus and attention, and mood regulation (primary); self-participation in activities of daily living (ADLs) and increased engagement in role as student (secondary). Participant A looked forward to using the iLs DPM (latent). Inferential statistics are in progress.

DISCUSSION: Data collected from parents and FBF showed support for use of iLs DPM. Statistical analysis was completed for Participant A, and the data from Participant B will be collected by the end of June. Data showed hours of sleep/week increased from 56.5 to 64.5 hr, average number of times waking/night decreased from 14.5 to 6.5 times/wk, average number of days the parent noted high attention and focus in the child increased from 0 to 4.5 times/wk, and average number of meltdowns decreased from 11 to 1 time/wk.

Thematic analysis shows that parents saw an increase in mood, emotional regulation, attention and focus, engagement in education, self-participation in ADLs and sleep preparation, and QOS and enjoyment in using iLs DPM. The iLs DPM was shown to increase both QOS and QOL in a child with ASD through improved function in daily occupations.

References

Fung, C., Wiseman-Hakes, C., Stergiou-Kita, M., Nguyen, M., & Colantonio, A. (2013). Time to wake up: Bridging the gap between theory and practice for sleep in occupational therapy. British Journal of Occupational Therapy, 76, 384–386. http://dx.doi.org/10.4276/030802213X13757040168432

Katz, T., & Malow, B. A. (2014). Sleep education and the importance of starting early. Sleep, 37, 1117–1125. http://dx.doi.org/10.5665/sleep.3754

Turnbull, K., Reid, G. J., & Morton, J. B. (2013). Behavioral sleep problems and their potential impact on developing executive function in children. Sleep, 36, 1077–1084. http://dx.doi.org/10.5665/sleep.2814