0915 Development of a Community-Engaged Sleep Intervention to Support School-Age Children on the Autism Spectrum: Preliminary Findings

Abstract Introduction Sleep disturbances occur at twice the rate in children on the autism spectrum compared to the general pediatric population, yet effective treatments for school-age children with autism remain limited. To address this gap, we adapted the Transdiagnostic Sleep and Circadian Intervention-Youth intervention for children with autism (TranS-C-Youth Autism). This report summarizes the feasibility and acceptability findings of a 12-week telehealth parallel-group randomized controlled trial comparing TranS-C-Youth Autism to a time-balanced enhanced usual care (EUC) condition. Methods We recruited a convenience sample of children with ASD (ages 6–12) and moderate or greater sleep disturbances without a known history of moderate-to-severe sleep apnea from clinical and community sources. Both groups participated in 5 telehealth-delivered sessions over 3 months, with assessments at baseline, 3, and 6 months. The primary outcomes include the Pediatric Sleep Clinical Global Impressions Scale (CGI) and the Pediatric Autism Insomnia Rating Scale (PAIRS). Secondary outcomes include Aberrant Behavior Checklist-Irritability (ABC-I), Parenting Stress Index (PSI-SF), and the Parenting Sense of Competence Scale (PSOC). Children are asked to wear an actigraph for seven nights at baseline and post-intervention. Feasibility benchmarks include acceptability (Treatment Evaluation Inventory), treatment fidelity, parent engagement, attendance, and attrition. Results Ten children have been randomized (Mean age = 9.1 ± 2.0 years; 70% Male). Feasibility: Attendance and retention are 100%. Inter-rater reliability and parent adherence are high (intervention: 99.6% ± 1.0 and 100%; EUC: 99.4% ± 1.8 and 100%). Preliminary efficacy baseline measures indicate moderate severity (CGI-S = 5.0 ± 0.8; PAIRS = 24.2 ± 6.6), notable irritability (ABC-I = 11.7 ± 9.2; 50% ≥ cutoff), elevated parenting stress (PSI-SF = 91.5 ± 18.9; 60% above threshold), and lower parental self-efficacy (PSOC = 75.3 ± 12.8; 50% below average). Nine participants completed actigraphy (6.4 ± 0.7 nights), showing a mean sleep efficiency of 79.6% ± 4.2% and total sleep of 8 h 08 m ± 38 m. Conclusion This ongoing RCT indicates that the TranS-C-Youth Autism intervention is feasible regarding recruitment and delivery. These preliminary findings support the foundation for larger studies to evaluate the intervention’s efficacy. Support (if any) American Academy of Sleep Medicine Foundation; Clinical and Translational Science Collaborative NIH NCATS UM1TR004528