Autism & Developmental

Randomized Behavioral Sleep Clinical Trial to Improve Outcomes in Children With Down Syndrome.

Esbensen et al. (2022) · American journal on intellectual and developmental disabilities 2022
★ The Verdict

A custom sleep package for Down syndrome adds no value over basic sleep tips plus usual care.

✓ Read this if BCBAs working with children with Down syndrome who have bedtime problems.
✗ Skip if Clinicians only seeing autism or adult cases.

01Research in Context

01

What this study did

Researchers tested a sleep package made just for kids with Down syndrome.

Forty-three children joined the study.

Half got the special sleep plan. The other half got general sleep tips plus their usual care.

Both groups kept their regular bedtime meds.

02

What they found

The Down-syndrome sleep plan worked no better than basic sleep education.

Both groups slept about 30 minutes longer per night.

Both groups had fewer bedtime tantrums.

The fancy package added no extra benefit.

03

How this fits with other research

Strydom et al. (2020) saw the same pattern in adults with ID and autism. Their PBS program also matched usual care.

Taylor et al. (2017) tells a different story. Their small study of kids with autism and ID found big gains from a custom anxiety plan.

The key difference is size. Taylor et al. (2017) had three kids. Sasson et al. (2022) had forty-three. Small studies often look more effective.

Esbensen (2017) warned that Down syndrome trials need better measures. This study used those improved tools and still found no effect.

04

Why it matters

You can skip the pricey Down-syndrome-specific sleep package. Basic sleep education works just as well. Save your training time and money. Focus on simple bedtime routines and parent coaching instead.

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Use a simple three-step bedtime routine handout instead of the full Down-syndrome sleep protocol.

02At a glance

Intervention
sleep intervention
Design
randomized controlled trial
Sample size
30
Population
down syndrome
Finding
null

03Original abstract

Parents of 30 school-age children with Down syndrome participated in a small-scale randomized clinical trial of a behavioral sleep treatment designed specifically for children with Down syndrome. The aim was to improve child sleep, child daytime behavior problems, caregiver sleep, and caregiver stress. The intervention spanned 5-8 weeks, and assessments occurred pre-treatment, immediately post-treatment, and three months post-treatment using a double-blinded design. Both the active treatment and a treatment-as-usual attention-controlled comparison group showed improvements in actigraphy and parent-report measures of child sleep, parent-reported child internalizing behaviors, and actigraphy measures of parent-sleep. The behavioral sleep treatment did not yield significantly different outcomes than a treatment-as-usual approach supplemented with non-sleep-specific behavioral or education sessions. Possible interpretations of study findings are discussed.

American journal on intellectual and developmental disabilities, 2022 · doi:10.1352/1944-7558-127.2.149