Service Delivery

Barriers and facilitators to treating insomnia in children with autism spectrum disorder and other neurodevelopmental disorders: Parent and health care professional perspectives.

Tan-MacNeill et al. (2020) · Research in developmental disabilities 2020
★ The Verdict

Sleep treatments exist but access is blocked by wait lists and low know-how—give parents clear education and flexible, web-ready plans.

✓ Read this if BCBAs serving kids with autism or other delays who have bedtime problems.
✗ Skip if Practitioners focused only on daytime skill acquisition with no sleep goals.

01Research in Context

01

What this study did

The team talked to parents and health-care staff. They asked what makes it hard to treat insomnia in kids with autism, ADHD, or other delays.

No numbers were counted. The goal was to list real-world roadblocks and helpers in everyday words.

02

What they found

Both groups told the same story. Biggest blocks: long wait lists, little sleep know-how, and child or parent stress.

Top helpers: clear parent teaching, steady support, and plans tweaked for each family.

03

How this fits with other research

Shi et al. (2025) asked only Chinese parents and heard the same gaps. This match shows the problem crosses cultures.

Vassos et al. (2023) took the barrier list and tested a web sleep program. Parents and clinicians liked the idea, proving the next step is digital.

Kuenzel et al. (2021) found UK autistic adults still get meds-first sleep care they dislike. The child and adult data line up: poor access lasts a lifetime, so early fixes matter.

Pitchford et al. (2019) showed online parent class works as well as face-to-face. Their trial answers the access barrier named in our target paper.

04

Why it matters

You now have a map of what stalls sleep treatment. Use it during intake: ask about wait times, knowledge, and stress, then plug the holes with parent handouts, flexible goals, or telehealth options shown in later studies. Starting here can cut nights of lost sleep before problems harden into lifelong habits.

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→ Action — try this Monday

Add a five-question sleep intake that asks about parent knowledge, stress, and preferred help format, then offer an online parent lesson or printed tip sheet the same day.

02At a glance

Intervention
not applicable
Design
qualitative
Sample size
87
Population
autism spectrum disorder, adhd, developmental delay, other
Finding
not reported

03Original abstract

BACKGROUND/AIMS: Insomnia is highly prevalent in children with neurodevelopmental disorders (NDDs), yet little research exists on sleep treatment access, utilization, and provision in this population. This study explores barriers and facilitators to access, use, and provision of treatment for sleep problems as experienced by parents of children with NDDs, including Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), Cerebral Palsy (CP) and Fetal Alcohol Spectrum Disorder (FASD), and health care professionals who work with children with these conditions. METHOD: Transcripts from online focus groups and interviews, conducted separately with parents of children with NDDs (n = 43) and health care professionals (n = 44), were qualitatively analyzed using content analysis for key themes. RESULTS: Barriers included limited access to/availability of treatment, lack of knowledge/training, NDD-specific factors (e.g., symptoms, medications, and comorbidities), parent factors (e.g., capacity to implement treatment, exhaustion), and the challenging, intensive nature of sleep treatment. Facilitators included positive beliefs and attitudes, education, support, and ability to modify treatments for NDD symptoms. Barriers and facilitators were similar across all four NDDs. CONCLUSIONS: Results highlight a need for more education about sleep in NDDs and to develop accessible interventions, as well as the potential of a transdiagnostic approach to sleep treatment in this population.

Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2020.103792