Date Presented 4/19/2018
Sleep disturbances in children with autism spectrum disorder (ASD) and sensory overresponsivity are a challenging issue to address. This study provides some support for the use of weighted blankets to assist children with ASD to calm, organize, fall asleep, and remain asleep.
Primary Author and Speaker: Bryan Gee
Additional Authors and Speakers: Garett Romriell, Spencer Vandenburg, and Kimberly Lloyd
RATIONALE AND BACKGROUND: Sleep and rest disturbances are important self-care challenges commonly faced by children with ASD, with 44% to 83% reporting sleep disturbances (Tumiran et al., 2013). Such disturbances are characterized by diminished duration of sleep because of difficulty falling and staying asleep. Occupational therapy practitioners work with children with ASD and their families to establish healthy sleep routines. Weighted blankets are a sensory-based intervention commonly used in helping children with ASD attain adequate sleep participation. The purpose of this study was to build on previous research by Gee et al. (2016) exploring both objective measures and parental perspectives related to the effectiveness of weighted blankets in promoting sleep quality in children diagnosed with ASD, sensory overresponsivity, and sleep difficulties.
METHOD: An ABA single-subject design was used for this study. In Phase A(1) baseline data were collected (up to 7 days), in Phase B the weighted blanket was implemented (14 days), and in Phase A(2) the intervention was withdrawn (7 days). The five participants selected for the study met the following criteria: diagnosis of ASD, evidence of a sleep disturbance according to the Child Sleep Habits Questionnaire, sensory overreactivity as evidenced by a threshold score on the Sensory Processing Measure, age 3–6, and home within a reasonable driving distance from the offices of the principal investigator. Caregivers met the following criteria: reported that their child had difficulty falling asleep and/or staying asleep; had daily, reliable Internet access throughout the duration of the study; were able and willing to complete an online survey daily for 30 days; and were able and willing to implement a weighted blanket as part of the child’s sleep routine for 14 consecutive days.
During each phase of the study, caregivers completed a daily survey assessing their child’s sleep quality, time to fall asleep, sleep duration, and behavior on waking. Child sleep quality and movement were tracked using an external monitoring device attached to the participant’s bed. Data were analyzed through visual analysis of repeated measure graphs that were generated. Visual analyses of the data points and trend lines were conducted.
RESULTS: Moderate improvements were observed in the measured constructs related to sleep quality in the four participants with the use of the weighted blanket. The participants exhibited evidence of an increase in total amount of sleep per night and a decrease in time to fall asleep. However, morning mood did not consistently improve for two of the four participants. On the basis of the online survey and the movement tracking device, it was determined that the participants slept between 1 and 3 extra hours a night as a result of the weighted blanket.
CONCLUSION: Sleep disturbances in children with ASD and sensory overresponsivity are a challenging issue to address. Occupational therapy practitioners use weighted blankets to assist children with ASD to calm, organize, fall asleep, and remain asleep. This study provides a springboard justifying the need for additional research related to improving the quality of sleep in children with ASD and sensory overresponsivity using more robust single-subject design methodology and measurement resources.
IMPACT STATEMENT: This is one of three single-subject occupational therapy–based studies looking at weighted blankets with children with ASD and sensory overresponsivity. This research helps clarify what part of the ASD population responds best to weighted blankets to improve sleep quality.
References
Gee, B. M., Peterson, T. G., Buck, A., & Lloyd, K. (2016). Improving sleep quality using weighted blankets among young children with an autism spectrum disorder. International Journal of Therapy and Rehabilitation, 23, 173–181. https://doi.org/10.12968/ijtr.2016.23.4.173
Tumiran, M. A., Mohamad, S. P., Saat, R. M., Yusoff, M. Y. Z. M., Rahman, N. N. A., & Adli, D. S. H. (2013). Addressing sleep disorder of autistic children with Qur’anic sound therapy. Health, 5, 73–79. https://doi.org/10.4236/health.2013.58A2011
