Objective To examine behavioral interventions for sleep problems in children with autism spectrum disorders (ASD). Methods A systematic review evaluating all published studies examining the effectiveness of behavioral treatment of sleep problems in children with ASD is presented. Results Based on the Chambless criteria for treatment efficacy, both standard extinction and scheduled awakenings met criteria for possibly efficacious interventions for sleep problems in children with ASD. Some positive outcomes have been reported, but there has not been enough research examining graduated extinction, faded bedtime, stimulus fading and chronotherapy to make any firm conclusions regarding treatment efficacy for children with ASD. Conclusions Although more rigorous research is required in order for any sleep interventions for children with ASD to be considered probably efficacious or well-established, the current literature should be used to guide clinical decisions and direct research questions.

Sleep is a vital physiological behaviour in children’s development, and as such it is important to be able to efficiently and accurately assess whether children display difficulties with sleep quality and quantity. The Children’s Sleep Habits Questionnaire (CSHQ; (1)) is one of the most commonly used assessment tools for pediatric sleep. However, this instrument has never been validated against the gold standard of sleep measurement (i.e., polysomnography; PSG), and studies comparing it to actigraphy are limited. Therefore, the current study assessed the validity of four subscales of the CSHQ via direct comparison with PSG and actigraphy for 30 typically developing school-aged children (ages 6 to 12). No significant correlations between relevant CSHQ subscales and PSG variables were found. In terms of the actigraphy variables, only the CSHQ Night Wakings subscale achieved significance. In addition, sensitivity and specificity analyses revealed consistently low sensitivity and high specificity. Overall, the CSHQ Sleep Onset Delay, Sleep Duration, Night Wakings, and Sleep Disordered Breathing subscales showed low construct validity and diagnostic validity. These results underscore that caution should be taken when using the CSHQ as the sole screening tool for sleep problems in children.

Objective Better Nights/Better Days , a distance intervention for insomnia in school-aged children (with and without attention-deficit/hyperactivity disorder [ADHD]), was evaluated to determine its effectiveness on children’s sleep and psychosocial functioning. Methods A single center, parallel group design randomized controlled trial (stratified on ADHD diagnosis) was conducted. Parents were randomized to intervention ( n = 31) or waitlist control ( n = 30), and completed questionnaires administered over the phone at baseline, postintervention (2 months), and follow-up (6 months). Actigraphy was also collected. The intervention consisted of a five-session manual and weekly telephone coach support. Results The intervention group demonstrated a significant reduction in sleep problems and improved psychosocial functioning at postintervention and follow-up. Actigraphy results indicated improved sleep onset, but not sleep duration. Children with and without ADHD responded in a similar manner to this intervention. Parents provided high satisfaction ratings. Conclusions This intervention holds promise as an accessible, sustainable, and effective program to address insomnia in school-aged children.