Supplemental Materials
A Brief Behavioral Intervention for Insomnia in Adolescents with Autism Spectrum Disorders
by W. A. Loring et al., 2016, Clinical Practice in Pediatric Psychology
TableS2. Summary of Education SessionsSession1
Learning Task / Approximate length of time
Adolescent and parent state their major sleep challenge and what they hope to achieve from the session. Psychologist reviews actigraphy results and asks the adolescent and parent questions regarding the adolescent's level of motivation in addressing identified sleep concerns. / 10 minutes
Target specific areas related to components of successful sleep based on responses to the Adolescent Sleep Hygiene Scale and the Adolescent Sleep Wake Scale. These include daytime habits (e.g., caffeine, light, naps, bedroom use, exercise), evening habits (e.g., decreased screen time, decreased activity), sleep environment, and sleep amount/timing/ and regularity. Create individualized recommendations regarding each area discussed. / 20-25 minutes
Review the Bedtime Routines Worksheet that was already completed by the parent. Based on the information reviewed regarding components of successful sleep, revise the bedtime routine and create a visual representation individualized to the adolescent’s preferences and developmental level. / 10 minutes
Discuss recommendations regarding sleep environment and individualize to participant’s situation. / 10 minutes
Identify necessary evidence-based strategies to support implementation of the recommendations given (e.g., visual reminders, task analyses, visual reinforcement systems) / 10 minutes
Distribute and explain homework sheet, distribute the responsibilities between the adolescent and parent regarding the recommendations discussed in this session (responsibilities with sleep diary, bedtime routine/environmental changes, reinforcement) and review the written summary of recommendations. / 10 minutes
Address the adolescent and parent’s specific concerns and highlight his/her independent role in sleep management and self-monitoring (completion of sleep diary, tracking rewards), to the extent that the adolescent/young adult is capable and motivated to participate. / 10 minutes
Session 2
Learning Task / Approximate length of time
Review homework sheet and the implementation of the recommendations and strategies provided in the previous session. Answer the parent and adolescent’s questions regarding concerns they have encountered with implementation, assist in making individualized alterations where applicable, and discuss potential next steps. / 20 minutes
Discuss strategies related to minimizing sleep resistance and night wakings, as well as the use of individualized and developmentally appropriate reinforcement and environmental supports to promote compliance. / 15 minutes
Discuss the use of relaxation and distraction strategies to address sleep onset delay. Specific components within these strategies will be highlighted based on individual need. Briefly role-play and model the use of these strategies and discuss a practice schedule. / 20 minutes
Highlight the use of environmental supports to promote independent use of these behavioral strategies and will provide additional supports (relaxation script, CD recording) as applicable. / 10 minutes
Distribute and explain homework sheet, distribute the responsibilities between the adolescent and parent regarding the recommendations discussed in this session (responsibilities with sleep diary, bedtime routine/environmental changes, reinforcement) and review the written summary of recommendations. / 10 minutes
Address the adolescent and parent’s specific concerns and highlight his/her independent role in sleep management and self-monitoring (completion of sleep diary, tracking rewards), to the extent that the adolescent/young adult is capable and motivated to participate. / 10 minutes
Review the next steps in the study, confirm the date and time for the first follow-up phone call. / 10 minutes