Behavioral treatments for sleep problems in autism: Empirically supported or just universally accepted?

With health maintenance organizations and insurance companies requiring proof of treatment efficacy, clinicians must determine whether research supports commonly used treatment methods. To determine the effectiveness of applied behavior analysis (ABA) for treating sleep problems in children with autism, a computer search of all relevant literature was conducted. The resulting articles revealed four basic themes of behavioral techniques for treating sleep disorders for children with autism: bedtime routines, extinction, stimulus fading, and faded bedtimes. Research on each technique was evaluated based on the Chambless criteria of treatment efficacy (Chambless and Hollon, 1998; Lonigan, Elbert, and Johnson, 1998). Of the ABA methods, only research on extinction provided sufficient evidence for a possibly efficacious intervention for sleep problems in children with autism. However, the lack of available research indicates significantly more research must be conducted before endorsing other ABA methods.