Emily A. Abel

Circadian Sleep Patterns in Toddlers Born Preterm: Longitudinal Associations with Developmental and Health Concerns.

Objective: Children born preterm are at elevated risk for several developmental and health concerns. Early sleep patterns may be associated with these concerns. The current study assesses the associations between toddler circadian sleep/activity patterns and later developmental, behavioral, attentional, and health concerns in this at-risk population. Method: We examined circadian sleep/activity patterns at 2 years of age in 99 children born preterm. Child cognitive skills were tested at 3 years of age, and behavior, attention, and health concerns were reported at 3 and 6 years of age. First, sleep/activity data collected via actigraphy were assessed using time series analysis (TSA). For this, we assessed how each childs sleep/activity pattern compared to a specified 24-hour circadian cycle (SCC) with an adjustment for daytime napping. Second, in a series of regression models child sleep/activity parameters from the TSA were assessed with child gender, prematurity, and family sociodemographic assets as covariates. Results: Toddlers with patterns that closely aligned with the SCC had higher abbreviated intelligence quotient scores at 3 years of age. Additionally, at 6 years these children had a lower risk for illness-related medical visits. Higher toddler average activity level was associated with fewer teacher-reported attention-deficit hyperactivity disorder symptoms and a lower risk for illness-related medical visits. Conclusion: The novel approach used in this study to index child circadian patterns provides a pattern-based analysis of sleep/activity, which may prove to be developmentally consequential. With replication, these findings may help practitioners promote optimal cognitive and health development via circadian sleep supports in infants born preterm.

Further refinement of video‐based brief multiple‐stimulus without replacement preference assessments

We compared the results of a brief video-based multiple-stimulus without replacement preference assessment with no access to chosen activities (MSWO-NO) to the results of the same assessment with access (MSWO-WA) with four children with autism. We also compared instructor rankings of activities to MSWO-WA results. Strong to moderate correlations between MSWO-NO and MSWO-WA assessment results were found across all participants. The correlation between MSWO-WA and instructor rankings ranged from strong to low across all participants. Implications and directions for future research are discussed.

An Evaluation of a Brief Video-Based Multiple-Stimulus Without Replacement Preference Assessment

We evaluated a brief multiple-stimulus without replacement (MSWO) preference assessment conducted in video format with four children with autism. Specifically, we compared the results of a video-based MSWO to the results of a tangible MSWO. Toys identified as highly preferred (HP) in the video-based MSWO were also HP in the tangible MSWO for three of four participants, and correlations between video-based and tangible MSWO assessment results across participants were strong and statistically significant. Therefore, video-based MSWOs may be an accurate compliment to tangible MSWOs for children with autism.

Mechanisms of cortisol – Substance use development associations: Hypothesis generation through gene enrichment analysis

There are many theories about the mechanisms of associations between hypothalamic-pituitary-adrenal (HPA) function (indexed by cortisol) and substance use. However, the potential for genes that contribute to both HPA function and substance use to confound the association (e.g., genetic confounding) has largely been ignored. We explore the potential role of genetics in cortisol-substance use associations, build a conceptual framework placing theories and mechanisms for how cortisol and substance use are related into a developmental progression, and develop new hypotheses based on our findings. We conclude that the relationship between cortisol function and substance use is complex, occurs at multiple levels of analysis, and is bidirectional at multiple phases of the substance use progression. Additionally, there is potential for genetic confounding in cortisol-substance use associations, and thus a need for genetically informed designs to investigate how and why cortisol function is associated with substance use phenotypes from initiation through disorder. Gene-environment interplay and developmental context are likely to impact the effectiveness of prevention and intervention efforts to reduce substance use problems.

Sleep and Challenging Behaviors in the Context of Intensive Behavioral Intervention for Children with Autism

This study examined the associations between sleep and challenging behaviors for average and night-to-night fluctuations in sleep, in 39 children with autism spectrum disorder (ASD) receiving intensive behavioral intervention (IBI). Child sleep was recorded (via actigraphy) for five nights in conjunction with clinician-reported observations of challenging behaviors. Results indicated that on average, poor sleep was associated with higher rates of repetitive behavior, negative affect, and a composite of overall challenging behaviors. These findings suggest that average sleep patterns are important within the context of IBI (rather than night-to-night fluctuations). Interventions aimed at improving overall patterns of sleep may have important cascading effects on challenging behaviors and developmental outcomes for children with ASD and their families.

Pediatric Videosomnography: Can Signal/Video Processing Distinguish Sleep and Wake States?

The term videosomnography captures a range of video-based methods used to record and subsequently score sleep behaviors (most commonly sleep vs. wake states). Until recently, the time consuming nature of behavioral videosomnography coding has limited its clinical and research applications. However, with recent technological advancements, the use of auto-videosomnography techniques may be a practical and valuable extension of behavioral videosomnography coding. To test an auto-videosomnography system within a pediatric sample, we processed 30 videos of infant/toddler sleep using a series of signal/video-processing techniques. The resulting auto-videosomnography system provided minute-by-minute sleep vs. wake estimates, which were then compared to behaviorally coded videosomnography and actigraphy. Minute-by-minute estimates demonstrated moderate agreement across compared methods (auto-videosomnography with behavioral videosomnography, Cohens kappa = 0.46; with actigraphy = 0.41). Additionally, auto-videosomnography agreements exhibited high sensitivity for sleep but only about half of the wake minutes were correctly identified. For sleep timing (sleep onset and morning rise time), behavioral videosomnography and auto-videosomnography demonstrated strong agreement. However, nighttime waking agreements were poor across both behavioral videosomnography and actigraphy comparisons. Overall, this study provides preliminary support for the use of an auto-videosomnography system to index sleep onset and morning rise time only, which may have potential telemedicine implications. With replication, auto-videosomnography may be useful for researchers and clinicians as a minimally invasive sleep timing assessment method.

Sleep phenotypes in infants and toddlers with neurogenetic syndromes

BACKGROUND Although sleep problems are well characterized in preschool- and school-age children with neurogenetic syndromes, little is known regarding the early emergence of these problems in infancy and toddlerhood. To inform syndrome-specific profiles and targets for intervention, we compared parent-reported sleep problems in infants and toddlers with Angelman syndrome (AS), Williams syndrome (WS), and Prader-Willi syndrome (PWS) with patterns observed among same-aged typically developing (TD) controls. METHODS Mothers of 80 children (18 AS, 19 WS, 19 PWS, and 24 TD) completed the Brief Infant Sleep Questionnaire. Primary dependent variables included (1) sleep onset latency, (2) total sleep duration, (3) daytime and nighttime sleep duration, and (4) sleep problem severity, as measured by both maternal impression and National Sleep Foundation guidelines. RESULTS Sleep problems are relatively common in children with neurogenetic syndromes, with 41% of mothers reporting problematic sleep and 29% of children exhibiting abnormal sleep durations as per national guidelines. Across genetic subgroups, problems are most severe in children with AS and WS, particularly in relation to nighttime sleep duration. Although atypical sleep is characteristically reported in each syndrome later in development, infants and toddlers with PWS exhibited largely typical patterns, potentially indicating delayed onset of sleep problems in concordance with other medical features of PWS. CONCLUSIONS Our findings suggest that sleep problems in neurogenetic syndromes emerge as early as infancy and toddlerhood, with variable profiles across genetic subgroups. This work underscores the importance of early sleep screenings as part of routine medical care of neurosyndromic populations and the need for targeted, syndrome-sensitive treatment.

Recommendations for Identifying Sleep Problems and Treatment Resources for Children with Autism Spectrum Disorder

Many young children experience sleep problems that may influence their daytime functioning. These sleep problems are especially prevalent in young children with autism spectrum disorder (ASD). Therefore, general recommendations for identifying and treating sleep problems in children with ASD are needed for behavior analysts to identify potential sleep problems and make empirically informed decisions regarding treatment options. The current paper seeks to provide behavior analysts, who work with children with ASD, with informative research on pediatric sleep problems, sleep measures, and options for behavioral sleep treatment.

A Brief Report on Time-on-Task Behavior in a Child With Autism: Comparing Material and Social Reinforcement in the Home Environment

COPYRIGHT 2016 BY PSI CHI, THE INTERNATIONAL HONOR SOCIETY IN PSYCHOLOGY (VOL. 21, NO. 3/ISSN 2164-8204) *Faculty mentor Autism spectrum disorder (ASD) represents a continuum of pervasive developmental d i sorders charac ter i zed by var y ing degrees of impairments in social and cognitive functioning (Johnson & Myers, 2007). Atypical social communication and restricted repetitive behaviors are two key characteristics of ASD. More specifically, high-functioning autism (HFA) is associated with more advanced skill sets, and often average or above average IQ levels. Children with HFA display fewer deficits in verbal communication than children with more severe forms of ASD. However, they consistently demonstrate impairments in social interaction, and engage in repetitive behaviors and routines. Additional symptoms include obsessions with particular items or subjects, lack of eye contact, and difficulty maintaining prolonged attention or on-task behavior (American Psychiatric Association, 2013). Currently, a significant concern facing clinicians, researchers, and educators is the lack of well-defined and effective treatment options for increasing positive sustained attention in children with HFA. Although off-task behavior has been noted in many children with HFA, it is difficult to accurately identify and individualize proper interventions for each child. However, it is clear that children with HFA can benefit from strategies used to increase attention including time-on-task behavior (Mesibov, Shea, & Adams, 2001).