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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
http://dx.doi.org/10.1037/cpp0000141
Table S2. Summary of Education Sessions
Session 1
Learning Task
Approximate length of time
Adolescent and parent state their major sleep challenge and 10 minutes
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.
Target specific areas related to components of successful 20-25 minutes
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.
Review the Bedtime Routines Worksheet that was already 10 minutes
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.
Discuss recommendations regarding sleep environment and 10 minutes
individualize to participant’s situation.
Identify necessary evidence-based strategies to support
10 minutes
implementation of the recommendations given (e.g., visual
reminders, task analyses, visual reinforcement systems)
Distribute and explain homework sheet, distribute the
10 minutes
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.
Address the adolescent and parent’s specific concerns and 10 minutes
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.
Session 2
Learning Task
Approximate length of time
Review homework sheet and the implementation of the
20 minutes
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.
Discuss strategies related to minimizing sleep resistance 15 minutes
and night wakings, as well as the use of individualized and
developmentally appropriate reinforcement and
environmental supports to promote compliance.
Discuss the use of relaxation and distraction strategies to 20 minutes
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.
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
10 minutes
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.
Address the adolescent and parent’s specific concerns and 10 minutes
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.
Review the next steps in the study, confirm the date and
time for the first follow-up phone call.
10 minutes