Description, Implementation Integrity, and Social Validity of a Computer-Assisted Sleep Monitoring System among Residential Care Providers of Students with Autism Spectrum Disorder

  • Andrew Shlesinger
  • Kimberly Duhanyan
  • Frank Bird
  • Jill M. Harper
  • James K. LuiselliEmail author


Several subjective and direct methods have been used to measure and assess sleep patterns and problems among children and youth with autism spectrum disorder (ASD). In this paper, we describe the design, operating functions, and application of a computer-assisted system of sleep monitoring and data recording to improve measurement integrity of overnight care providers at a residential school. Descriptive and longitudinal evaluation conducted over a four-year evaluation period revealed that care providers averaged 91% implementation integrity with the system. A subsequent social validity assessment through survey questionnaire found that care providers uniformly rated the system as easy to learn, understand, and implement. We discuss the advantages of the system for sleep measurement and assessment of children and youth who have ASD and receive services in residential-care settings.


Autism spectrum disorder Direct measurement Implementation integrity Residential services Sleep assessment Sleep disorders Social validity 


Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. Carr, J. E., Wilder, D. A., Majdalany, I., Mathisen, D., & Strain, LO. (2013). An assessment based solution to a human service employee performance problem: An initial evaluation of the Performance Diagnostic Checklist-Human Services. Behavior Analysis is Practice, 6, 16–31.Google Scholar
  2. Didden, R., Curfs, L. M. G., Sikkema, S. P. E., & de Moor, J. (1998). Functional assessment and treatment of sleeping problems with developmentally disabled children: Six case studies. Journal of Behavior Therapy & Experimental Psychiatry, 29, 85–97.CrossRefGoogle Scholar
  3. Durand, V. M. (2014). Sleep problems. In J. K. Luiselli (Ed.), Children and youth with autism spectrum disorder (ASD): Recent advances and innovations in assessment, education, and intervention (pp. 174–192). New York: Oxford University Press.CrossRefGoogle Scholar
  4. Gabriels, R. L., Cuccaro, M. L., Hill, D. E., Ivers, B. J., & Goldson, E. (2005). Repetitive behaviors in autism: Relationships with associated clinical features. Research in Developmental Disabilities, 26, 169–181.CrossRefGoogle Scholar
  5. Goldman, S. E., Surdyka, K., Cuevas, R., Adkins, K., Wang, L., & Malow, B. A. (2009). Defining the sleep phenotype in children with autism. Developmental Neuropsychology, 34, 560–573.CrossRefGoogle Scholar
  6. Goldman, S. E., McGrew, S., Johnson, K. P., Richdate, A. L., Clemons, T., & Marlow, B. A. (2011). Sleep is associated with problem behaviors in children and adolescents with autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 1223–1229.CrossRefGoogle Scholar
  7. Hodge, D., Parnell, A. M. N., Hoffman, C. D., & Sweeney, D. P. (2012). Methods for assessing sleep in children with autism spectrum disorders: A review. Research in Autism Spectrum Disorders, 6, 1337–1344.CrossRefGoogle Scholar
  8. Hodge, D., Hoffman, C. D., Sweeney, D. P., & Riggs, M. L. (2013). Relationship between children’s sleep and mental health in mothers of children with and without autism. Journal of Autism and Developmental Disorders, 43, 956–963.CrossRefGoogle Scholar
  9. Hogan, J. N., & Baucom, B. R. (2016). Behavioral, affective, and physiological monitoring. In J. K. Luiselli & A. J. Fischer (Eds.), Computer-assisted and web based innovations in psychology, special education, and health (pp. 3–31). New York: Elsevier/Academic Press.CrossRefGoogle Scholar
  10. Hollway, J. A., & Aman, M. G. (2011). Sleep correlates of pervasive developmental disorders: A review of the literature. Research in Developmental Disabilities, 32, 1399–1421.CrossRefGoogle Scholar
  11. Kotagal, S., & Broomall, E. (2012). Sleep in children with autism spectrum disorder. Pediatric Neurology, 47, 242–251.Google Scholar
  12. Lesser, A. D., Luczynski, K. C., & Hood, S. A. (2019). Evaluating motion detection to score sleep disturbance for children: A translational approach to developing a measurement system. Journal of Applied Behavior Analysis, 52, 580–599.CrossRefGoogle Scholar
  13. Luiselli, J. K. (2016). Sleep and sleep-related problems. In J. K. Luiselli (Ed.), Behavioral health promotion and intervention in intellectual and developmental disabilities (pp. 163–176). New York: Springer.CrossRefGoogle Scholar
  14. Luiselli, J. K., Magee, C., Sperry, J. M., & Parker, S. (2005). Descriptive assessment of sleep patterns among community-living adults with mental retardation. Mental Retardation, 43, 416–420.CrossRefGoogle Scholar
  15. Malow, B. A., Crowe, C., Henderson, L., McGrew, S. G., Wang, L., Song, Y., & Stone, W. L. (2009). A sleep habits questionnaire for children with autism spectrum disorders. Journal of Child Neurology, 24, 19–24.CrossRefGoogle Scholar
  16. Malow, B. A., MacDonald, L. L., Fawkes, D. B., & Alder, M. L. (2016). Teaching children with autism spectrum disorder how to sleep better: A pilot educational program for parents. Clinical Practice in Pediatric Psychology, 4, 125–136.CrossRefGoogle Scholar
  17. Mannion, A., & Leader, G. (2014). Sleep problems in autism spectrum disorder: A literature review. Review Journal of Autism and Developmental Disorders, 1, 101–109.CrossRefGoogle Scholar
  18. McKay, D., Przeworski, A., & O’Neill, S. (2016). Emerging technologies for clinical practice. In J. K. Luiselli & A. J. Fischer (Eds.), Computer-assisted and web based innovations in psychology, special education, and health (pp. 365–378). New York: Elsevier/Academic Press.CrossRefGoogle Scholar
  19. McLay, L. K., France, K. G., Knight, J., Blampied, N. M., & Hastie, B. (2019). The effectiveness of function-based interventions to treat sleep problems including unwanted co-sleeping in children with autism. Behavioral Interventions, 34, 30–51.Google Scholar
  20. Meltzer, L. J. (2011). Factors associated with depressive symptoms in parents of children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 361–367.CrossRefGoogle Scholar
  21. Owens, J. A., Nobile, C., McGuinn, M., & Spirito, A. (2000). The Children’s sleep habits questionnaire: Construction and validation of a sleep survey for school-age children. Sleep, 23, 1043–1051.CrossRefGoogle Scholar
  22. Richdale, A. L., & Schreck, K. A. (2009). Sleep problems in autism spectrum disorders: Prevalence, nature, and possible biopsychosocial etiologies. Sleep Medicine Reviews, 13, 403–411.CrossRefGoogle Scholar
  23. Richdale, A., Gavidia-Payne, S., Francis, A., & Cotton, S. (2000). Stress, behavior, and sleep problems in children with intellectual disability. Journal of Intellectual and Developmental Disability, 25, 147–161.CrossRefGoogle Scholar
  24. Rzepecka, H., McKenzie, K., McClure, I., & Murphy, S. (2011). Sleep, anxiety, and challenging behavior in children with intellectual disability and/or autism spectrum disorder. Research in Developmental Disabilities, 32, 2758–2766.CrossRefGoogle Scholar
  25. Sadeh, A. (2004). A brief screening questionnaire for infant sleep problems: Validation and findings for an internet sample. Pediatrics, 113, 570–577.CrossRefGoogle Scholar
  26. Sadeh, A. (2011). The role and validity of actigraphy in sleep medicine: An update. Sleep Medicine Review, 15, 259–267.CrossRefGoogle Scholar
  27. Sadeh, A. (2015). Sleep assessment methods. Monographs of the Society of Research in Child Development, 80, 33–48.CrossRefGoogle Scholar
  28. Schreck, K. A., Mulick, J. A., & Rojahn, J. (2003). Development of the behavioral evaluation of disorders of sleep scale. Journal of Child and Family Studies, 12, 349–359.CrossRefGoogle Scholar
  29. Schreck, K. A., Mulick, J. A., & Smith, A. F. (2004). Sleep problems as possible predictors of intensified symptoms in autism. Research in Developmental Disabilities, 25, 57–66.CrossRefGoogle Scholar
  30. Williams, P., Sears, L. L., & Allard, A. (2004). Sleep problems in children with autism. Journal of Sleep Research, 13, 265–268.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Melmark New EnglandAndoverUSA

Personalised recommendations