From ontogenesis to clinical practice: waking up to infant sleep.

This article describes the author's research journey exploring infant and toddler sleep. From polygraphic recording in hospital nurseries to using videosomnography in homes, the author traced the longitudinal development of infant/toddler nighttime sleep and waking behaviors. The home-based video observations led to a redefinition of a pediatric milestone; namely, "sleeping through the night," and provided a framework for assessing and treating infant/toddler nighttime sleep problems.

Sleep Problems and Autism Impairments in a Large Community Sample of Children and Adolescents.

Sleep problems are common in individuals with autism spectrum disorder (ASD). How sleep problems reflect specific ASD phenotypes is unclear. We studied whether sleep problems indexed functional impairment in a heterogeneous community sample of individuals with ASD.

Behavioral interventions for infant sleep problems: the role of parental cry tolerance and sleep-related cognitions.

Study Objectives: This study tested whether parental cry tolerance (PCT) and distress-attribution cognitions predict outcomes of behavioral interventions for infant sleep problems. It additionally examined intervention effects on these parental factors.

Methods: Participants were 91 infants aged 9-18 months (61% boys) with sleep-related problems and their parents.

Autism Heterogeneity in a Densely Sampled U.S. Population: Results From the First 1,000 Participants in the RI-CART Study.

The objective of this study was to establish a large, densely sampled, U.S. population-based cohort of people with autism spectrum disorder (ASD).

Behavioral interventions for pediatric insomnia: one treatment may not fit all.

Study Objectives: Behavioral interventions for pediatric insomnia are cost-effective and benefit most families, but there is no evidence indicating which treatments are most suitable for specific patient populations. This randomized controlled trial evaluated the moderating role of infant separation anxiety in two brief interventions for infant sleep problems.

Methods: Ninety-one infants aged 9-18 months (61% boys) with pediatric insomnia were randomized to either Checking-in, a Graduated extinction protocol which involves gradual separation from parents, or to the Camping-out intervention, in which parental presence is maintained.

Household chaos and family sleep during infants' first year.

Household chaos has been linked with dysregulated family and individual processes. The present study investigated linkages between household chaos and infant and parent sleep, a self-regulated process impacted by individual, social, and environmental factors. Studies of relations between household chaos and child sleep have focused on older children and teenagers, with little attention given to infants or parent sleep.

Brief Report: Factors Influencing Healthcare Satisfaction in Adults with Autism Spectrum Disorder.

The current study investigated healthcare satisfaction and factors related to satisfaction in 92 adults with Autism Spectrum Disorder (ASD). Participants or their caregiver completed a survey about their experiences with primary care and specialty physicians. Respondents reported a high level of satisfaction with their healthcare.

Low parental tolerance for infant crying: an underlying factor in infant sleep problems?

Parenting behaviours play a major role in the evolution of infant sleep. Sleep problems in infancy have been associated with excessive parental involvement at night-time, and with shorter delays in response to infant night wakings and signalling. Infant crying and sleep problems are linked, yet little is known about the impact of parental responses to crying on infant sleep patterns.

Sleep Onset and Night Waking Insomnias in Preschoolers with Psychiatric Disorders.

This study examined the nature and prevalence of diagnostically defined sleep disorders, including Sleep Onset Insomnia (SOI) and Night Waking Insomnia (NWI), in a sample of 183 young children admitted to an early childhood psychiatric day treatment program. A semi-structured diagnostic interview, the Diagnostic Infant and Preschool Assessment, was used to assess for sleep and other psychiatric disorders. Daily sleep diaries and the Child Behavior Checklist were also examined.

Daytime secretion of salivary cortisol and alpha-amylase in preschool-aged children with autism and typically developing children.

We examined daytime salivary cortisol and salivary alpha-amylase (sAA) secretion levels and variability in preschool-aged children with autism (AUT) and typically developing children (TYP). Fifty-two subjects (26 AUT and 26 TYP) were enrolled. Salivary samples were obtained at waking, midday, and bedtime on two consecutive days at three phases (baseline, 3 months later, 6 months later).

Six-month sleep-wake organization and stability in preschool-age children with autism, developmental delay, and typical development.

This study examined sleep-wake patterns in 3 matched comparison groups of preschool-aged children: children with autism (AUT), children with developmental delay (DD) without AUT, and children who are developing typically (TYP). Sleep was assessed via actigraphy and parent-report diaries for 7 consecutive 24-hr periods across 3 time points: at enrollment (n = 194), 3 months later (n = 179), and 6 months after enrollment (n = 173). At each recording period, children in the AUT group slept less per 24-hr period, on average, and were less likely to awaken at night than children in the other two groups.

Daytime sleep and parenting interactions in infants born preterm.

Objective: After a transactional perspective, this longitudinal study assessed concurrent and time-lagged associations between infant daytime sleep behaviors and maternal play interactions within a sample of infants born preterm.

Method: Data were collected from 134 families recruited from 3 Wisconsin neonatal intensive care units. Multiple methods were used to collect data at infant neonatal intensive care unit discharge and when infants were 4, 9, and 24 months postterm, including parent report infant sleep logs, family sociodemographic assets, and a 15-minute video-taped play session.

The efficacy of melatonin for sleep problems in children with autism, fragile X syndrome, or autism and fragile X syndrome.

Study Objective: To determine the efficacy of melatonin on sleep problems in children with autistic spectrum disorder (ASD) and fragile X syndrome (FXS).

Methods: A 4-week, randomized, double blind, placebo-controlled, crossover design was conducted following a 1-week baseline period. Either melatonin, 3 mg, or placebo was given to participants for 2 weeks and then alternated for another 2 weeks.

Sleep problems, sleepiness and daytime behavior in preschool-age children.

Background: Sleep problems are a common complaint of parents of preschool children. Children with neurodevelopmental disorders have even more disrupted sleep than typically developing children. Although disrupted nighttime sleep has been reported to affect daytime behavior, the pathway from sleep disruption to sleep problems, to impairments in daytime performance or behavior is not clear.

Six-month persistence of sleep problems in young children with autism, developmental delay, and typical development.

Objective: This study examined the persistence of sleep problems in preschool children with autism and two matched comparison groups: children with developmental delay without autism and typically developing children. Sleep problems were defined subjectively by parent report, by the Children's Sleep Habits Questionnaire (CSHQ), and objectively by quantitative Research Diagnostic Criteria (RDC) derived from actigraphic recordings.

Method: Children were studied on three occasions, each separated by a 3-month interval.

Child and adolescent psychiatry for the future: challenges and opportunities.

In this article, the authors focus on three particularly salient sets of issues that face the field of child and adolescent psychiatry as a sub-specialty of general psychiatry today-those related to workforce, public perception, and professional identity. In an article directed at the general psychiatrist, the authors present possibilities for refocusing the activities of the child and adolescent psychiatrist to emphasize consultative and collaborative roles. The authors embrace working in systems of care with communities and families as partners.

Objective sleep measurement in typically and atypically developing preschool children with ADHD-like profiles.

Objective: This study investigated the association between preschool children's sleep patterns measured by actigraphy and parent-reported hyperactivity symptoms. Many previous studies have reported sleep problems in children with attention deficit hyperactivity disorder (ADHD)-like symptoms.

Methods: This study examined a cross-sectional sample of 186 preschoolers age 2-5 years in three groups: children with autism, children with developmental delay without autism, and typically developing children recruited from the general population.

A 2-year progress report of the AACAP-Harvard Macy Teaching Scholars Program.

Objective: The American Academy of Child and Adolescent Psychiatry (AACAP) has partnered with the Harvard Macy Program for Healthcare Educators so that selected child and adolescent psychiatry academic faculty might enhance their teaching expertise in order to possibly enhance recruitment of medical students into child and adolescent psychiatry.

Methods: Thirteen child psychiatry faculty have graduated from the AACAP-Harvard Macy Teaching Scholars Program (HMTSP). There are 10 additional child and adolescent psychiatry faculty members in the process of completing the program.

Sleep patterns in preschool-age children with autism, developmental delay, and typical development.

Objective: A prominent noncore symptom of autistic disorder is disturbed sleep, but relatively few studies have investigated this symptom.

Method: A multimethod approach assessed the quantity and quality of sleep in 194 children (68 with autism [AUT], 57 with developmental delay without autism [DD], 69 with typical development) recorded over 1 week. Parent perceptions, structured questionnaires, and actigraphy were compared.

The Children's Sleep Habits Questionnaire in toddlers and preschool children.

Objective: Twenty to 40% of young children are reported to have behavioral insomnias of childhood. Concerns about sleep at these ages are the most common problem expressed to pediatricians at the time of well child visits. A screening questionnaire, the Children's Sleep Habits Questionnaire (CSHQ), has been used in clinical settings and in research studies to assess children ages 4 to 10 for the presence of sleep problems.

The use of actigraphy to study sleep disorders in preschoolers: some concerns about detection of nighttime awakenings.

Study Objectives: This study compared actigraphy with videosomnography in preschool-aged children, with special emphasis on the accuracy of detection of nighttime awakenings.

Design: Fifty-eight participants wore an actigraph for 1 week and were videotaped for 2 nights while wearing the actigraph.

Setting: Participants were solitary sleepers, studied in their homes.

Nocturnal sleep and daytime nap behaviors in relation to salivary cortisol levels and temperament in preschool-age children attending child care.

The purpose of this study was to describe nocturnal sleep and daytime nap duration in relation to salivary cortisol levels and child temperament in nonproblem nappers and problem nappers. Nighttime sleep and nap durations were obtained with continuous actigraph recordings for 3 days and nights (Tuesday, Wednesday, and Thursday) on 38 children aged 3 to 5 years who attended full-day child care centers. Nap times and disruptive behaviors were also observed and coded on each of the 3 days.