Parent-Implemented Bedtime Fading and Positive Routines for Children with Autism Spectrum Disorders.

Only six children were studied, so the results cannot show how the interventions would work in a larger or more varied group. All children were also receiving 20 hours per week of one-to-one ABA tutoring, so the separate contribution of bedtime fading or positive routines cannot be isolated. Sleep was measured by parent diaries, not objective sleep measures, so parents may have missed wakings or overestimated sleep because they were asleep themselves. The children were aged 2 to 7, had average sleep under 7 hours, and were recruited from one early intervention setting, so the results may not apply to other ages, sleep problems or settings. No child met the target total sleep duration during the study. The paper did not report severity of autism or IQ, which can affect how well children follow behavioural routines.

The paper does not provide a funding or conflict-of-interest declaration. The researcher was employed by the early intervention setting from which participants were recruited.

Do not conclude that bedtime fading alone improves sleep in children with autism. The children also received 20 hours per week of ABA tutoring, only three children were assigned to bedtime fading, and sleep was measured by parent diaries, so the study cannot separate the sleep intervention from ABA or generalise widely.