Search

Sleep disturbances in children with neurodevelopmental disabilities are common and have a profound effect on the quality of life of the child, as well as the entire family. Although interventions for sleep problems in these children often involve a combination of behavioral and pharmacologic strategies, the first line of treatment is the promotion of improved sleep habits or “hygiene.” Despite the importance of sleep-hygiene principles, defined as basic optimal environmental, scheduling, sleep-practice, and physiologic sleep-promoting factors, clinicians often lack appropriate knowledge and skills to implement them. In addition, sleep-hygiene practices may need to be modified and adapted for this population of children and are often more challenging to implement compared with their healthy counterparts. This first comprehensive, multidisciplinary review of sleep hygiene for children with disabilities presents the rationale for incorporating these measures in their treatment, outlines both general and specific sleep-promotion practices, and discusses problem-solving strategies for implementing them in a variety of clinical practice settings.

Drs Banta and Thacker have alleged that factual errors and misunderstandings appeared in our June editorial (Pediatrics 63:942, 1979). With the exception of one minor point, which will be mentioned below, we were unable to find any other inaccuracies in our commentary. The authors apparently feel that our interpretation of their material is different from what they intended it to be. If so, this is a result of the indirect way some of their material was presented.

Regarding "An Evaluation of the Pharmacologic Approaches to Learning Impediments," I found the Report of the Committee on Drugs (Pediatrics 46: 142) very disappointing: (1) The title is rather presumptuous, since nothing new is being communicated beyond some rather trite statements that the methodology is difficult, long-term studies are necessary, but that drugs offer some promise. (2) The language is excessively tortuous, and in places unclear. For example, what is a "behavior impediment"? What is the meaning of the word "effective" in the sentence "The administration of appropriate or effective antiepileptic agents... may result in some improvements"? There are many other examples of similar obscurities.