***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Although melatonin and cognitive-behavioural therapy have shown efficacy in treating sleep disorders in children with autism spectrum disorders , little is known about their relative or combined efficacy . One hundred and sixty children with autism spectrum disorders , aged 4 - 10 years , suffering from sleep onset insomnia and impaired sleep maintenance , were assigned r and omly to either ( 1 ) combination of controlled-release melatonin and cognitive-behavioural therapy ; ( 2 ) controlled-release melatonin ; ( 3 ) four sessions of cognitive-behavioural therapy ; or ( 4 ) placebo drug treatment condition for 12 weeks in a 1 : 1 : 1 : 1 ratio . Children were studied at baseline and after 12 weeks of treatment . Treatment response was assessed with 1-week actigraphic monitoring , sleep diary and sleep question naire . Main outcome measures , derived actigraphically , were sleep latency , total sleep time , wake after sleep onset and number of awakenings . The active treatment groups all result ed in improvements across all outcome measures , with moderate-to-large effect sizes from baseline to a 12-week assessment . Melatonin treatment was mainly effective in reducing insomnia symptoms , while cognitive-behavioural therapy had a light positive impact mainly on sleep latency , suggesting that some behavioural aspects might play a role in determining initial insomnia . The combination treatment group showed a trend to outperform other active treatment groups , with fewer dropouts and a greater proportion of treatment responders achieving clinical ly significant changes ( 63.38 % normative sleep efficiency criterion of > 85 % and 84.62 % , sleep onset latency < 30 min ) . This study demonstrates that adding behavioural intervention to melatonin treatment seems to result in a better treatment response , at least in the short term BACKGROUND Children with high-functioning autism spectrum disorders ( ASD ) are at high risk for developing significant anxiety . Anxiety can adversely impact functioning across school , home and community environments . Cognitive behavioral therapies ( CBT ) are frequently used with success for children with anxiety symptoms . Modified CBT interventions for anxiety in children with ASD have also yielded promising results . METHODS Fifty children with high-functioning ASD and anxiety were r and omizedto group CBT or treatment-as-usual ( TAU ) for 12 weeks . Independent clinical evaluators , blind to condition , completed structured interviews ( Anxiety Disorders Interview Schedule – Parent Version;ADIS-P ) pre- and post-intervention condition . RESULTS Forty-seven children completed either the CBT or TAU condition . Results indicated markedly better outcomes for the CBT group . Significant differences by group were noted in Clinician Severity Ratings , diagnostic status , and clinician ratings of global improvement . In the intent-to-treat sample , 10 of 20 children ( 50 % ) in the CBT group had a clinical ly meaningful positive treatment response , compared to 2 of 23 children ( 8.7 % ) in the TAU group . CONCLUSIONS Initial results from this r and omized , design ed treatment study suggest that agroup CBT intervention specifically developed for children with ASD may be effective in decreasing anxiety . Limitations of this study include small sample size , lack of an attention control group , and use of outcome measures normed with typically developing OBJECTIVE Better Nights/Better Days , a distance intervention for  insomnia in school-aged children ( with and without attention-deficit/hyperactivity disorder [ ADHD ] ) , was evaluated to determine its effectiveness on  children 's sleep and psychosocial functioning . METHODS A single center , parallel group design r and omized controlled trial ( stratified on ADHD diagnosis ) was conducted . Parents were r and omized to intervention ( n = 31 ) or waitlist control ( n = 30 ) , and completed question naires administered over the phone at baseline , postintervention ( 2 months ) , and follow-up ( 6 months ) . Actigraphy was also collected . The intervention consisted of a five-session manual and weekly telephone coach support . RESULTS The intervention group demonstrated a significant reduction in sleep problems and improved psychosocial functioning at postintervention and follow-up . Actigraphy results indicated improved sleep onset , but not sleep duration .  Children with and without ADHD responded in a similar manner to this intervention . Parents provided high satisfaction ratings . CONCLUSIONS This intervention holds promise as an accessible , sustainable , and effective program to address insomnia in school-aged children Objective To examine whether behavioural strategies design ed to improve children ’s sleep problems could also improve the symptoms , behaviour , daily functioning , and working memory of children with attention deficit hyperactivity disorder ( ADHD ) and the mental health of their parents . Design R and omised controlled trial . Setting 21 general paediatric practice s in Victoria , Australia . Participants 244 children aged 5 - 12 years with ADHD attending the practice s between 2010 and 2012 . Intervention Sleep hygiene practice s and st and ardised behavioural strategies delivered by trained psychologists or trainee paediatricians during two fortnightly consultations and a follow-up telephone call . Children in the control group received usual clinical care . Main outcome measures At three and six months after r and omisation : severity of ADHD symptoms ( parent and teacher ADHD rating scale IV— primary outcome ) , sleep problems ( parent reported severity , children ’s sleep habits question naire , actigraphy ) , behaviour ( strengths and difficulties question naire ) , quality of life ( pediatric quality of life inventory 4.0 ) , daily functioning ( daily parent rating of evening and morning behavior ) , working memory ( working memory test battery for children , six months only ) , and parent mental health ( depression anxiety stress scales ) . Results Intervention compared with control families reported a greater decrease in ADHD symptoms at three and six months ( adjusted mean difference for change in symptom severity −2.9 , 95 % confidence interval −5.5 to −0.3 , P=0.03 , effect size −0.3 , and −3.7 , −6.1 to −1.2 , P=0.004 , effect size −0.4 , respectively ) . Compared with control children , intervention children had fewer moderate-severe sleep problems at three months ( 56 % v 30 % ; adjusted odds ratio 0.30 , 95 % confidence interval 0.16 to 0.59 ; P<0.001 ) and six months ( 46 % v 34 % ; 0.58 , 0.32 to 1.0 ; P=0.07 ) . At three months this equated to a reduction in absolute risk of 25.7 % ( 95 % confidence interval 14.1 % to 37.3 % ) and an estimated number needed to treat of 3.9 . At six months the number needed to treat was 7.8 . Approximately a half to one third of the beneficial effect of the intervention on ADHD symptoms was mediated through improved sleep , at three and six months , respectively . Intervention families reported greater improvements in all other child and family outcomes except parental mental health . Teachers reported improved behaviour of the children at three and six months . Working memory ( backwards digit recall ) was higher in the intervention children compared with control children at six months . Daily sleep duration measured by actigraphy tended to be higher in the intervention children at three months ( mean difference 10.9 minutes , 95 % confidence interval −19.0 to 40.8 minutes , effect size 0.2 ) and six months ( 9.9 minutes , −16.3 to 36.1 minutes , effect size 0.3 ) ; however , this measure was only completed by a subset of children ( n=54 at three months and n=37 at six months ) . Conclusions A brief behavioural sleep intervention modestly improves the severity of ADHD symptoms in a community sample of children with ADHD , most of whom were taking stimulant medications . The intervention also improved the children ’s sleep , behaviour , quality of life , and functioning , with most benefits sustained to six months post-intervention . The intervention may be suitable for use in primary and secondary care . Trial registration Current Controlled Trials IS RCT N68819261 OBJECTIVE Sleep difficulties are common reasons why parents seek medical intervention in children with autism spectrum disorders ( ASDs ) . We determined whether a pamphlet alone could be used by parents to help their child ’s insomnia . METHODS Thirty-six children with ASD , ages 2 to 10 years , were enrolled . All had prolonged sleep latency confirmed by actigraphy showing a mean sleep latency of 30 minutes or more . Parents were r and omly assigned to receive the  sleep education pamphlet or no intervention . Children wore an actigraphy device to record baseline sleep parameters , with the primary outcome variable being change in sleep latency . Actigraphy data were collected a second time 2 weeks after the parent received the r and omization assignment and analyzed by using Student ’s t test . Parents were also asked a series of questions to gather information about the pamphlet and its usefulness . RESULTS Although participants r and omized to the 2 arms did not differ statistically in age , gender , socioeconomic status , total Children ’s Sleep Habits Question naire score , or actigraphy parameters , some differences may be large enough to affect results . Mean change in sleep-onset latency did not differ between the r and omized groups ( pamphlet versus no pamphlet ) . Parents commented that the pamphlet contained good information , but indicated that it would have been more useful to be given specific examples of how to take the information and put it into practice . CONCLUSIONS A sleep education pamphlet did not appear to improve sleep latency in children with ASDs Background : Settling and night waking problems are particularly prevalent , persistent , and generally considered difficult to treat in children with a learning disability , although intervention trials are few . Scarce re sources , however , limit access to proven behavioural treatments . Aims : To investigate the efficacy of a media based brief behavioural treatment of sleep problems in such children by comparing ( 1 ) face-to-face delivered treatment versus control and ( 2 ) booklet delivered treatment versus controls . Methods : The parents of 66 severely learning disabled children aged 2–8 years with settling and /or night waking problems took part in a r and omised controlled trial with a wait-list control group . Behavioural treatments were presented either conventionally face-to-face or by means of a 14 page easy to read illustrated booklet . A composite sleep disturbance score was derived from sleep diaries kept by parents . Results : Both forms of treatment were almost equally effective compared with controls . Two thirds of children who were taking over 30 minutes to settle five or more times per week and waking at night for over 30 minutes four or more times per week improved on average to having such settling or night waking problems for only a few minutes or only once or twice per week ( H = 34.174 , df = 2 , p<0.001 ) . These improvements were maintained after six months . Conclusions : Booklet delivered behavioural treatments  for sleep problems were as effective as face-to-face treatment for most children in this population Abstract Objectives . We tested the hypothesis that sleep training would improve emotional , social and behavioural functioning in children with attention-deficit/hyperactivity disorder ( ADHD ) compared to children with ADHD without such intervention and to healthy controls . Methods . Forty children with ADHD were r and omly assigned to intervention and control conditions . Parents of 20 children with ADHD were instructed and thoroughly supervised in improving their children 's sleep schedules and sleep behaviour .  Parents of the other 20 children with ADHD and parents of 20 healthy children  received general information about sleep hygiene . At baseline and 12 weeks later , parents and children completed question naires related to children 's sleep and psychological functioning . Results . Relative to the control groups , children in the intervention group improved sleep quantitatively and qualitatively ( F values < 3.33 , P values < 0.05 ) . The intervention group children reported improvements in mood , emotions , and relationships ( F values < 2.99 , P values < 0.05 ) . Parents reported that their children improved in physical and psychological wellbeing , mood , emotions , relationships , and social acceptance ( F values < 3.02 , P values < 0.05 ) . Conclusions . Training and monitoring parents of children with ADHD in regulating and supervising children 's sleep schedules leads to positive changes in the emotions , behaviour and social lives of these children OBJECTIVE To examine associations between sleep problems during development and subsequent emotional and behavioral difficulties . DESIGN Prospect i ve longitudinal study . SETTING The Dutch province of Zuid-Holl and . PARTICIPANTS At time 1 of data collection , a representative sample of 2076 children aged 4 to 16 years participated in the study . OUTCOME MEASURES Parents rated their children 's ( 4 - 19 years old ) sleep at 5 assessment s by completing the Child Behavior Checklist . Participants reported on their own emotional and behavioral symptoms at a later assessment ( when aged 18 - 32 years ) by completing the Young Adult Self-Report . RESULTS After adjusting for sex , age , socioeconomic status , and parent-rated scores through development for the difficulty being predicted , having any parental reports of sleeping less than others was a risk indicator of high scores on the Anxious/Depressed scale ( odds ratio , 1.43 ; 95 % confidence interval , 1.07 - 1.90 ; P = .01 ) and the Aggressive Behavior scale ( odds ratio , 1.51 ; 95 % confidence interval , 1.13 - 2.02 ; P = .005 ) . There was some ( albeit less robust ) support for links between other reported sleep difficulties and later problems . Parental reports of sleeping more than others and nightmares were not associated with later difficulties . CONCLUSIONS Physicians should inquire about sleep problems during child development and should be aware that some , but perhaps not others , may constitute risk indicators of later difficulties Objective : Sleep problems are common in children with autism spectrum disorders ( ASD ) and ADHD and impact adversely on child and parent well-being . The study evaluated the efficacy of a brief behavioral sleep inter 
    Output:
    
Changes in cognition and academic skills were not examined in any studies .
CONCLUSIONS BSIs  improve sleep , at least in the short-term , in children with NNDDs .
Benefits may extend to functional improvements in behavior .