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Sleep Initiation and Maintenance Disorders: HELP
Articles by Lynn Cole
Based on 1 article published since 2010
(Why 1 article?)

Between 2010 and 2020, Lynn Cole wrote the following article about Sleep Initiation and Maintenance Disorders.
+ Citations + Abstracts
1 Article Family-Driven Goals to Improve Care for Children With Autism Spectrum Disorder. 2018

Bellesheim, Katherine R / Cole, Lynn / Coury, Daniel L / Yin, Larry / Levy, Susan E / Guinnee, Meghan A / Klatka, Kirsten / Malow, Beth A / Katz, Terry / Taylor, Jane / Sohl, Kristin. ·Thompson Center for Autism and Neurodevelopmental Disorders, and. · Departments of Psychological Sciences and. · University of Rochester Medical Center, University of Rochester, Rochester, New York. · Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio. · Children's Hospital Los Angeles, Los Angeles, California. · Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. · Catalyst Research, Depew, New York. · National Institute for Children's Health Quality, Boston, Massachusetts. · Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee; and. · Department of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado. · Thompson Center for Autism and Neurodevelopmental Disorders, and sohlk@health.missouri.edu. · Child Health, University of Missouri, Columbia, Missouri. ·Pediatrics · Pubmed #30108141.

ABSTRACT: OBJECTIVES: Constipation and insomnia are not consistently identified and treated in children with autism spectrum disorder (ASD) despite their high prevalence and deleterious impact in this population. To standardize care, a constipation practice pathway and an insomnia practice pathway were previously developed by Autism Treatment Network clinicians. Our objective was to implement and refine these practice pathways in clinical settings. METHODS: Eleven Autism Treatment Network sites participated in a Learning Collaborative (ie, multidisciplinary quality improvement team) and chose to implement either the constipation or insomnia practice pathway in the clinical setting. Families set intervention goals (eg, increase stool frequency, decrease nighttime awakenings) before treatment. Each site began implementation with 1 patient and then increased implementation by factors of 5. Before each increase, the Learning Collaborative evaluated progress and refined the practice pathways. Process improvement was measured primarily by duration until goal attainment and by percentage of families who meet their goals. RESULTS: Across sites, 82 children with ASD and constipation and 101 children with ASD and insomnia were managed. Difficulties with intervention adherence and communication between providers and families were reported and were subsequently improved with parallel refinements to both practice pathways. The most notable modification was incorporating a goal-setting session in which families generated their own intervention goals (ie, family-driven goals). In this quality improvement initiative, 75% of families met at least 1 constipation or insomnia goal, with the median time to improvement being 6 weeks. CONCLUSIONS: By integrating a family-centered approach into the standardization of care, constipation and insomnia practice pathways may improve engagement, adherence, and management of medical conditions in children with ASD.