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Parent-Child Interaction Therapy for Children with Developmental Delay

The Role of Sleep Problems

Acosta, Juliana, MS*; Garcia, Dainelys, PhD; Bagner, Daniel M., PhD*

Journal of Developmental & Behavioral Pediatrics: April 2019 - Volume 40 - Issue 3 - p 183–191
doi: 10.1097/DBP.0000000000000647
Original Articles

Objective: Sleep problems are common and associated with externalizing behavior problems in young children, particularly among young children with developmental delay (DD). The aims of the current study, which was a secondary data analysis of 2 previously conducted randomized controlled trials, were to assess whether parent-child interaction therapy (PCIT) led to decreases in child sleep problems and whether initial sleep problems moderated the effect of PCIT on child behavior.

Methods: The study participants were 44 children (M = 49.19 months, SD = 13.1) with DD or borderline DD and with co-occurring clinically significant levels of externalizing behavior problems and their mothers (M = 35.9 years, SD = 7.3). These participants were randomly assigned to either an immediate treatment group or a waitlist control group.

Results: Findings revealed a significant direct effect of PCIT on decreases in sleep problems. Additionally, moderation analyses revealed that lower levels of child sleep problems at pretreatment were associated with greater improvements in observed child compliance compared with higher levels of child sleep problems at pretreatment.

Conclusion: This study extends previous findings by providing support for the preliminary efficacy of PCIT in reducing sleep problems in children with DD and borderline DD and highlighting the role of sleep problems as a factor associated with differential treatment effects in behavioral parenting intervention research.

*Department of Psychology and Center for Children and Families, Florida International University, Miami, FL; and

Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL.

Address for reprints: Juliana Acosta, MS, Department of Psychology, Florida International University, 11200 S.W. 8th St, AHC1, Miami, FL 33199; e-mail:

Supported by pre- and postdoctoral training awards from the National Institute of Mental Health (F31 MH068947) and the National Institute of Child Health and Human Development (F32 HD056748).

Portions of the data were previously presented at the 2017 Miami International Child and Adolescent Mental Health Conference in Miami, FL; the 2017 American Psychological Association Convention in Washington, DC; and the 2017 Parent-Child Interaction Therapy Convention in Traverse City, MI. This research is based on a master's project by Juliana Acosta, supervised by D. M. Bagner.

Received March 28, 2018

Accepted December 03, 2018

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