A Participation-Focused Exercise Intervention for Children with Neurodevelopmental Disorders: Feasibility, Acceptability, and Impact on Sleep and Wellbeing

Abstract

Sleep-related difficulties are common in children with neurodevelopmental disabilities. Poor sleep health is associated with detrimental impacts not only for the child/young person, but also their family members. Exercise is considered to be important for sleep health, improving duration and quality of sleep in adult studies, however there is limited literature on impact in children with neurodevelopmental disabilities, and barriers to participation exist for this group. We set out to test the feasibility and acceptability of an exercise-intervention for children with neurodevelopmental disorders and troublesome sleep, whilst also evaluating impact on child’s sleep and whole family wellbeing. Design: Feasibility study. Setting: Community-based Sleep Clinic for children with neurodevelopmental disorders. Patients: Total 15 children aged 5 years 0 months to 15 years 11 months. Intervention: A 10-week exercise intervention, providing one swimming session, and one dry-sports session (1.5 hours per session) per week (overall 20 x 1.5 hours). Main outcome measures: Mixed-methods design; primary outcomes of feasibility and acceptability measured by ability to run intervention, attrition rate, and semi-structured parent-completed questionnaire of acceptability, appropriateness, and free-text comments. Secondary outcomes of impact on sleep and wellbeing measured by pre-and post-intervention parent-reported diary of child’s sleep (14-nights) and semi-structured parent-reported Likert-scale questionnaire for impact on child’s sleep, wellbeing, mood and behaviour, and family wellbeing. Descriptive analyses applied to the generated data. Primary outcomes: Twelve of 15 recruited participants took part on a regular basis; attendance rate remained high throughout the 10 weeks at swimming sessions, but was lower at dry-sports sessions. Parent-reported Likert-scale measures found the intervention to be acceptable to families and appropriate to their child’s needs. All attending families were interested in future sessions if these were to be offered. Secondary outcomes: Average parent-reported sleep-onset latency, night-wakings, and estimated overall sleep duration of child improved over the course of the intervention. Families’ perceived impact on child and family wellbeing was overwhelmingly positive. Provision of a participation-focused exercise intervention for children with neurodevelopmental disorders in our area has been possible, and has been well-received by families. Families reported positive impacts on child’s sleep, wellbeing, and family wellbeing over the course of the intervention. Perceived barriers to completing the intervention included competing family priorities, family stressors, language barriers, and transport barriers. Overcoming such barriers to participation in physical activity for children with neurodevelopmental disorders continues to be important.