Meet the AIR-P Researchers
Beth Malow, M.D., M.S.
Dr. Malow is Principle Investigator for the HRSA AIR-P research project, "Development of a Parent-Based Sleep Education Program for Children with Autism Spectrum Disorder", and chairs the ATN subspecialty committee on Sleep.
Beth Malow, M.D., M.S., is a Professor of Neurology and Director of the Vanderbilt Sleep Disorders Center and the Vanderbilt Sleep Research Core. She is also an Associate Director of Vanderbilt University's General Clinical Research Center and Chief of the Vanderbilt Sleep Disorders Division.
Dr. Malow received her M.D. degree at Northwestern University in Chicago, Illinois. She completed residency training in Neurology at the Harvard-Longwood Program in Boston, Massachusetts, followed by fellowship training in epilepsy, EEG, and sleep medicine at the National Institutes of Health. The focus of Dr. Malow's research focuses on the impact of treating sleep disorders on neurological disease.
1. How did you become interested in sleep disorders and sleep research?
I was treating adults and children with epilepsy, and was fascinated by how sleep affected brain activity (I noticed that during rapid eye movement sleep, seizures were rare). I was also impressed that treating sleep disorders in epilepsy patients improved their seizure control. That got me interested in the possibility that sleeping better could improve functioning in other conditions as well.
2. In your work have you found that there are significant differences in the types of sleep disturbances you encounter among children with Autism Spectrum Disorder (ASD) as opposed to those you find among typically developing children?
Insomnia is the biggest difference—children with ASD have a very difficult time "shutting their brain down" to sleep. Their minds are very active at night.
3. What previous work undertaken either by you or others has led to this particular study?
In a small group of about 20 parents, we piloted our sleep education program. It was very well received by the parents and we found that their children's sleep improved with the classes. The parents also expressed to us that their successes in getting their children to sleep empowered them to take on new challenges in helping their children overcome their disability.
4. Would you briefly describe the AIR-P study, the participating institutions and how the study will work?
We will determine whether nurse-led, parent-based interventions focused on sleep education improve sleep in children with autism. We are also going to look at the impact on daytime behavior and the parents' sense of satisfaction and mastery related to the educational program. The participating institutions are Vanderbilt, Cincinnati Children's Hospital, University of Colorado, and Toronto Autism Coalition (Bloorview Kids Rehab, Hospital for Sick Children and Surrey Place Centre). In the first phase, we will compare how well an educational pamphlet improves sleep. In the second phase, we will compare a group intervention with a one-on-one intervention for efficacy as well as parent preference and sense of mastery. In the third phase, we will compare the preferred/efficacious intervention from phase two with the non-nurse intervention (pamphlet). Throughout the study, we will collect baseline data on sleep patterns via an actigraph (wrist-watch device that measures activity and rest to track sleep patterns) and sleep and behavioral data from parental questionnaires.
5. What is the age range of the children you will be studying?
2-10 years
6. Why is this work important to families with a child with ASD? How will it help them?
Sleep difficulties are one of the most common concerns in families that have children with ASD. Treating sleep difficulties can not only improve sleep in the children but also impact favorably on their daytime behavior and on family functioning. For example, a well rested child may get more out of a therapy session, and the well rested parent may be able to better cope with the stressors related to raising a child with ASD.
7. Can you give us a sense of where you see your research is heading?
This work is an important piece of the work our ATN sleep committee is doing on developing guidelines and toolkits for helping autism specialists successfully address sleep concerns in children with ASD. My research, and that of my collaborators at the other ATN sites, aims to understand the causes of sleep disturbances in children with ASD so that we can plan effective treatments. We are interested in defining the role of behavioral and pharmacological approaches, and also extending our work to teenagers and young adults with ASD.
8. What do you see as important for the future of autism research?
In addition to focusing on the causes of autism, it is important to conduct research on treatments that affect families in the here and now—particularly as they relate to the medical comorbidities associated with ASD, including sleep disturbances, epilepsy, and GI disturbances. These comorbidities may also provide important clues to understanding the causes of autism and autism subtypes in a similar way to how language functioning can define specific types of autism.
