Skip to main content

Advertisement

Log in

Effects of Antecedent Manipulations and Social Reinforcement to Increase Lateral Positioning in a Premature Infant with Obstructive Sleep Apnea

  • Brief Practice
  • Published:
Behavior Analysis in Practice Aims and scope Submit manuscript

Abstract

Recent research suggests supine positioning for sleeping infants is the safest position to prevent breathing related difficulties; however doing so can significantly increase obstruction in apneic infants resulting in decreased sleep quality. We implemented a multi-component treatment package compromised of antecedent interventions and parent-mediated social reinforcement to increase lateral positioning in a premature infant with obstructive sleep apnea. Results indicate that the intervention increased lateral positioning in the participant by over 80 % in the final phase of the study, indicating efficacy of the intervention. Limitations and suggestions for future research are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Afrashi, A., & Ucar, Z. (2015). Effect of prone positioning in mild to moderate obstructive sleep apnea syndrome. Sleep & Breathing, 19(3), 1027–1034.

    Article  Google Scholar 

  • Bacher, M., Sautermeister, J., Urschitz, M., Buchenau, W., Arand, J., & Poets, C. (2011). An oral appliance with velar extension for treatment of obstructive sleep apnea in infants with Pierre robin sequence. Cleft Palate-Craniofacial Journal, 48(3), 331–336.

    Article  PubMed  Google Scholar 

  • Bhat, R., Hannam, S., Pressler, R., Rafferty, G., Peacock, J., & Greenough, A. (2006). Effect of prone and supine position in sleep, apneas, and arousal in preterm infants. Pediatrics, 118(1), 101–107.

    Article  PubMed  Google Scholar 

  • Hauck, F. R., Tanabe, K. O., McMurry, T., & Moon, R. Y. (2015). Evaluation of bedtime basics for babies: a national crib distribution program to reduce the risk of sleep-related sudden infant deaths. Journal of Community Health, 40(3), 457–463.

  • Goffinski, A., Stanley, M. A., Shepherd, N., Duvall, N., Jenkinson, S. B., Davis, C., et al. (2015). Obstructive sleep apnea in young infants with Down syndrome evaluated in a Down syndrome specialty clinic. American Journal of Medical Genetics Part A, 167(2), 324–330.

    Article  Google Scholar 

  • House, A., House, B., & Campbell, M. (1981). Measures of interobserver agreement: calculation formulas and distribution effects. Journal of Behavioral Assessment, 3(1), 37–57.

    Article  Google Scholar 

  • Kadey, H., & Roane, H. (2012). Effects of access to a stimulating object on infant behavior during tummy time. Journal of Applied Behavior Analysis, 45(2), 395–399.

    Article  PubMed  PubMed Central  Google Scholar 

  • Katz, E., Mitchell, R., & D’Ambrosio, C. (2012). Obstructive sleep apnea in infants. American Journal of Respiratory and Critical Care Medicine, 185(8), 805–816.

    Article  PubMed  Google Scholar 

  • McMullen, S. (2013). Transitioning premature infants to supine: state of the science. American Journal of Maternal Child Nursing, 38(1), 8–12.

    Article  PubMed  Google Scholar 

  • Menon, A., & Kumar, M. (2013). Influence of body position on severity of obstructive sleep apnea: a systematic review. ISRN Otolaryngology, 2013, 1–7.

    Article  Google Scholar 

  • Ortega, R., & Fienup, D. M. (2015). Effects of a preferred stimulus and mother’s attention on infant behavior during tummy time. Behavior Analysis in Practice, 8(1), 66–69.

  • Pogliani, L., Mameli, C., Fabiano, V., & Zuccotti, G. V. (2011). Positional plagiocephaly: what the pediatrician needs to know. A review. Child's Nervous System, 27(11), 1867–1876.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank our young participant as well as his family for their continued participation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Harry Voulgarakis.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from the parents of all individual participants included in the study.

Additional information

Summary for Clinicians

• A single case analysis was completed with a premature infant suffering obstructive sleep apnea using a rigorous, multi-element treatment package.

• Antecedent manipulations such as placement of a stimulus are generally simple to implement, yet effective in increasing socially valid behavioral outcomes while, in this study, also increasing physiologically necessary outcomes.

• Utility of behavioral methods is effective in various populations and can be advantageous beginning in early infancy.

• Parent attention when combined with other manipulations is effective for shaping sleeping posture in infants.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Voulgarakis, H., Forte, S., Giacomelli, C. et al. Effects of Antecedent Manipulations and Social Reinforcement to Increase Lateral Positioning in a Premature Infant with Obstructive Sleep Apnea. Behav Analysis Practice 10, 83–86 (2017). https://doi.org/10.1007/s40617-016-0141-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40617-016-0141-0

Keywords

Navigation