Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.


Special Education

Committee Chair

Scott, Terry M.

Author's Keywords

Sleep problems; Blind; ActiGraph; Blindness; Single-subject; Visual impairment


Sleep disorders in children; Children--Sleep; Blind children


Research has confirmed that individuals with blindness have an increased risk of developing sleep problems; this is especially problematic for families with young children who are blind. Not only does the lack of sleep impact the growth and development of the child, but it also directly affects the entire family. A single-subject A-B-A-B research design was implemented with three young children having visual acuities of light perception or no light perception that were having sleep problems. At the start of study, none of the children had any other major medical diagnosis other than their visual impairment. The intervention (B phases) consisted of a bubble tube activated at bedtime and turned off in the morning serving as an auditory zeitgeber (time cue) and positive sleep association. Although light is typically the primary zeitgeber, research indicates that until the age of three to four-years-old, children are stilling developing their sleep patterns and may be amenable to learning other zeitgebers that help them establish an appropriate 24-hour sleep cycle. Sleep patterns were measured using an ActiGraph monitor worn continuously throughout the study, in addition to information provided by caregivers in a daily sleep log. Although there were some positive effects noted, the investigation failed to show a functional relationship between the independent variable, the use of the bubble tube, and the dependent variables of sleep latency, nighttime awakenings, daytime naps, and total time slept per a day. However, caregiver perceptions on the effectiveness were much higher than the actual data and all of the participants continued to use the bubble tube post study. The research also reinforced the importance of parental education on bedtime routines and good sleep hygiene within the context of early intervention services.