Summary
The prevalence of OSAS in children with DS is markedly increased compared to that of typically developing children and most are not cured by adenotonsillectomy (AT). Many children with DS are referred for positive airway pressure (PAP) therapy initiation due to persistent OSAS after AT but PAP adherence can be challenging. The purpose of this proposal is to conduct a mixed methods research study during the R61 phase that will inform the randomized controlled trial to be performed during the R33 phase, during which participants will be randomized to a 6-month intensive behavioral intervention (INT) to improve PAP adherence vs standard clinical care (CON) and undergo standardized evaluations of behavior, attention, quality of life, family-relevant outcomes identified during the R61 phase, PAP adherence, and health care utilization at baseline, 6, and 12 months.