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Margaret Souders

I am committed to the profession of nursing and the generation of evidence to guide clinical practice. As a board certified pediatric nurse practitioner in the Biobehavioral Unit and the Regional Autism Center at CHOP, I have provided care for children with autism spectrum disorders (ASD) and their families for 12 years. Individuals with ASD vary in the degree to which they exhibit the core features of the disorder. I have educated families about the core deficits of ASD specific to their child and have tailored their recommendations to optimize each child’s functional and behavioral outcomes. As a member of an interdisciplinary team in the Biobehavioral Unit, I have been trained in applied behavioral analysis techniques and have guided families on the type and intensity of the behavioral program most appropriate for their child’s needs. I have developed excellent clinical and differential diagnostic skills under the mentorship of Dr. Susan E. Levy, Medical Director of the Regional Autism Center at CHOP. I was trained in 2001 to perform diagnostic evaluations in children with ASD and have conducted developmental testing with more than 500 children. In addition, I have advanced training in the use of psychotropic medications in children with ASD with severe maladaptive behaviors and have collaboratively practiced with pediatric psychiatrists and developmental pediatricians for the past decade.

At the present time, I am a Post Doctoral Fellow in the Center for Sleep in the Schools of Medicine/Nursing at the University of Pennsylvania. My mission is to develop new knowledge that can be can be used by clinicians and researchers to improve their understanding of the underlying mechanisms of insomnia and develop targeted interventions to promote sleep in this vulnerable population. Chronic, severe insomnia is one of the most common medical conditions among children with ASD. The prevalence of chronic insomnia among children with ASD is 60-80%, a two-three fold increase over typically developing (TD) children. Chronic insomnia has detrimental effects on cognitive development, behavior and mood. Moreover, disruptive sleep in children with ASD has been shown to severely alter the quality of the sleep of parents, who report great stress as a result. In addition, I have has observed that chronic insomnia may impede the benefits of the intensive and costly daytime interventions children with ASD receive. In response, I have has worked diligently at trying to improve the sleep of children with ASD using behavioral, alternative modalities and pharmacological interventions. However, very little data exist on effective treatments of insomnia in children with ASD. We have collaborated with the Center for Sleep at CHOP and we have been struggling to improve the sleep of children with ASD on a trial and error basis. We acknowledge that the substantial heterogeneity of ASD makes choosing the most appropriate intervention to promote sleep very difficult. Moreover, behavioral and medication trials are time consuming and draining for families; choosing the most appropriate one based on each child’s individual characteristics and family needs is critical.

Sample of Significant Publications

Coplan, J., Souders, M.C., Mulberg, A., Belchic, J, Wray, J. Jawad, A., Gallagher, P., Mitchell, R., Levy,S.E. Parents of Children with Autistic Spectrum Disorder (ASD) are Unable to Distinguish Single-Dose Synthetic Human Secretin from Placebo. Archives of Disease in Childhood. 2003. 88: 737-739.

Giarelli,E., Souders,M.C., Pinto-Martin,J., Bloch,J., Levy,S.E. Intervention Pilot for Parents of Children with Autistic Spectrum Disorder. Pediatric Nursing. 2005. 31(5): 389-399.

Levy, S.E., Souders, M.C., Wray J, Coplan, J.C., Belchic, J.K., Mitchell, R.,Jawad, A., Gallagher, P., & Mulberg.A. Comparison of Placebo and Single Dose of Human Synthetic Secretin in Children with Autistic Spectrum Disorders. Archives of Disease in Childhood. 2003. 88: 731-736.

Levy, S.E., Souders,M.C., Ittenbach,R.F., Giarelli,E., Mulberg, A.E., Pinto-Martin,J.A. Relationship of Dietary Intake to Gastrointestinal Symtoms in Children with Autistic Spectrum Disorders. Biological Psychiatry. 2007. 61: 492-497.

Machefsky, A., Souders, M.C., Mandell, D.S. Sleep and activity levels in children with Autism Spectrum Disorder (in revision). Journal of Autism and Developmental Disorders. 2009.

Pinto-Martin, J., Souders, M.C. , Giarelli, E., Levy, S.E. The role of nurses in screening for autistic spectrum disorders in pediatric primary care. Journal of Pediatric Nursing. 2005. 20(3): 163-169.

Souders, M.C., Freeman, K., DePaul, D., Levy, S.E. Caring for Children with Autism who require challenging procedures. Pediatric Nursing. 2002. 28(6): 555-562.

Souders, M.C., Mason, T.A, Valadares, O., Bucan , M. Levy, S.E., Mandell, D., T.E. Weaver, Pinto-Martin, J. Sleep behaviors and sleep quality in children with Autism Spectrum Disorder. Sleep. 2009. 32(12): 1566-1578.

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