55 Profiles of Sleep Problems among Young Children with Autism Spectrum Disorders

Abstract Background Sleep problems are more common and severe among children with autism spectrum disorder (ASD) compared to their typically developing peers. The goal of this study was to characterize sleep problems profiles and their clinical correlates, based on a five-factor model of the Children’s Sleep Habits Questionnaire (CSHQ) among preschool children with ASD. Objectives (1) To describe empirically-derived patterns (i.e., latent profiles) of sleep problems among young children with ASD; and (2) To examine relations between family cumulative risk and emotional-behavioral dysregulation symptoms and sleep profile membership. Design/Methods The study included 318 three-to-five year old children (M= 49.45 months; SD = 5.77). Latent profile analysis was used to identify and describe profiles of sleep problems. Sleep problems were assessed using a previously established CSHQ five-factor model: (1) Bedtime Routine; (2) Sleep Onset & Duration; (3) Night Waking; (4) Morning Waking; and (5) Sleep Disordered Breathing, with higher scores indicating greater problems. We assess whether profile membership was associated with dysregulation difficulties (CBCL 1.5-5) and family cumulative risk index (CRI; constructed based on socioeconomic status, maternal distress, family functioning, and other related factors) using a three-step method (Vermunt & Magidson, 2013). Results A five-profile model of children’s sleep problems showed the best fit (Figure 1). Profile 1, Nighttime Sleep Problems (28%), consisted of children with scores around the sample mean, except relatively lower scores on Morning Waking. Profile 2, Severe Sleep Problems (25%), consisted of children with relatively high scores across all sleep problems. Profile 3, Low Sleep Problems (18%), included children with the lowest levels of all sleep problems. Profile 4, Moderate Sleep Problems (17%), included children with all sleep problem levels near the sample mean. Profile 5, Morning Waking Problems (12%), consisted of children with low scores on Bedtime Routine problems but pronounced Morning Waking problems. Dysregulation difficulties (Wald = 13.90; p = .001) and family CRI (Wald = 13.27; p =.001) emerged as significant predictors of profile membership. Higher CRI was associated with higher odds of membership in Profile 2 (Severe Sleep Problems), and lower scores for dysregulation difficulties were associated with higher odds of membership in Profile 3 (Low Sleep Problems). Conclusion Children with ASD present distinct profiles of sleep problems that differ, not only by overall severity, but also by relative severity across types of sleep problems. Children’s dysregulation and family risk should be considered in examining children’s sleep.

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Sleep Disturbances in Children With Autism Spectrum Disorder at a Malaysian Tertiary Hospital

Frontiers in Pediatrics ◽

10.3389/fped.2020.608242 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ho Wai Koo ◽

Juriza Ismail ◽

Wai Wai Yang ◽

Syed Zulkifli Syed Zakaria

Keyword(s):

Autism Spectrum Disorder ◽

Sleep Disturbances ◽

Sleep Problems ◽

Sleep Latency ◽

Children With Autism ◽

Female Gender ◽

Autism Spectrum ◽

Age Group ◽

Children With Asd ◽

Sleep Length

Introduction: Children with autism spectrum disorder (ASD) have a variety of co-morbid medical problems, including sleep disturbances. Prevalence of sleep disorders has been reported to be higher in this group as compared to the general population. Identifying sleep problems in children with ASD may help increase awareness and improve the overall quality of care for them. The aim of this study was to determine the prevalence of sleep problems and associated factors in a group of Malaysian children aged 6–16 years, with ASD.Method: This is a cross-sectional study at the Child Development Centre of UKM Medical Centre (UKM MC) on ASD children aged 6–16 years. Demographic data was obtained and the Sleep Disturbances Scale for Children (SDSC) questionnaire was completed by the main caregiver. Logistic regression analysis was used to determine factors related to higher total SDSC scores.Results: A total of 128 patients were recruited (111 boys) with a median age of 8 years 3 months (IQR: 2 years 10 months). Forty-seven (36.7%) of them obtained total SDSC scores in the pathological range with 19 (14.8%) scoring high for overall disturbances and 28 (21.9%) for at least one subtype of sleep disorders: 25 (19.5%) DIMS, 18 (14.1%) SBD, 10 (7.8%) DOES, 5 (3.9%) DOA, 6 (4.7%) SWTD, and 3 (2.3%) SHY. More than half of the children (57.8%) were reported to have sufficient sleep duration of 8–11 h, but longer sleep latency of at least 15 min (82.8%). Half of the ASD children also had co-morbidities in which one-third (34.4%) had attention-deficit hyperactivity disorder (ADHD). Using logistic regression analysis, four factors were significantly associated with higher total SDSC scores; female gender (p = 0.016), older age group (11–16 years old) (p = 0.039), shorter sleep length (p = 0.043), and longer sleep latency (p < 0.001).Conclusion: The prevalence of sleep disturbances is high among Malaysian children with ASD, especially DIMS. Female gender, older age group, shorter sleep length, and longer sleep latency were found to be associated with the sleep disturbances. Evaluation of sleep problems should form part of the comprehensive care of children with ASD.

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Variations in Genes Related to Sleep Patterns in Children With Autism Spectrum Disorder

Biological Research For Nursing ◽

10.1177/1099800419843604 ◽

2019 ◽

Vol 21 (3) ◽

pp. 335-342 ◽

Cited By ~ 2

Author(s):

Ann E. E. Johansson ◽

Janice S. Dorman ◽

Eileen R. Chasens ◽

Christine A. Feeley ◽

Bernie Devlin

Keyword(s):

Autism Spectrum Disorder ◽

Suprachiasmatic Nucleus ◽

Sleep Problems ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Sleep Patterns ◽

Large Sample ◽

Melatonin Synthesis ◽

Children With Asd

Background: Sleep disturbance is a frequent comorbidity in children with autism spectrum disorder (ASD), affecting an estimated 40–80% of cases. Previous reports have shown relationships between several circadian rhythm–related genes and sleep problems in ASD. The purpose of the present study was to relate variation in and around melatonin synthesis and suprachiasmatic nucleus genes to sleep problems in a large sample of children with ASD. Method: This secondary analysis used existing genotypic and phenotypic data for 2,065 children, aged 4–18 years, from the Simons Simplex Collection (SSC). Sleep problems were measured with the SSC Sleep Interview. Expression quantitative trait loci and single nucleotide polymorphisms in 25 circadian genes were chosen primarily for their impact on expression levels of target genes in the brain. Associations between variants and composite sleep problems, nighttime problems, daytime problems, and sleep duration problems were calculated using logistic regression analysis. Age, sex, nonverbal IQ, ASD severity, gastrointestinal distress, seizures, and ancestry were included as covariates. Transmission disequilibrium tests were performed to test for overtransmission of alleles in the same variants. Results: No significant associations or transmission disequilibrium were found between gene variants and sleep problems in this sample of children with ASD. Conclusion: Variation in expression of investigated genes in the melatonin synthesis and suprachiasmatic nucleus pathways did not have notable impacts on sleep problems in this large sample of children with ASD. Future research could explore translational and posttranslational effects of these genes or the effects of genes in other sleep-homeostasis pathways on sleep patterns.

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Sleep Disorder in Children Suﬀering from Autism Spectrum Disorder in the Hilly Area of Uttarakhand

Asian Journal of Clinical Pediatrics and Neonatology ◽

10.47009/ajcpn.2020.8.2.1 ◽

2020 ◽

Vol 8 (2) ◽

pp. 1-5

Author(s):

Ashok Kumar ◽

Shweta Joshi ◽

Sushil Ojha

Keyword(s):

Sleep Disorder ◽

Sleep Problems ◽

Sleep Onset ◽

Autism Spectrum ◽

Normal Children ◽

Sleep Habit ◽

Children With Asd ◽

Spectrum Disorders ◽

Children’S Sleep ◽

Age Range

Background: Autism Spectrum Disorder (ASD) includes neurodevelopmental problems throughout life that affect all areas of child development such as abnormal and impaired social interaction, problems in communication, restricted interest, repetitive and stereotypical behaviors. Sleep problems are most commonly complained by parents of children suffering from ASD. About 20-30% of children less than 5 years with normal development give complaints of sleep problems mainly of bedtime resistance, sleep onset delay and night awakening. Less commonly reported sleep disturbance by parents is nightmares or night terrors repetitive and stereotypical behavior. Less frequently reported complain is of breathing sleep disorder. It has already been proved by many studies that ASD children have more complaints about sleep problems than in normal children. But the data of children with ASD having sleep problems in the Indian population is less, so with our study we want to know the prevalence of ASD children with sleep problems in children of the hilly area of Uttarakhand. Objective: The study aims to know the different problems related to sleep faced by children suffering from ASD ( Age range from 4 to 10 years ) with autistic spectrum disorders using the Children’s Sleep Habit Questionnaire (Preschool and school-age, abbreviated version). Subjects and Method s: All patients of ASD presenting to the Psychiatry and Pediatric Outpatient department of Government Medical College and Susheela Tiwari trust Hospital, Haldwani, Uttarakhand from in February 2019 to January 2020. It’s a cross-sectional study of children with different problems related to sleep faced by children suffering from ASD ( Age range from 4 to 10 years ) with autistic spectrum disorders using the Children’s Sleep Habit Questionnaire (CSHQ) (Preschool and school-age, abbreviated version). Results: Demographic and clinical characteristics: The sample consisted of 30 children of ASD with sleep problems ( Mean Age 8.06 years, SD 3.25, Male 21 and Female 9 Children) age range from 4 Years to 10 Years and is compare from 30 normal children (mean age 9.06 Years, SD 3.15, Male 21 and Female 9) for the control group. Both groups were analysed using CSHQ tools. There were no statistically significant differences in age and gender (P value more than 0.05). About 60% (n=18) of the children suffering from ASD had an intellectual disability and 40% (n=12) children with ASD had normal Intellectual. Comparison of Total CSHQ score, bedtime resistance and sleep anxiety showed a statistically significant difference in children suffering from ASD with sleep disorder when compared from normal children. Using CSHQ tools sleep onset delay, night waking, day time sleepiness, parasomnias and sleep –disorder breathing does not show any statistical difference between children with ASD and normal children used as Control. Conclusion: This study compared sleep problems between children with ASD and typically developing children (4-10 Years of age) and examined associated factors of sleep problems in ASD from a different point of view.

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Effect of Daily Physical Activity on Sleep Characteristics in Children with Autism Spectrum Disorder

Sports ◽

10.3390/sports9070091 ◽

2021 ◽

Vol 9 (7) ◽

pp. 91

Author(s):

Thai Duy Nguyen ◽

Michel Guinot ◽

Véronique-Aurélie Bricout

Keyword(s):

Physical Activity ◽

Autism Spectrum Disorder ◽

Sleep Quality ◽

Sleep Problems ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Large Individual ◽

Sedentary Behaviors ◽

Children With Asd

Background. Sleep problems have been reported in children with autism spectrum disorder (ASD). One of the methods proposed to improve sleep characteristics is based on physical activity (PA). Objective. To assess characteristics of sleep and the effect of PA level on sleep quality in children with ASD compared to controls. Methods. Fifty boys with ASD (ASD; 10.8 ± 2.6 years) and 18 controls (CONT, 10.1 ± 2.2 years) wore an accelerometer device for five consecutive days to obtain measures of activity and sleep characteristics. Results. Some significant differences were reported between ASD and CONT groups. Wake-up time resistance was significantly higher (p < 0.05) in ASD. Total time for PA, and daily steps number were significantly lower in the ASD group (p < 0.05). Time for sedentary behavior was significantly higher (p < 0.01) in the ASD group. Using a principal component analysis and an agglomerative hierarchical analysis, we observed three clusters. Two showed the same poor-quality indices of sleep but two opposing profiles of PA, either an insufficient PA volume (cluster 1, Total time PA = 75.1 min; Daily steps: 7704) or an important PA volume (cluster 3, Total time PA = 222.1 min; Daily steps: 17,164). Cluster 2 was characterized by moderate participation in PA and children with the best sleep indices (Total time PA = 166.8 min; Daily steps: 12,718). Conclusion. The dose–response effect of exercise on sleep may indicate large individual differences but the present findings are important to prevent sedentary behaviors or to correct over-activity that could be detrimental to the sleep quality in children with ASD.

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Sleep Problems in Children with Autism Spectrum Disorders

Journal of Educational and Developmental Psychology ◽

10.5539/jedp.v7n1p1 ◽

2016 ◽

Vol 7 (1) ◽

pp. 1

Author(s):

Christine K. Syriopoulou-Delli ◽

Grigorios Simos ◽

Andreas Grigoriadis

Keyword(s):

Autism Spectrum Disorder ◽

Sleep Problems ◽

Children With Autism ◽

Autism Spectrum ◽

Typical Development ◽

Northern Greece ◽

Children With Asd ◽

Falling Asleep ◽

Spectrum Disorders ◽

Structured Questionnaire

This study examines sleep problems of children with Autism Spectrum Disorder (ASD), as reported by their parents. To investigate this issue a total of 35 children with ASD and 35 children of Typical Development (TD) were selected from northern Greece. A structured questionnaire (Williams et al., 2004) was used, a modified version of the questionnaire study conducted by the Kosair Children’s Hospital Sleep Center (Gozal, 1998). Results show that children with ASD often experience sleep problems compared to TD individuals and also exhibit frequent awakenings during the night, difficulty in falling asleep, breathing concerns during sleep, morning headaches, sleepwalking, nightmares and fall asleep at school.

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The association of sleep problems in children with autism and parental quality of life

10.21203/rs.2.15245/v1 ◽

2019 ◽

Author(s):

Ruiting Liu ◽

Huixi Dong ◽

Ying Wang ◽

Xiaozi Lu ◽

Yamin Li ◽

...

Keyword(s):

Quality Of Life ◽

Linear Regression ◽

Physical Health ◽

Pathway Analysis ◽

Sleep Problems ◽

Children With Autism ◽

Autism Spectrum ◽

Negatively Associated ◽

Children’S Sleep

Abstract Background Many children with autism suffer from sleep problems that impact not only children’s daytime behavior and cognitive development but also their parents’ life and health. The current study explored how and to what extent sleep problems in children with autism spectrum disorder (ASD) impacted their parents’ quality of life (QOL).Methods This study adopted a case-control study design. A total of 440 ASD children aged 4 to 10 years and 344 age-matched typically developing (TD) children were included in the study. The Children’s Sleep Habits Questionnaire (CSHQ) was used to measure sleep problems in the enrolled children, and parental QOL was measured by the Short Form 36 Health Survey Questionnaire Version 2.0 (SF-36v2). Linear regression and pathway analysis were used to explore the impact of children’s sleep problems on parental QOL.Results The linear regression model showed that the CSHQ total scores were negatively associated with maternal mental health summary (MCS) scores (β=-2.831, p=0.005) in the TD group. In the ASD group, the CSHQ total scores were negatively associated with the parental physical health summary (PCS) scores (β=-3.030, p=0.003 for mothers, β=-3.651, p<0.001 for fathers) after adjusting for the child’s age, parental age, parental Zarit Caregiver Burden Interview (ZBI) score and Social Responsiveness Scale (SRS) score as covariates. The pathway analysis indicated that sleep problems in ASD children had both direct and indirect effects on maternal PCS.Conclusion The main results of the current study showed that sleep problems in children with or without ASD may affect parental QOL in different ways, and ASD children’s sleep problems affect parental physical health as a risk factor independent from the social impairments associated with ASD and the childcare burden of the parents.

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Analysis Of Occupational Therapy’s Role to Promote Healthy Sleep Participation to Support Caregivers of Children with Autism Spectrum Disorder

10.46409/sr.aqgf6621 ◽

2021 ◽

Author(s):

◽

Sophia Roman

Keyword(s):

Autism Spectrum Disorder ◽

Occupational Therapy ◽

Sleep Disturbances ◽

Sleep Problems ◽

Occupational Therapists ◽

Children With Autism ◽

Autism Spectrum ◽

Occupational Engagement ◽

Sleep Habits ◽

Children With Asd

Children with autism spectrum disorder (ASD) face sleep disturbances. Healthy sleep habits are essential for children with ASD and their caregivers to properly engage in their everyday lives. Occupational therapists are trained to evaluate clients in areas that contribute to sleep dysfunction and to focus on promoting optimal sleep performance. There is limited research on caregivers’ perceptions of their child’s sleep disturbances, these disturbances’ influence on occupational engagement, and whether occupational therapists have collaborated with caregivers of children with ASD to treat this area of occupation. Collecting data from caregivers by using a questionnaire can provide occupational therapy (OT) practitioners the emphasis on healthy sleep habits to promote healthy occupational engagement for children with ASD. This project was pursued to see if all research questions relating to sleep, occupational therapy, and occupational engagement were answered. Although rest and sleep are part of the OT practice framework, there is not enough literature to describe roles and caregivers’ perceptions to determine evidence for sleep interventions in children with ASD. This study will benefit caregivers to express their perceptions on how OT manages sleep difficulties to increase their children’s occupational engagement. The benefit of having more sleep resources available for these families can also assist caregiver stresses. The questionnaire results suggested that there is a relationship between age of child and sleep disturbance, there is a relationship between a caregiver expressing concerns about their child’s sleep problems with their occupational therapist and receiving services to address sleep during the OT intervention, there is a relationship between a caregiver expressing concerns about their child’s sleep problems with their occupational therapist and receiving services to address sleep during the OT evaluation, and there is a relationship between sleep disturbances and occupational engagement. The findings from this quantitative study support an increased role for OT practitioners to address sleep in the initial evaluation and treatment sessions.

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The association of sleep problems in children with autism and parental quality of life

10.21203/rs.2.15245/v2 ◽

2020 ◽

Author(s):

Ruiting Liu ◽

Huixi Dong ◽

Ying Wang ◽

Xiaozi Lu ◽

Yamin Li ◽

...

Keyword(s):

Quality Of Life ◽

Linear Regression ◽

Physical Health ◽

Pathway Analysis ◽

Sleep Problems ◽

Children With Autism ◽

Autism Spectrum ◽

Negatively Associated ◽

Children’S Sleep

Abstract Background Many children with autism suffer from sleep problems that impact not only children’s daytime behavior and cognitive development but also their parents’ life and health. The current study explored how and to what extent sleep problems in children with autism spectrum disorder (ASD) impacted their parents’ quality of life (QOL). Methods This study adopted a case-control study design. A total of 440 ASD children aged 4 to 10 years and 344 age-matched typically developing (TD) children were included in the study. The Children’s Sleep Habits Questionnaire (CSHQ) was used to measure sleep problems in the enrolled children, and parental QOL was measured by the Short Form 36 Health Survey Questionnaire Version 2.0 (SF-36v2). Linear regression and pathway analysis were used to explore the impact of children’s sleep problems on parental QOL. Results The linear regression model showed that the CSHQ total scores were negatively associated with maternal mental health summary (MCS) scores (β=-2.831, p=0.005) in the TD group. In the ASD group, the CSHQ total scores were negatively associated with the parental physical health summary (PCS) scores (β=-3.030, p=0.003 for mothers, β=-3.651, p<0.001 for fathers) after adjusting for the child’s age, parental age, parental Zarit Caregiver Burden Interview (ZBI) score and Social Responsiveness Scale (SRS) score as covariates. The pathway analysis indicated that sleep problems in ASD children had both direct and indirect effects on maternal PCS. Conclusion The main results of the current study showed that sleep problems in children with or without ASD may affect parental QOL in different ways, and ASD children’s sleep problems affect parental physical health as a risk factor independent from the social impairments associated with ASD and the childcare burden of the parents.

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Disfluency Characteristics Observed in Young Children With Autism Spectrum Disorders: A Preliminary Report

Perspectives on Fluency and Fluency Disorders ◽

10.1044/ffd20.2.42 ◽

2010 ◽

Vol 20 (2) ◽

pp. 42-50 ◽

Cited By ~ 11

Author(s):

Laura W. Plexico ◽

Julie E. Cleary ◽

Ashlynn McAlpine ◽

Allison M. Plumb

Keyword(s):

Autism Spectrum Disorders ◽

Young Children ◽

Children With Autism ◽

Descriptive Study ◽

Autism Spectrum ◽

Typically Developing ◽

Children With Asd ◽

Young Children With Autism ◽

Spectrum Disorders ◽

Developmental Stuttering

This descriptive study evaluates the speech disfluencies of 8 verbal children between 3 and 5 years of age with autism spectrum disorders (ASD). Speech samples were collected for each child during standardized interactions. Percentage and types of disfluencies observed during speech samples are discussed. Although they did not have a clinical diagnosis of stuttering, all of the young children with ASD in this study produced disfluencies. In addition to stuttering-like disfluencies and other typical disfluencies, the children with ASD also produced atypical disfluencies, which usually are not observed in children with typically developing speech or developmental stuttering. (Yairi & Ambrose, 2005).

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The Role of the SLP in Autism Spectrum Disorder Screening and Assessment

Perspectives on Language Learning and Education ◽

10.1044/lle15.2.50 ◽

2008 ◽

Vol 15 (2) ◽

pp. 50-59 ◽

Cited By ~ 1

Author(s):

Amy Philofsky

Keyword(s):

Language Development ◽

Critical Role ◽

Children With Autism ◽

Autism Spectrum ◽

Children With Asd ◽

Prevalence Estimates ◽

Notable Increase ◽

Screening Assessment ◽

Critical Components

AbstractRecent prevalence estimates for autism have been alarming as a function of the notable increase. Speech-language pathologists play a critical role in screening, assessment and intervention for children with autism. This article reviews signs that may be indicative of autism at different stages of language development, and discusses the importance of several psychometric properties—sensitivity and specificity—in utilizing screening measures for children with autism. Critical components of assessment for children with autism are reviewed. This article concludes with examples of intervention targets for children with ASD at various levels of language development.

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