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First published online September 27, 2012

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Children With Autism: Sleep Problems and Symptom Severity

Megan E. Tudor, MA, Charles D. Hoffman, PhD, and Dwight P. Sweeney, PhDView all authors and affiliations

Volume 27, Issue 4

https://doi.org/10.1177/1088357612457989

Abstract
References

Abstract

Relationships between the specific sleep problems and specific behavioral problems of children with autism were evaluated. Mothers’ reports of sleep habits and autism symptoms were collected for 109 children with autism. Unlike previous research in this area, only children diagnosed with autism without any commonly comorbid diagnoses (e.g., intellectual disability, epilepsy) were included in the analysis. Consistent with prior work, a positive correlation between the severity of sleep problems and the severity of autism symptoms was obtained. Sleep onset delay and sleep duration were positively correlated with autism symptoms and autism severity. Sleep onset delay was the strongest predictor of communication deficit, stereotyped behavior, and autism severity. These results provide support for specific sleep problem and symptom relationships that are unique to autism and suggest the importance of including the treatment of sleep problems as part of a comprehensive behavioral intervention for children with autism.

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References

Acock A. C. (2005). Working with missing values. Journal of Marriage and Family, 67, 1012–1028.

Allik H., Larsson J. O., Smedje H. (2006). Sleep patterns of school-age children with Asperger syndrome or high-functioning autism. Journal of Autism and Developmental Disorders, 36, 585–595.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

American Sleep Disorders Association. (1990). International classification of sleep disorders: Diagnostic and coding manual. Rochester, MN: Author.

Autism Society of America. (1994). Definition of autism. Advocate: Newsletter of the Autism Society of America, 26, 3.

California Department of Developmental Services. (2008). Information about regional centers. Available from http://www.dds.ca.gov

Carr E. G. (1992). Emerging themes in the functional analysis of problem behavior. Journal of Applied Behavior Analysis, 27, 393–399.

Chervin R. D., Archbold K. H., Dillon J. E., Panahi P., Pituch K. J., Dahl R. E., Guilleminault C. (2002). Inattention, hyperactivity, and symptoms of sleep-disordered breathing. Pediatrics, 109, 449–456.

Christodulu K. V., Durand V. M. (2004). Reducing bedtime disturbance and night waking using positive bedtime routines and sleep restriction. Focus on Autism and Other Developmental Disabilities, 19, 130–139.

Corkum P., Tannock R., Moldofsky H., Hogg-Johnson S., Humphries T. (2001). Actigraphy and parental ratings of sleep in children with attention deficit/hyperactivity disorder. Sleep, 24, 3030–3312.

Cortesi F., Giannotti F., Ottaviano S. (2005). Sleep problems and daytime behavior in childhood idiopathic epilepsy. Epilepsia, 40, 1557–1565.

Cotton S., Richdale A. (2006). Brief report: Parental descriptions of sleep problems in children with autism, Down syndrome, and Prader-Willi syndrome. Research in Developmental Disabilities, 27, 151–161.

DeVincent C. J., Gadow K. D., Delosh D., Geller L. (2007). Sleep disturbance and its relation to DSM-IV psychiatric symptoms in preschool-age children with pervasive developmental disorder and community controls. Journal of Child Neurology, 22, 161–169.

Didden R., Korzilius H., van Aperlo B., van Overloop C., de Vries M. (2002). Sleep problems and daytime problem behaviours in children with intellectual disability. Journal of Intellectual Research, 46, 537–547.

Elia M., Ferri R., Musumeci S. A., Del Gracco S., Bottitta M., Scuderi C.,. . .Grubar J. C. (2000). Sleep in subjects with autistic disorder: A neurophysiological and psychological study. Brain & Development, 22, 88–92.

Filipek P. A., Accardo P. J., Ashwal S., Baranek G. T., Cook E. H. Jr., Dawson G,. . .Volkmar F. R. (2000). Practice parameters: Screening and diagnosis of autism. American Academy of Neurology, 55, 468–479.

Gilliam J. E. (1995). Gilliam Autism Rating Scale. Austin, TX: Pro-Ed.

Gilliam J. E. (2006). Gilliam Autism Rating Scale–Second edition. Austin, TX: Pro-Ed.

Goodlin-Jones B., Schwichtenberg A. J., Iosif A. M., Tang K., Liu J., Anders T. F. (2009). Six-month persistence of sleep problems in young children with autism, developmental delay, and typical development. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 847–854.

Gottlieb D. J., Vezina R. M., Chase C. (2003). Symptoms of sleep-disordered breathing in 5-year-old children with sleepiness and problem behaviors. Pediatrics, 112, 870–877.

Guénolé F., Godbout R., Nicolas A., Franco P., Claustrat B., Baleyte J. (2011). Melatonin for disordered sleep in individuals with autism spectrum disorders: Systematic review and discussion. Sleep Medicine Reviews, 15, 379–387.

Hoban T. F. (2000). Sleeplessness in children with neurodevelopmental disorders: Epidemiology and management. CNS Drugs, 14, 11–22.

Hoffman C. D., Sweeney D. P., Gilliam J. E., Apodaca D. D., Lopez-Wagner M. C., Castillo M. M. (2005). Sleep problems and symptomology in children with autism. Focus on Autism and Other Developmental Disabilities, 20, 194–200.

Hoffman C. D., Sweeney D. P., Gilliam J. E., Lopez-Wagner M. C. (2006). Sleep problems in children with autism and in typically developing children. Focus on Autism and Other Developmental Disabilities, 21, 146–152.

Hoffman C. D., Sweeney D. P., Lopez-Wagner M. C., Hodge D., Nam C., Botts B. (2008). Children with autism: Sleep problems and mothers’ stress. Focus on Autism and Other Developmental Disabilities, 23, 155–165.

Honomichl R. D., Goodlin-Jones B. L., Burnham M. M., Gaylor E., Anders T. F. (2002). Sleep patterns of children with pervasive developmental disorders. Journal of Autism and Other Developmental Disorders, 29, 143–147.

Kheirandish L., Gozal D. (2006). Neurocognitive dysfunction in children with sleep disorders. Developmental Science, 9, 388–399.

Krakowiak P., Goodlin-Jones B., Hertz-Picciotto I., Croen L. A., Hansen R. L. (2008). Sleep problems in children with autism spectrum disorders, developmental delays, and typical development: A population based study. Journal of Sleep Research, 17, 197–206.

Lecavalier L. (2005). An evaluation of the Gilliam Autism Rating Scale. Journal of Autism and Developmental Disorders, 35, 795–805.

Liu X., Hubbard J. A., Fabes R. A., Adam J. A. (2006). Sleep disturbances and correlates of children with autism spectrum disorders. Child Psychiatry & Human Development, 37, 179–191.

Maganti R., Hausman N., Koehn M., Sandok E., Glurich I., Mukesh B. N. (2006). Excessive daytime sleepiness and sleep complaints among children with epilepsy. Epilepsy & Behavior, 8, 272–277.

Malow B. A., Marzec M. L., McGrew S. G., Wang L., Hendersen L. M., Stone W. L. (2006).Characterizing sleep in children with autism spectrum disorders: A multidimensional approach. Sleep, 29, 1563–1571.

Matson J. L., Nebel-Schwalm M. S. (2005). Comorbid psychopathology with autism spectrum disorder in children: An overview. Research in Developmental Disabilities, 28, 341–352.

Mindell J. A. (1993). Sleep disorders in children. Health Psychology, 12, 151–162.

National Institutes of Health. (2003). National sleep disorders research plan. Washington, DC: U.S. Department of Health and Human Services, National Center on Sleep Disorders Research.

National Research Council. (2001). Educating children with autism. Washington, DC: National Academic Press.

O’Connor A. B., Healy O. (2010). Long-term post-intensive behavioral intervention outcomes for five children with autism spectrum disorder. Research in Autism Spectrum Disorders, 4, 594–604.

Owens J. A., Spirito A., McGuinn M. (2000). The Children’s Sleep Habits Questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep, 23, 1043–1051.

Oyane N. M. F., Bjorvatn B. (2005). Sleep disturbances in adolescents and young adults with autism and Asperger syndrome. Autism: The International Journal of Research and Practice, 9, 83–94.

Paavonen E. J., Vehkalahti K., Vanhala R., von Wendt L., Nieminen-von Wendt T., Aronen E. T. (2008).Sleep problems in children with Asperger syndrome. Journal of Autism and Developmental Disorders, 38, 41–51.

Patzold L. M., Richdale A. L., Tonge B. J. (1998). An investigation into sleep characteristics of children with autism and Asperger’s disorder. Journal of Paediatric Child Health, 34, 528–533.

Randazzo A. C., Meuhlbach M. J., Schweitzer P. K., Walsh J. K. (1998). Cognitive function following acute sleep restriction in children ages 10-14. Sleep, 21, 861–868.

Richdale A. L. (1999). Sleep problems in autism: Prevalence, cause and intervention. Developmental Medicine & Child Neurology, 41, 60–66.

Richdale A. L., Francis A., Gavidia-Payne S., Cotton S. (2000). Stress, behaviour and sleep problems in children with an intellectual disability. Journal of Intellectual & Developmental Disability, 25, 147–161.

Richdale A. L., Schreck K. A. (2009). Sleep problems in autism spectrum disorders: Prevalence, nature, & possible biopsychosocial aetiologies. Sleep Medicine Reviews, 13, 403–411.

Ritvo E. R., Freeman B. J. (1978). National Society for Autistic Children definition of the syndrome of autism. Journal of Autism and Childhood Schizophrenia, 8, 162–167.

Sadeh A., Gruber R., Raviv A. (2002). Sleep, neurobehavioral functioning, and behavior problems in school-age children. Child Development, 73, 405–417.

Schreck K. A., Mulick J. A. (2000). Parental report of sleep problems in children with autism. Journal of Autism and Developmental Disorders, 30, 127–135.

Schreck K. A., Mulick J. A., Smith A. F. (2004). Sleep problems as possible predictors of intensified symptoms of autism. Research in Developmental Disabilities, 25, 57–66.

Schwichtenberg A. J., Iosif A. M., Goodlin-Jones B., Tang K., Anders T. (2011). Daytime sleep patterns in preschool children with autism, developmental delay, and typical development. American Journal of Intellectual and Developmental Disabilities, 116, 142–152.

South M., Williams B. J., McMahon W. M., Owley T., Filipek P. A., Shernoff E.,. . .Ozonoff S. (2002). Utility of the Gilliam Autism Rating Scale in research and clinical populations. Journal of Autism and Developmental Disorders, 32, 593–599.

Statistical Package for the Social Sciences. (2006). Statistical Package for the Social Sciences (Release 15.0) [Computer software]. Chicago: Author.

Stuart M., McGrew J. H. (2009). Caregiver burden after receiving a diagnosis of an autism spectrum disorder. Research in Autism Spectrum Disorders, 3, 86–97.

Waterhouse L., Morris R., Allen D., Dunn M., Fein D., Feinstein C.,. . .Wing L. (1996). Diagnosis and classification in autism. Journal of Autism and Developmental Disorders, 26, 59–86.

Wiggs L. D. (2003). Pediatric sleep disorders: The need for multidisciplinary sleep clinics. International Journal of Pediatric Otorhinolarynology, 67, 115–120.

Wiggs L., Stores G. (2004). Sleep patterns and sleep disorders in children with autistic spectrum disorders: Insights using parent report and actigraphy. Developmental Medicine & Child Neurology, 46, 372–380.

Williams P. G., Sears L. L., Allard A. (2004). Sleep problems in children with autism. Journal of Sleep Research, 13, 265–268.

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