Abstract
Sleep problems are common in children with autism spectrum disorder (ASD). However, few studies have undertaken group comparisons of sleep profiles and factors associated with poorer sleep between children with ASD without intellectual disability (ID; hereafter referred to as ASD) and ASD with co-occurring ID (hereafter referred to as ASD + ID). This study aimed to (1) compare child (sleep problems and emotional and behavioural problems (EBPs)) and parent factors (parenting stress and mental health) for children with ASD compared to children with ASD + ID, and (2) examine the associations between sleep problems and child and parent factors in both groups. Parents of 56 children with ASD (22 ASD, 34 ASD + ID) aged 6–13 years took part in the study. No statistically significant differences in sleep problems were found between children with ASD compared to children with ASD + ID. However, total EBPs were independently associated with child sleep problems in both groups. Further, ‘Self-Absorbed’ and ‘Communication Disturbance’ EBPs were significantly greater in the ASD + ID compared to the ASD group. Overall treatment outcomes for children with ASD may be further improved if consideration is given to the specific types of EBPs being experienced by the child and their association with sleep problems.
Highlights
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by persistent social communication and interaction difficulties, and restricted, repetitive behaviours or interests [1]
Given the prevalence of emotional and behavioural problems experienced by children with autism spectrum disorder (ASD) [6] and the association with sleep problems [24,25], further research is needed to understand potential differences in the types of emotional and behavioural problems experienced and their associations with sleep difficulties for children with ASD without intellectual disability (ID) versus ASD + ID
Children with ASD demonstrated more difficulties with Night Waking/Parasomnias, Daytime Alertness and total sleep problems, whereas children with ASD + ID demonstrated more difficulty with Sleep Initiation and Duration with a medium-effect size, which supports the meta-analysis findings by Elrood and Hood [22], who reported shorter sleep duration for children with ASD + ID. These results suggest that ID may exacerbate some but not all types of sleep problems experienced by children with ASD
Summary
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by persistent social communication and interaction difficulties, and restricted, repetitive behaviours or interests [1]. Many of the symptoms of both ASD and ID overlap, creating a challenge for the nosology and diagnosis of ASD or ID alone or as co-occurring conditions [3]. Other co-occurring conditions are common for children with ASD, with approximately 62–79%. Experiencing emotional and behavioural problems [5,6]. 50–80% of children with ASD experience sleep problems [7,8,9]. Common sleep problems include long sleep-onset latency (time to fall asleep), less overall time asleep, increased overnight awakenings, and poor sleep efficiency
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