Longitudinal developmental trajectories in young autistic children presenting with sleep problems, compared to those presenting without sleep problems, gathered via parent-report using a mobile application

Abstract

The effect of sleep problems in 2- to 5-year-old autistic children was investigated in the largest and the longest observational study to-date. Parents assessed the development of 8540 children quarterly for three years on five orthogonal subscales: combinatorial receptive language, expressive language, sociability, sensory awareness, and health. 57% of caregivers reported no sleep problems, 31% reported mild sleep problems, 10% reported moderate sleep problems, and 2% reported severe sleep problems. In order to investigate the effect of sleep problems, children with moderate and severe sleep problems (N = 651) were matched to those with no sleep problems using a propensity score based on age, gender, expressive language, combinatorial receptive language, sociability, sensory awareness, and health at the 1st evaluation. There were 643 matched participants in each group. Children with no sleep problems developed faster compared to matched children with sleep problems in all subscales. The greatest difference in trajectories was detected in the health subscale. When controlling for the health score (in addition to each subscale score at baseline as well as gender and ASD severity), the effect of sleep problems decreased in all subscales except the combinatorial receptive language subscale (where the effect of sleep problems was increased), suggesting that sleep problems affect combinatorial language acquisition regardless of the overall health. This study confirms a high prevalence of sleep problems in autistic children and provides information on the effect of sleep problems on various aspects of children’s development.