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Sadikova E, Mazurek MO. The Association Between Adverse Childhood Experiences and Sleep in Children with Autism Spectrum Disorder. J Autism Dev Disord 2024:10.1007/s10803-024-06321-6. [PMID: 38970717 DOI: 10.1007/s10803-024-06321-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2024]
Abstract
Children with autism spectrum disorder are at higher risk for adverse childhood experiences (ACEs). They are also more vulnerable to sleep problems and are less likely to obtain the recommended number of hours of sleep than neurotypical children. In the general population, ACEs have been linked to future sleep difficulties. Despite increased vulnerabilities to both ACEs and sleep problems, no study has examined this association in ASD. Using the National Survey of Children's Health across four cohorts, we examined whether ACEs were a risk factor to obtaining the recommended number of hours of sleep, while accounting for demographic and health factors typically associated with sleep duration. Findings indicate that children with ASD with more ACEs were less likely to get the recommended number of hours of sleep than children with fewer ACEs. Other factors associated with sleep included race, anxiety, autism severity, and overall health. These findings indicate that sleep problems in children with ASD are complex and multifaceted. Among other considerations, it is important for clinicians to screen children with ASD for ACEs and consider the possible impact of ACEs on sleep.
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Affiliation(s)
- Eleonora Sadikova
- University of Virginia, 417 Emmet Street South, Charlottesville, VA, 22904, USA.
| | - Micah O Mazurek
- University of Virginia, 417 Emmet Street South, Charlottesville, VA, 22904, USA
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2
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de Groot ER, Dudink J, Austin T. Sleep as a driver of pre- and postnatal brain development. Pediatr Res 2024:10.1038/s41390-024-03371-5. [PMID: 38956219 DOI: 10.1038/s41390-024-03371-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024]
Abstract
In 1966, Howard Roffwarg proposed the ontogenic sleep hypothesis, relating neural plasticity and development to rapid eye movement (REM) sleep, a hypothesis that current fetal and neonatal sleep research is still exploring. Recently, technological advances have enabled researchers to automatically quantify neonatal sleep architecture, which has caused a resurgence of research in this field as attempts are made to further elucidate the important role of sleep in pre- and postnatal brain development. This article will review our current understanding of the role of sleep as a driver of brain development and identify possible areas for future research. IMPACT: The evidence to date suggests that Roffwarg's ontogenesis hypothesis of sleep and brain development is correct. A better understanding of the relationship between sleep and the development of functional connectivity is needed. Reliable, non-invasive tools to assess sleep in the NICU and at home need to be tested in a real-world environment and the best way to promote healthy sleep needs to be understood before clinical trials promoting and optimizing sleep quality in neonates could be undertaken.
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Affiliation(s)
- Eline R de Groot
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Topun Austin
- NeoLab, Evelyn Perinatal Imaging Centre, The Rosie Hospital, Cambridge University Hospitals, Cambridge, UK.
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3
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Sakamoto N, Oe M, Ozone M. An Exploratory Study of the Associations Between Sensory Processing Patterns and Emotional/Behavioral Problems in Children with Autism Spectrum Disorder. Kurume Med J 2024; 70:47-52. [PMID: 38556271 DOI: 10.2739/kurumemedj.ms7012002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
AIM In autism spectrum disorder (ASD), abnormal sensory processing patterns are observed in various sensory modalities, including visual, auditory, touch, olfactory, taste, vestibular, and proprioceptive senses. Few studies have examined the relationship between sensory processing patterns and emotions, or their effects on daily life. We investigated the relationship between sensory processing patterns and emotional/behavioral problems in children with ASD. PARTICIPANTS AND METHODS A retrospective chart review was conducted. Forty-three children with ASD (33 boys, 10 girls, median age 9 years) in the outpatient clinic of a psychiatric hospital participated; their parent (s) were invited to complete the Sensory Profile 2 (SP2) and the Child Behavior Checklist (CBCL) questionnaires. The participants' teachers were invited to complete the Teacher's Report Form (TRF). RESULTS In the correlation analyses, each of the four quadrants of the SP2 (low registration, sensory seeking, hypersensitivity, and sensory avoiding) had significant positive correlations with different types of emotional and behavioral problems measured by the CBCL. Focusing on emotion, 'anxious/depressed' was correlated with low registration (r = 0.41) and sensory avoiding (r = 0.60), while 'withdrawal/depressed' was correlated with sensory avoiding (r = 0.46). Only one significant correlation was revealed between the SP2 and the TRF. CONCLUSION Our results suggest a link between sensory processing patterns and emotional/behavioral problems. In school settings, the relationship between sensory processing patterns and emotional/behavioral problems may be easily overlooked.
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Affiliation(s)
| | - Misari Oe
- Kurume University Health Service Center
- Department of Neuropsychiatry, Kurume University School of Medicine
| | - Motohiro Ozone
- Department of Neuropsychiatry, Kurume University School of Medicine
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4
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Ezedinma U, Burgess S, Nikles J, Downer T, Jones E, Metse A, Fjaagesund S, Oprescu F. The potential of repetitive transcranial magnetic stimulation for addressing sleep difficulties in children with autism - A brief communication. Sleep Med 2024; 118:78-80. [PMID: 38613860 DOI: 10.1016/j.sleep.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/01/2024] [Accepted: 04/06/2024] [Indexed: 04/15/2024]
Abstract
Sleep difficulties can co-occur with autistic traits and have been frequently reported in children diagnosed with autism. Thus, sleep difficulties may impact neural development, cognition, and behavioural functioning in children with autism. Interventions, such as repetitive transcranial magnetic stimulation (rTMS), that target aberrant neural structures underpinning autistic traits and sleep difficulties in children could have beneficial effects. The rTMS effects on the pathophysiological pathways hypothesised to underpin autism and sleep difficulties are well-established in the literature; however, clinical evidence of its potential to improve sleep difficulties in children with autism is limited. While the preliminary data is promising, further robust rTMS studies are warranted to encourage its use in clinical practices.
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Affiliation(s)
- Uchenna Ezedinma
- University of the Sunshine Coast, Australia; Brain Treatment Centre Australia, Australia.
| | - Scott Burgess
- Queensland Children's Lung and Sleep Specialists, Australia; University of Queensland, Australia
| | | | | | - Evan Jones
- University of the Sunshine Coast, Australia; Brain Treatment Centre Australia, Australia
| | - Alexandra Metse
- University of the Sunshine Coast, Australia; School of Psychological Science, University of Newcastle, Australia
| | - Shauna Fjaagesund
- University of the Sunshine Coast, Australia; Health Developments Corporation, Australia
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5
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Sadikova E, Soland J, Menezes M, Mazurek M. Impact of adverse childhood experiences and family resilience on sleep duration in autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241235880. [PMID: 38807297 DOI: 10.1177/13623613241235880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
LAY ABSTRACT Autistic children are more likely to have sleep difficulties and to experience adverse childhood experiences. Adverse childhood experiences can include parental divorce, bullying, or witnessing violence. We also know that children in families who are resilient (e.g. families who are connected, work together, and help each other) are less impacted by adverse childhood experiences. Our study examined whether there was a relationship between adverse childhood experiences and sleep duration in autistic children. We also wanted to find out whether family resilience protects from the negative impact of adverse childhood experiences on sleep duration. We used data from 3247 parent surveys about their children that we got from the National Survey of Children's Health. We found that children with adverse childhood experiences are more likely to get less sleep. We also found that children with resilient families were more likely to get more sleep. Our results show that family resilience helps weaken the relationship between adverse childhood experiences and sleep, so it is important to help families build resilience.
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McLay LK, Hansen SG, Blampied NM, France KG, Rispoli M. The Type, Severity, and Impact of Sleep Problems in Children With Angelman Syndrome and Parental Help-seeking Patterns. Behav Sleep Med 2024; 22:285-297. [PMID: 37592732 DOI: 10.1080/15402002.2023.2241943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Angelman syndrome (AS) is a rare genetic developmental disability that presents with high rates of co-occurring sleep difficulties. Most existing research has focused on the pathophysiology of sleep problems in people with AS, and suggests that sleep problems are the result of genetic and neurobiological factors. However, little is known about the role of the social environment and learning in sleep problems in children with AS. This descriptive study used survey data from 139 parents of children with AS to investigate: 1) the type, topography and severity of children's sleep problems; 2) the collateral child, parent and family impacts of the sleep problems; 3) treatment selection practices and the perceived effectiveness of these treatments; and 4) sources of support and treatment advice received. Parents reported that the majority of children experienced sleep problems, resulting in numerous deleterious effects on child and family functioning. They also reported high levels of concern about these sleep problems, but low levels of perceived support. Study findings highlight the need to establish a disability-specific profile of the type and impact of sleep problems experienced by children with AS, and have further implications for the delivery of clinical services and support provided to parents of children with AS.
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Affiliation(s)
- Laurie K McLay
- Te Kaupeka Oranga, Faculty of Health, University of Canterbury, Te Whare Wānanga O Waitaha, Christchurch, New Zealand
| | - Sarah G Hansen
- College of Education and Human Development, Georgia State University, Atlanta, GA, USA
| | - Neville M Blampied
- School of Psychology, Speech and Hearing, University of Canterbury, Te Whare Wānanga O Waitaha, Christchurch, New Zealand
| | - Karyn G France
- Te Kaupeka Oranga, Faculty of Health, University of Canterbury, Te Whare Wānanga O Waitaha, Christchurch, New Zealand
| | - Mandy Rispoli
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
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Lin CY, Wu YL, Chien YL, Gau SSF. Quality of life and clinical correlates in cognitively-able autistic adults: A special focus on sensory characteristics and perceived parental support. J Formos Med Assoc 2024:S0929-6646(24)00183-9. [PMID: 38570236 DOI: 10.1016/j.jfma.2024.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/14/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Quality of life (QoL) has been suggested as an indicator of outcomes in autistic adults. Factors associated with QoL in autistic individuals remain unclear. This study aims to examine the subjective QoL for autistic adults in Taiwan and investigate the determinants for different domains of QoL. METHODS The study comprised 90 autistic adults (aged 26.9, SD 7.3; males, 80.9%). We used Taiwanese version of World Health Organization Quality of Life-BREF to measure QoL. Four domains of QoL were compared with 61 non-autistic controls, including physical, psychological, social, and environment. To identify the correlates of QoL domains, we assessed IQ, personality trait, family support, anxiety/depressive symptoms, autistic severity, and sensory symptoms by various questionnaires, and assessed their association with QoL by correlation analyses and model selection. RESULTS Our results showed that autistic adults reported lower QoL on the World Health Organization Quality of Life (WHOQOL)-BREF across all domains. QoL was significantly associated with autistic symptom severity, harm avoidance, family support, sensory symptoms, anxiety, and depression, but not intelligence. Model selections revealed male sex, poor paternal support, autism severity, depression, anxiety, and sensory symptoms were associated with specific QoL domains. CONCLUSION Findings supported lower QoL in autistic adults. Modifying the QoL correlates may improve life quality in autistic adults. Furthermore, our findings revealed the importance of sensory symptoms and paternal support in QoL of autistic adults, which was a novel finding in this population.
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Affiliation(s)
- Chun-Yi Lin
- Department of Psychiatry, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Yi-Lun Wu
- Department of Psychiatry, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, 10002, Taiwan; Symphonic Yard Clinic, 2F., Building B, No. 218-2, Section 4, Zhong-Xiao East Road, Taipei, 106059, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, 10002, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, No.7, Chung-Shan South Road, Taipei, 10002, Taiwan.
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, 10002, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, No.7, Chung-Shan South Road, Taipei, 10002, Taiwan.
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Harris HK, Kook M, Boedeker P, Gusick AG, Lyons-Warren AM, Goin-Kochel RP, Murali C, Berry LN, Storch EA. The Impact of Cognitive Behavioral Therapy on Sleep Problems in Autistic Children with Co-occurring Anxiety. J Autism Dev Disord 2024:10.1007/s10803-024-06309-2. [PMID: 38557905 DOI: 10.1007/s10803-024-06309-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE This study seeks to examine the relationship between anxiety-symptom severity and sleep behaviors in autistic children receiving cognitive behavioral therapy (CBT). METHODS We conducted a secondary-data analysis from a sample of 93 autistic youth, 4 to 14 years, participating in 24 weeks of CBT. Clinicians completed the Pediatric Anxiety Rating Scale (PARS) and parents completed the Children's Sleep Habits Questionnaire, Abbreviated/Short Form (CSHQ-SF) at baseline, mid-treatment, post-treatment and 3 months post-treatment. Mediation analysis evaluated the role of anxiety symptoms in mediating the effect of time in treatment on sleep. RESULTS There was a negative association between time in treatment and scores on the CSHQ-SF (b = - 3.23, SE = 0.493, t = - 6.553, p < 0.001). Increased time in treatment was associated with decreased anxiety (b = - 4.66, SE = 0.405, t = - 11.507, p < 0.001), and anxiety symptoms decreased with CSHQ-SF scores (b = 0.322, SE = 0.112, t = 2.869, p = 0.005). The indirect effect of time in treatment on CSHQ-SF scores through PARS reduction was negative, but not statistically significant. CONCLUSION Increased time in CBT was associated with decreased anxiety severity and improved sleep behaviors. Reductions in anxiety symptoms may mediate improvements in sleep problems, but larger sample sizes are necessary to explore this further.
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Affiliation(s)
- Holly K Harris
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
- Division of Developmental-Behavioral Pediatrics, Meyer Center for Developmental Pediatrics and Autism, 8080 North Stadium Drive, Suite 100, Houston, TX, 77054, USA.
| | - Minjee Kook
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Peter Boedeker
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Department of Education, Innovation and Technology, Baylor College of Medicine, Houston, TX, USA
| | - Andrew G Gusick
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Ariel M Lyons-Warren
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, USA
| | - Robin P Goin-Kochel
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Autism Program, Meyer Center for Developmental and Behavioral Pediatrics, Texas Children's Hospital, Houston, TX, USA
| | - Chaya Murali
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Leandra N Berry
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Autism Program, Meyer Center for Developmental and Behavioral Pediatrics, Texas Children's Hospital, Houston, TX, USA
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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Estes A, Hillman A, Chen ML. Sleep and Autism: Current Research, Clinical Assessment, and Treatment Strategies. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:162-169. [PMID: 38680972 PMCID: PMC11046719 DOI: 10.1176/appi.focus.20230028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Autism spectrum disorder is associated with a high rate of sleep problems, affecting over 80% of autistic individuals. Sleep problems have pervasive negative effects on health, behavior, mood, and cognition but are underrecognized in autistic children. Problems initiating and maintaining sleep-hallmarks of insomnia-are common. Sleep-disordered breathing and restless legs syndrome have also been described in autism at a higher prevalence than in community populations. The authors describe current research on sleep in autistic children and potential pathophysiologic mechanisms. They describe practical approaches to sleep assessment and synthesize approaches to addressing sleep problems in autistic children.
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Affiliation(s)
- Annette Estes
- Department of Speech and Hearing Sciences (Estes) and Department of Pediatrics, Division of Pulmonary and Sleep Medicine (Chen), University of Washington, Seattle; University of Washington Autism Center (Estes, Hillman); Pediatric Sleep Disorders Center and Pulmonary and Sleep Medicine Division, Seattle Children's Hospital (Chen)
| | - Arianna Hillman
- Department of Speech and Hearing Sciences (Estes) and Department of Pediatrics, Division of Pulmonary and Sleep Medicine (Chen), University of Washington, Seattle; University of Washington Autism Center (Estes, Hillman); Pediatric Sleep Disorders Center and Pulmonary and Sleep Medicine Division, Seattle Children's Hospital (Chen)
| | - Maida Lynn Chen
- Department of Speech and Hearing Sciences (Estes) and Department of Pediatrics, Division of Pulmonary and Sleep Medicine (Chen), University of Washington, Seattle; University of Washington Autism Center (Estes, Hillman); Pediatric Sleep Disorders Center and Pulmonary and Sleep Medicine Division, Seattle Children's Hospital (Chen)
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Sidhu N, Wong Z, Bennett AE, Souders MC. Sleep Problems in Autism Spectrum Disorder. Pediatr Clin North Am 2024; 71:253-268. [PMID: 38423719 DOI: 10.1016/j.pcl.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Sleep problems are common in children with autism spectrum disorder (ASD), with 40% to 80% prevalence. Common disorders include insomnia, parasomnias, and circadian rhythm sleep-wake disorders. These problems have a multifactorial etiology and can both exacerbate and be exacerbated by core ASD symptoms. Sleep problems also impact the health and quality of life of both patients and their caregivers. All children with autism should be regularly screened for sleep problems and evaluated for co-occurring medical contributors. Behavioral interventions with caregiver training remain first-line treatment for sleep disorders in both neurotypical and neurodiverse youth.
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Affiliation(s)
- Navjot Sidhu
- Division of Developmental and Behavioral Pediatrics, The Children's Hospital of Philadelphia, 3550 Market Street, 3rd Floor, Philadelphia, PA 19104, USA
| | - Zoe Wong
- The Children's Hospital of Philadelphia, Center for Autism Research, Sidney Kimmel Medical College, Thomas Jefferson University
| | - Amanda E Bennett
- Division of Developmental and Behavioral Pediatrics, The Children's Hospital of Philadelphia, 3550 Market Street, 3rd Floor, Philadelphia, PA 19104, USA; The Children's Hospital of Philadelphia, Center for Autism Research, Sidney Kimmel Medical College, Thomas Jefferson University; Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine; Autism Integrated Care Program, Division of Developmental and Behavioral Pediatrics, The Children's Hospital of Philadelphia, 3550 Market Street, 3rd Floor, Philadelphia, PA 19104, USA.
| | - Margaret C Souders
- The University of Pennsylvania School of Nursing, The Children's Hospital of Philadelphia
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Sommers L, Papadopoulos N, Fuller-Tyszkiewicz M, Sciberras E, McGillivray J, Howlin P, Rinehart N. The Connection Between Sleep Problems and Emotional and Behavioural Difficulties in Autistic Children: A Network Analysis. J Autism Dev Disord 2024:10.1007/s10803-024-06298-2. [PMID: 38526802 DOI: 10.1007/s10803-024-06298-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/27/2024]
Abstract
The interactions between sleep problems, autism symptoms and emotional and behavioural difficulties were explored using network analysis in 240 autistic children (mean age: 8.8 years, range 5-13 years) with moderate to severe sleep problems. Findings revealed a highly connected and interpretable network, with three separate clusters identified of the modelled variables. Depression, anxiety and behavioural difficulties were the most central variables of the network. Depression, anxiety and restricted repetitive and stereotyped patterns behaviours (RRBs) were the strongest bridging variables in the network model, transmitting activation both within and between other symptom clusters. The results highlight that depression and anxiety were highly connected symptoms within the network, suggesting support in these areas could be helpful, as well as future research.
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Affiliation(s)
- Lucy Sommers
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
- School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
| | - Nicole Papadopoulos
- Monash Krongold Clinic, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Emma Sciberras
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Jane McGillivray
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Patricia Howlin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Nicole Rinehart
- Monash Krongold Clinic, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia
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Garcia JM, Murray M, Brazendale K, Rice DJ, Fukuda D. Effects of a family judo program on sleep quality in youth with Autism Spectrum Disorder. Sleep Med 2024; 115:152-154. [PMID: 38367356 DOI: 10.1016/j.sleep.2023.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/20/2023] [Indexed: 02/19/2024]
Abstract
OBJECTIVE The purpose of this study was to examine the effects of a family-based judo program on sleep quality in youth diagnosed with Autism Spectrum Disorder (ASD). METHODS Eighteen youth (13.17 years ± 3.76, 78% male) diagnosed with ASD participated in a 14-week family judo program. Sleep quality was assessed using the Actigraph GT9X accelerometer pre- and post-judo intervention. Non-parametric paired t-tests were conducted to examine changes in sleep quality variables. RESULTS There was a significant increase in sleep efficiency (p = .05), and a significant decrease in both sleep latency (p = .001) and wake after sleep onset (p = .02) following participation in the judo program. There were no changes in sleep duration observed in this sample (p = .83). CONCLUSION Participation in a family judo program may improve sleep quality in youth with ASD. More research is necessary to understand the mechanisms by which judo may improve sleep quality in youth with ASD.
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Affiliation(s)
- Jeanette M Garcia
- School of Sport Sciences, College of Applied Human Sciences, West Virginia University, Morgantown, WV, USA.
| | - Michelle Murray
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Keith Brazendale
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - David J Rice
- School of Sport Sciences, College of Applied Human Sciences, West Virginia University, Morgantown, WV, USA
| | - David Fukuda
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
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Vives-Vilarroig J, Ruiz-Bernardo P, García-Gómez A. Effects of Horseback Riding on the Postural Control of Autistic Children: A Multiple Baseline Across-subjects Design. J Autism Dev Disord 2024:10.1007/s10803-023-06174-5. [PMID: 38246963 DOI: 10.1007/s10803-023-06174-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 01/23/2024]
Abstract
The aim of this research was to study the effect of a horseback-riding programme on postural control in a group of autistic children (ASD). Nine children aged 9 to 12 years participated in this study through a multiple baseline across subjects design. The whole programme took place over nine months. Participants followed a previously developed specific horseback-riding programme, consisting of 45-minute sessions held twice a week for at least three months. To evaluate postural control, the average velocity of the centre of pressure displacement was measured by means of a posturographic platform. Results indicated that this intervention with horses had a positive effect on the postural control in children with ASDs.
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Affiliation(s)
- Juan Vives-Vilarroig
- Universidad Cardenal Herrera, CEU, Castellón, C. Grecia, 31, Castellón de la Plana, 12006, España
| | - Paola Ruiz-Bernardo
- Universidad Jaume I. Castellón, Av. Vicent Sos Baynat, s/n, Castellón de la Plana, 12071, España.
| | - Andrés García-Gómez
- Universidad de Extremadura. Badajoz, Av. de Elvas, s/n, Badajoz, 06006, España
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Davis-Cheshire R, Bennington S, Hartsek A, Kelly T, Marinelli J, Perez A. The Impact of Weighted Blanket Use on Adults with Sensory Sensitivity and Insomnia. Occup Ther Int 2023; 2023:3109388. [PMID: 38152339 PMCID: PMC10752672 DOI: 10.1155/2023/3109388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023] Open
Abstract
Purpose This study's purpose was to determine the impact of weighted blanket use on moderate to severe insomnia in adults with sensory sensitivity greater than the average population. Methods For this study, a four-week, single-case, multiple-participant ABA study design was used. Through convenience sampling, four participants scoring 15 or greater on the Insomnia Severity Index (ISI), which categorizes them as having moderate to severe insomnia, and much more than most people in sensory sensitivity on the Adolescent/Adult Sensory Profile were recruited. First, seven-day baseline sleep data was gathered, followed by two weeks of weighted blanket use, concluding with a seven-day withdrawal phase. Additional outcome measures included: Tuck and Snooze Survey, Consensus Sleep Diary Morning, and Additional Sleep Diary Questions. Data analysis included visual analysis, mean comparisons, Tau-U calculations, and pre- to post-ISI category comparisons. Results All participants' ISI scores were categorized as one level less severe postintervention. All participants demonstrated increased sleep quality, and three participants showed an increase in sleep duration based on individual mean comparisons between baseline and intervention phases. Conclusion Weighted blankets appear beneficial in reducing insomnia severity in adults with much more than the average population sensory sensitivity. In addition, those with self-reported anxiety may have increased benefit from this intervention.
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Affiliation(s)
| | | | - Allison Hartsek
- Kettering College, 3737 Southern Blvd, Kettering, OH 45429, USA
| | - Teresa Kelly
- Kettering College, 3737 Southern Blvd, Kettering, OH 45429, USA
| | | | - Amanda Perez
- Kettering College, 3737 Southern Blvd, Kettering, OH 45429, USA
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15
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Kose S, Turer F, Inal Kaleli I, Calik Senturk HN, Ozuysal Uyar DH, Bildik T. The Relationship Between Social Skills and Sensory Profile, Emotion Regulation, and Empathizing/Systemizing in Adolescents on the Autism Spectrum. J Autism Dev Disord 2023:10.1007/s10803-023-06190-5. [PMID: 38127185 DOI: 10.1007/s10803-023-06190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
This study aims to evaluate the relationship between social skills and sensory features, emotion regulation, and empathy in adolescents on the autism spectrum. One hundred and twenty-three adolescents were included in the study (50 autistic, 73 typically developing-TD adolescents). The participants filled out the Adolescent/Adult Sensory Profile (AASP) and Emotion Regulation Questionnaire. Parents of the participants completed the Child Empathy and Systemizing Quotient (EQ-C/SQ-C) and Autism-Social Skills Profile (ASSP) scales. Social reciprocity, social participation/avoidance, ASSP total scores, empathy and systemizing scores were lower, and detrimental social behaviors, low registration sensory profile scores were higher in the autism spectrum group. While a difference between genders was observed in sensory sensitivity, sensation avoiding, low registration quadrants and empathy scores, no gender and group interaction was found in any domain. Social skill total scores were correlated to sensation seeking and low registration sensory features, empathy, systemizing, and reappraisal emotion regulation scores. A hierarchical multiple linear regression analysis was conducted controlling for group and gender, sensation seeking (p = .032, β = 0.138), low registration (p = .012, β = - 0.215) of the AASP, and empathy (p < .001, β = 0.555) and systemizing (p = .033, β = 0.138) scores of the EQ/SQ-C was found to significantly predict social skill total scores. Although emotional regulation strategies may play a role, sensory processing features and empathy and systemizing skills seem to be the more significant contributors to social skills during adolescence. Interventions targeting sensory processing and especially improving empathy and systematization skills may positively affect social skills in adolescents on the autism spectrum.
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Affiliation(s)
- Sezen Kose
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Furkan Turer
- Department of Child and Adolescent Psychiatry, Corlu State Hospital, Tekirdag, Turkey.
| | - Ipek Inal Kaleli
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Hilal Nur Calik Senturk
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Damla Hazal Ozuysal Uyar
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Tezan Bildik
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
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16
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Lo A, Lowery LA, Kuhlthau K, Parker RA, Chan J, Haddad F, Radom-Aizik S, Gehricke JG. Effects of physical exercise, LEGO, and Minecraft activities on anxiety in underserved children with autism: Study design and methodological strategies. MethodsX 2023; 11:102332. [PMID: 37649622 PMCID: PMC10463252 DOI: 10.1016/j.mex.2023.102332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/16/2023] [Indexed: 09/01/2023] Open
Abstract
Anxiety is a common comorbidity for individuals with ASD, and there is some preliminary data about the efficacy of physical exercise to alleviate anxiety. However, we are not aware of any studies that have compared the effects of a physical exercise program on anxiety in underserved children with ASD using a randomized controlled research design. This paper describes a method to evaluate and compare the efficacy of an 8-week physical exercise intervention with a sedentary play intervention to alleviate anxiety in young children with autism spectrum disorders (ASD) from underserved backgrounds. We assessed anxiety and its physical symptoms using the parent-rated Child Behavior Checklist DSM-5 anxiety (CBCL DSM-5) subscale, the child-rated Screen for Childhood Anxiety Related Emotional Disorder (SCARED), the parent-rated Child's Sleep Habits Questionnaire (CSHQ), and salivary cortisol. We also utilized the Physical Activity Questionnaire for Older Children (PAQ-C) to assess physical activity level and identify compounds. Unique components of this study include: •Implementation of novel physical exercise and sedentary play interventions that have been designed for children with ASD.•Recruitment of predominantly underserved and non-English speaking families.
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Affiliation(s)
- Angelina Lo
- University of California, Irvine, School of Medicine. 1001 Health Sciences Rd, Irvine, CA 92617, USA
| | - Lea Ann Lowery
- Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri. 205 Portland Street, Columbia, MO 65211, USA
| | - Karen Kuhlthau
- Massachusetts General Hospital (MGH), Harvard University. 125 Nashua Street 8th Floor Boston, MA 02114, USA
| | - Robert A. Parker
- Massachusetts General Hospital (MGH), Harvard University. 125 Nashua Street 8th Floor Boston, MA 02114, USA
| | - James Chan
- Massachusetts General Hospital (MGH), Harvard University. 125 Nashua Street 8th Floor Boston, MA 02114, USA
| | - Fadia Haddad
- Pediatric Exercise & Genomics Research Center, Department of Pediatrics, University of California, Irvine. 101 Academy, Suite 150, Irvine, CA 92617, USA
| | - Shlomit Radom-Aizik
- Pediatric Exercise & Genomics Research Center, Department of Pediatrics, University of California, Irvine. 101 Academy, Suite 150, Irvine, CA 92617, USA
| | - Jean-G. Gehricke
- The Center for Autism & Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, 2500 Red Hill Ave #100, Santa Ana, CA 92705, USA
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17
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Liang X, Haegele JA, Healy S, Tse ACY, Qiu H, Zhao S, Li C. Age-Related Differences in Accelerometer-Assessed Physical Activity and Sleep Parameters Among Children and Adolescents With and Without Autism Spectrum Disorder: A Meta-Analysis. JAMA Netw Open 2023; 6:e2336129. [PMID: 37801316 PMCID: PMC10559179 DOI: 10.1001/jamanetworkopen.2023.36129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/22/2023] [Indexed: 10/07/2023] Open
Abstract
Importance Physical inactivity and sleep disorders are health-related concerns of youth with autism spectrum disorder (ASD) that can persist from childhood and exacerbate core symptoms. However, evidence on group differences in accelerometer-assessed physical activity and sleep parameters among youth with and without ASD is inconclusive and age-specific effects remain unclear. Objective To synthesize evidence on group differences in accelerometer-assessed physical activity and sleep parameters and examine the moderating effects of age between children and adolescents with and without ASD. Data Sources American Psychological Association PsychInfo, CINAHL Ultimate, ERIC, MEDLINE, SPORTDiscus with Full Text, and Web of Science from inception to February 2023. Study Selection Two independent reviewers screened articles for observational research comparing accelerometer-assessed physical activity levels and sleep parameters in children and adolescents with and without ASD. Data Extraction and Synthesis After developing a standardized form, relevant data were extracted. Quality was assessed using the McMaster Critical Review Form and rated based on sample, measurement, and analyses. The Preferring Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. Main Outcomes and Measures The primary outcomes were actigraphy-measured MVPA, sleep latency, sleep efficiency, total sleep time, and wake after sleep onset. Data were pooled using a random-effects model. Hedges g was used to express the effect size index. Meta-regression on age was also performed to investigate the potential moderating effects. Results Collectively, 1757 studies were initially identified. Among 104 articles that were assessed, 28 were included, comprising moderate-to-vigorous physical activity (MVPA), 4 sleep parameters, and 73 independent effect sizes. A total of 28 studies were included in analysis, comprising 805 children and adolescents with ASD and 1573 without ASD (age range, 5.1-16.9 years). Compared with peers without ASD, children and adolescents with ASD had a small-to-moderate difference in MVPA (g = -0.450; 95% CI, -0.622 to -0.277), total sleep time (g = -0.332; 95% CI, -0.574 to -0.090), sleep efficiency (g = -0.424; 95% CI, -0.645 to -0.203), and a moderate difference in sleep latency (g = 0.514; 95% CI, 0.351 to 0.677) measured by actigraphy. Children and adolescents with ASD experienced an age-related decline in moderate-to-vigorous physical activity (β = -0.049 [95% CI, -0.097 to -0.001]; P = .045), indicating that younger children with ASD showed a smaller difference in MVPA compared with their peers without ASD. Moderating effects of age on sleep parameters were not significant. Conclusions and Relevance The findings of this meta-analysis suggested that children and adolescents with ASD had lower MVPA and worse sleep than peers without ASD, and the difference in MVPA varied with age. These findings reinforce the need for public health initiatives aimed at reducing these group disparities.
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Affiliation(s)
- Xiao Liang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Justin A. Haegele
- Department of Human Movement Sciences, Old Dominion University, Norfolk, Virginia
- Center for Movement, Health, & Disability, Old Dominion University, Norfolk, Virginia
| | - Sean Healy
- Department of Physical Education and Sports Science, University of Limerick, Limerick, Ireland
| | - Andy Choi-Yeung Tse
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong
| | - Hui Qiu
- Department of Educational Administration and Policy, The Chinese University of Hong Kong, Hong Kong
| | - Shi Zhao
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Chunxiao Li
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, China
- Adapted Physical Activity Laboratory, South China Normal University, Guangzhou, China
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18
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Shui AM, Lampinen LA, Richdale A, Katz T. Predicting future sleep problems in young autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2063-2085. [PMID: 36755236 DOI: 10.1177/13623613231152963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
LAY ABSTRACT Sleep problems are common in autistic children and negatively impact daytime functioning. A method for predicting sleep problems could help with treatment and prevention of such problems. This study aimed to determine predictors of sleep problems among young autistic children. Study participants consisted of autistic children aged 2-5 years who did not have sleep problems at a first visit (Autism Treatment Network Registry) and had sleep data available at a subsequent visit (Registry Call-Back Assessment study). Sleep problems for five study cohorts of children were defined by different methods, including parent questionnaires and parent- or clinician-report of sleep problems. We found that self-injurious behavior, sensory issues, dental problems, and lower primary caregiver education level were significant risk factors of future sleep problems. These predictors may help clinicians provide prevention or earlier treatment for children who are at risk of developing sleep problems.
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Affiliation(s)
- Amy M Shui
- Massachusetts General Hospital, USA
- University of California, San Francisco, USA
| | | | | | - Terry Katz
- University of Colorado School of Medicine, USA
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19
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Raman N, Ringold SM, Jayashankar A, Butera CD, Kilroy E, Harrison L, Cermak SA, Aziz-Zadeh L. Relationships between Affect Recognition, Empathy, Alexithymia, and Co-Occurring Conditions in Autism. Brain Sci 2023; 13:1161. [PMID: 37626517 PMCID: PMC10452701 DOI: 10.3390/brainsci13081161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
Prior studies show differences in empathy and affect-recognition ability between those with autism spectrum disorder (ASD) and typically developing (TD) individuals. Autistic individuals also exhibit increased behavioral, gastrointestinal, and sleep issues. In the current study, we explored the differences in empathy and affect recognition between the ASD and TD groups; and we investigated their associations with conditions co-occurring in ASD. A total of 54 TD and 56 ASD children (8-17 years) were included. As compared to the TD group, the ASD group showed lower scores for affect recognition and perspective taking (PT) and higher scores for personal distress (PD). Interestingly, results from hierarchical linear regressions suggested that disparities in the PD and PT between the groups were primarily attributable to attenuated levels of alexithymia, rather than being mediated by the presence of an autism diagnosis. Differences in affect-recognition ability, however, were mediated by both an autism diagnosis and alexithymia. We also found significant correlations between empathy and affect recognition and measures of related conditions common in ASD. Alexithymia, hence, contributes to difficulties in empathy while both alexithymia and autism are associated with affect-recognition ability in ASD. Additionally, the association between affect recognition and empathic ability with co-occurring conditions in ASD needs to be considered during assessments and interventions.
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Affiliation(s)
- Nandita Raman
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Sofronia M. Ringold
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Aditya Jayashankar
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Christiana D. Butera
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Emily Kilroy
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Laura Harrison
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Sharon A. Cermak
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Lisa Aziz-Zadeh
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
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20
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Iwamoto BK, Neece CL, Nair A, Rockwood NJ, Fenning RM, Krantz ML, Van Dyk TR. Exploring Bidirectional Relationships: Child Sleep Duration, Child Behavior Problems, and Parenting Stress in Families of Children with Autism Spectrum Disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 106:102197. [PMID: 37484880 PMCID: PMC10358315 DOI: 10.1016/j.rasd.2023.102197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Background Youth with Autism Spectrum Disorder (ASD) are at-risk for sleep and behavior problems, and their parents are at-risk for high stress. Child sleep duration, behavior problems, and parenting stress are interrelated; however, directionality of these associations is unclear and research including youth with ASD is lacking. Using a day-to-day, within-person design, this study explores the directionality of these relationships in families of children with ASD. Method Twenty-six children (ages 3-5, 73.1% male, 65.4% Hispanic/Latino) with ASD and their mothers participated in a 14-day study. Child sleep duration (parent-report and actigraphy), behavior problems, and parenting stress were measured daily. Constructs were decomposed into their within- and between-person components and analyzed with random intercept cross-lagged panel models. Results While between-person relationships were directionally expected in that shorter sleep, more behavior problems, and greater parenting stress were associated, within-person relationships were complicated. Better-than-average child behavior was associated with less next-day parenting stress, yet more parenting stress than average was associated with better next-day child behavior. As expected, longer-than-average child sleep was associated with less next-day parenting stress, while greater child behavior problems were associated with less sleep that night. Conclusions Understanding the directionality of associations between child and parent factors allows for the optimization of interventions to improve the quality of life for families of children with ASD. Interventions that target child behavior and/or help parents manage stress while maintaining effective parenting strategies for sleep and behavior may be useful.
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Affiliation(s)
- Brooke K. Iwamoto
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Loma Linda, CA 92354, United States
| | - Cameron L. Neece
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Loma Linda, CA 92354, United States
| | - Aarti Nair
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Loma Linda, CA 92354, United States
| | - Nicholas J. Rockwood
- Division of Interdisciplinary Studies, Loma Linda University; 11065 Campus Street, Loma Linda, CA 92350, United States
| | - Rachel M. Fenning
- Department of Psychological Science and The Claremont Autism Center, Claremont McKenna College; 850 Columbia Avenue, Claremont, CA 91711, United States
| | - Megan L. Krantz
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Loma Linda, CA 92354, United States
| | - Tori R. Van Dyk
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Loma Linda, CA 92354, United States
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21
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Molcho-Haimovich A, Tikotzky L, Meiri G, Ilan M, Michaelovski A, Schtaierman H, Golan HM, Sadaka Y, Menashe I, Dinstein I. Sleep disturbances are associated with irritability in ASD children with sensory sensitivities. J Neurodev Disord 2023; 15:21. [PMID: 37480057 PMCID: PMC10362763 DOI: 10.1186/s11689-023-09491-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/29/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Parent reports suggest that 44-84% of children with ASD exhibit sleep disturbances that are of clinical concern. Previous studies have reported that, in children with ASD, the severity of sleep disturbances is associated with the severity of either sensory problems or aberrant behaviors, but none have performed combined analyses with measures of both sensory and aberrant behaviors symptom domains from the same children. METHODS We examined parent reports of 237 children with ASD, 1.4-8.7 years old, using the child sleep habits questionnaire (CSHQ), sensory profile (SP), and aberrant behaviors checklist (ABC). RESULTS The analyses revealed that sleep disturbances were most strongly associated with SP sensory sensitivity and ABC irritability scores. Together these scores explained 35% of the variance in total CSHQ scores. Moreover, sensory sensitivity scores moderated the association between irritability and sleep disturbances, indicating that sleep disturbances were significantly associated with irritability only in children with moderate to severe sensory sensitivities. CONCLUSION We suggest that the three symptom domains may interact and exacerbate each other such that successful intervention in one symptom domain may have positive impact on the others. Further intervention studies testing this hypothesis are highly warranted.
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Affiliation(s)
- Alona Molcho-Haimovich
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel.
- The Azrieli National Centre for Autism and Neurodevelopment Research (ANCAN), Ben Gurion 1, Beer-Sheva, Israel.
| | - Liat Tikotzky
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Gal Meiri
- The Azrieli National Centre for Autism and Neurodevelopment Research (ANCAN), Ben Gurion 1, Beer-Sheva, Israel
- Pre-School Psychiatry Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Michal Ilan
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
- The Azrieli National Centre for Autism and Neurodevelopment Research (ANCAN), Ben Gurion 1, Beer-Sheva, Israel
- Pre-School Psychiatry Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Analya Michaelovski
- The Azrieli National Centre for Autism and Neurodevelopment Research (ANCAN), Ben Gurion 1, Beer-Sheva, Israel
- Zusman Child Development Center, Soroka University Medical Center, Beer Sheva, Israel
| | - Hen Schtaierman
- Child Development Center, Maccabi Health Services, Beer Sheva, Israel
| | - Hava M Golan
- The Azrieli National Centre for Autism and Neurodevelopment Research (ANCAN), Ben Gurion 1, Beer-Sheva, Israel
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Yair Sadaka
- Child Development Center, Ministry of Health, Beer Sheva, Israel
| | - Idan Menashe
- The Azrieli National Centre for Autism and Neurodevelopment Research (ANCAN), Ben Gurion 1, Beer-Sheva, Israel
- Public Health Department, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ilan Dinstein
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
- The Azrieli National Centre for Autism and Neurodevelopment Research (ANCAN), Ben Gurion 1, Beer-Sheva, Israel
- Cognitive & Brain Sciences Department, Ben-Gurion University of the Negev, Beer Sheva, Israel
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22
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Galion AW, Farmer JG, Connolly HV, Allhusen VD, Bennett A, Coury DL, Lam J, Neumeyer AM, Sohl K, Witmans M, Malow BA. A Practice Pathway for the Treatment of Night Wakings in Children with Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06026-2. [PMID: 37358787 DOI: 10.1007/s10803-023-06026-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 06/27/2023]
Abstract
Children with autism spectrum disorder (ASD) report high rates of sleep problems. In 2012, the Autism Treatment Network/ Autism Intervention Research Network on Physical Health (ATN/AIR-P) Sleep Committee developed a pathway to address these concerns. Since its publication, ATN/AIR-P clinicians and parents have identified night wakings as a refractory problem unaddressed by the pathway. We reviewed the existing literature and identified 76 scholarly articles that provided data on night waking in children with ASD. Based on the available literature, we propose an updated practice pathway to identify and treat night wakings in children with ASD.
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Affiliation(s)
- Anjalee W Galion
- Division of Neurology, Children's Hospital of Orange County, 1201 W. La Veta Avenue, Orange, CA, 92868, USA.
| | - Justin G Farmer
- Massachusetts General Hospital for Children, Boston, MA, USA
| | | | - Virginia D Allhusen
- Division of Neurology, Children's Hospital of Orange County, 1201 W. La Veta Avenue, Orange, CA, 92868, USA
| | - Amanda Bennett
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Janet Lam
- Kennedy Krieger Institute, Baltimore, MD, USA
| | - Ann M Neumeyer
- Massachusetts General Hospital for Children, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Kristin Sohl
- University of Missouri School of Medicine, Columbia, MO, USA
| | | | - Beth A Malow
- Vanderbilt University Medical Center, Nashville, TN, USA
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23
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Rossow T, MacLennan K, Tavassoli T. The Predictive Relationship Between Sensory Reactivity and Depressive Symptoms in Young Autistic Children with Few to No Words. J Autism Dev Disord 2023; 53:2384-2394. [PMID: 35338437 PMCID: PMC8956453 DOI: 10.1007/s10803-022-05528-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 11/24/2022]
Abstract
Depression and sensory reactivity are both common in autism. However, there is little understanding of the predictive relationship between these factors, or the nature of this relationship in autistic children who speak few to no words. This study set out to explore the longitudinal relationship between sensory reactivity and depressive symptoms in 33 young autistic children who speak few to no words. We found positive correlations between depressive symptoms and hyper-reactivity and sensory seeking at both timepoints, and across timepoints. We further found a bidirectional predictive relationship between depressive symptoms and sensory seeking. These results implicate sensory seeking in the development of depressive symptoms in young autistic children who use few to no words. Our findings have important implications for preventative mental health interventions, especially for those with a developmental language delay.
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Affiliation(s)
- Timothy Rossow
- University of Reading, Harry Pitt Building, Earley Gate, Reading, RG6 6BZ, UK.
| | - Keren MacLennan
- University of Reading, Harry Pitt Building, Earley Gate, Reading, RG6 6BZ, UK
| | - Teresa Tavassoli
- University of Reading, Harry Pitt Building, Earley Gate, Reading, RG6 6BZ, UK
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Hartman AG, McKendry S, Akcakaya M, Soehner A, Bodison SC, DeAlmeida D, Bendixen R. Characterizing rest-activity rhythms and sleep for children with and without tactile sensitivities: An observational study. Sleep Med 2023; 106:8-16. [PMID: 37030035 PMCID: PMC10159915 DOI: 10.1016/j.sleep.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/01/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
Abstract
STUDY OBJECTIVES This cross-sectional, observational study aimed to characterize and compare movement-based rest-activity rhythms (RARs) and sleep period variables of children with tactile hypersensitivities (SS) and non-sensitive peers (NSS) to expand the understanding of experienced differences in sleep. METHODS Children (ages 6-10) wore Actigraph GT9X watches for 2 weeks and caregivers completed daily sleep diaries. RARs and sleep period variables (e.g., sleep efficiency, duration, wake after sleep onset) were analyzed and localized means were plotted to visualize average rhythms for each group. Groups were compared using Student's t tests, or non-parametric alternatives, and Hedge's g effect sizes. RESULTS Fifty-three children and their families participated in this study (nSS = 21 nNSS = 32). The groups had similar RARs and sleep period variables. In both groups, sleep efficiency was low (SESS = 78%, SENSS = 77%) and total sleep time was short (TSTSS = 7 hrs 26 mins, TSTNSS- 7 h, 33 min) compared to national recommendations. Despite these similarities, children with SS took noticeably longer to settle down and fall asleep (53 min) than children with NSS (26 min, p = .075, g = 0.95). CONCLUSION This study provides preliminary data describing RAR and sleep period variables in children with and without tactile hypersensitivities. While overall RAR and sleep variables were similar between groups, there is evidence that children with SS spend a longer time transitioning to sleep. Evidence is provided that wrist-worn actigraphy is tolerable and acceptable for children with tactile sensitivities. Actigraphy provides important, movement-based data that should be used in tandem with other measures of sleep health for future studies.
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Affiliation(s)
- Amy G Hartman
- University of Pittsburgh, Department of Psychiatry, United States.
| | - Sarah McKendry
- University of Pittsburgh, Department of Occupational Therapy, United States
| | - Murat Akcakaya
- University of Pittsburgh, Department of Engineering, United States
| | - Adriane Soehner
- University of Pittsburgh, Department of Psychiatry, United States
| | - Stefanie C Bodison
- University of Florida, Department of Occupational Therapy, United States
| | - Dilhari DeAlmeida
- University of Pittsburgh, Department of Health Information Management, United States
| | - Roxanna Bendixen
- Medical University of South Carolina, Division of Occupational Therapy, United States
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Maurer JJ, Choi A, An I, Sathi N, Chung S. Sleep disturbances in autism spectrum disorder: Animal models, neural mechanisms, and therapeutics. Neurobiol Sleep Circadian Rhythms 2023; 14:100095. [PMID: 37188242 PMCID: PMC10176270 DOI: 10.1016/j.nbscr.2023.100095] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/16/2023] [Accepted: 04/08/2023] [Indexed: 05/17/2023] Open
Abstract
Sleep is crucial for brain development. Sleep disturbances are prevalent in children with autism spectrum disorder (ASD). Strikingly, these sleep problems are positively correlated with the severity of ASD core symptoms such as deficits in social skills and stereotypic behavior, indicating that sleep problems and the behavioral characteristics of ASD may be related. In this review, we will discuss sleep disturbances in children with ASD and highlight mouse models to study sleep disturbances and behavioral phenotypes in ASD. In addition, we will review neuromodulators controlling sleep and wakefulness and how these neuromodulatory systems are disrupted in animal models and patients with ASD. Lastly, we will address how the therapeutic interventions for patients with ASD improve various aspects of sleep. Together, gaining mechanistic insights into the neural mechanisms underlying sleep disturbances in children with ASD will help us to develop better therapeutic interventions.
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Lewis S, Papadopoulos N, Mantilla A, Hiscock H, Whelan M, McGillivray J, Rinehart N. The impact of COVID-19 on sleep for autistic children: A systematic review. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 102:102110. [PMID: 36713069 PMCID: PMC9868385 DOI: 10.1016/j.rasd.2023.102110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/21/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Up to 80% of children with autism experience behavioural sleep problems, predominantly relating to bedtime resistance, sleep anxiety, sleep dysregulation, and shorter duration, which are associated with increased autistic symptom expression and emotional and behavioural difficulties. Researchers predicted the COVID-19 pandemic would worsen sleep and behavioural difficulties for autistic children, due to their need for routine and certainty. This systematic review is the first to focus on delineating the role of sleep disturbance in exacerbating autistic symptoms and internalising and externalising behaviours during the pandemic. METHOD In this PROSPERO registered systematic review, we aggregated and synthesised findings from empirical studies from 2020 onwards that included children with autism and examined sleep outcomes, using narrative and framework synthesis due to the variety of methods and designs employed. We identified additional relevant themes through inductive thematic analysis. RESULTS Seventy-one studies met the search criteria, and we selected seventeen for review following screening and quality assessment. These studies reported mixed findings; with strongest support for worsening of sleep problems typically experienced by autistic children, including difficulties with sleep regulation and shorter sleep duration. Further, sleep problems were associated with increased expression of autistic characteristics. CONCLUSIONS Preliminary findings of worsening sleep and increased autistic characteristics for autistic children throughout the COVID-19 pandemic highlight the need for ongoing, accessible and flexible service provision during exposure to environmental stressors. We propose that behavioural sleep interventions are well suited to telehealth adaptation and play an important role in supporting families when in-person treatment for sleep problems is not possible.
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Affiliation(s)
- Samantha Lewis
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora-Imparo Way, Clayton, Victoria 3800, Australia
| | - Nicole Papadopoulos
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora-Imparo Way, Clayton, Victoria 3800, Australia
| | - Ana Mantilla
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora-Imparo Way, Clayton, Victoria 3800, Australia
| | - Harriet Hiscock
- Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia
| | - Moira Whelan
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora-Imparo Way, Clayton, Victoria 3800, Australia
| | - Jane McGillivray
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia
| | - Nicole Rinehart
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora-Imparo Way, Clayton, Victoria 3800, Australia
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27
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Unwin KL, Barbaro J, Uljarevic M, Hussain A, Chetcuti M, Lane AE. The Sensory Observation Autism Rating Scale (SOAR): Developed using the PROMIS® framework. Autism Res 2023; 16:617-629. [PMID: 36565256 DOI: 10.1002/aur.2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/11/2022] [Indexed: 12/25/2022]
Abstract
Autistic people experience the sensory world differently, impacting behavior. First-hand accounts and group-based research have found that sensory differences impact a range of things including family life, anxiety, participation, and daily living. Early sensory differences are widely reported to be associated with a cascade of developmental difference, suggesting that early autism diagnosis and sensory mapping could enable the provision of supports to facilitate flourishing. However, appropriate measurement tools are not available as all rely on proxy report or are observation measures which include limited modalities or domains and require the administration of stimuli. Therefore, following the gold-standard recommendations for measurement development outlined by the PROMIS® framework, we created the Sensory Observation Autism Rating scale (SOAR). We identified sensory behaviors across all primary domains and modalities through an extensive autism-sensory literature review and from focus groups with autism stakeholders. The initial item bank was then refined by an expert panel and through video coding five-minutes of free play from Autism Diagnostic Observation Schedule assessments of 105 age- and gender-matched autistic and developmentally delayed children (aged 13-36 months; 38 female). An additional 25% of the sample were double coded to investigate interrater reliability. Observational data and expert review supported the reduction of the item bank to 37 items. We propose that the refined SOAR has excellent face and ecological validity, along with interrater reliability (Intraclass correlation = 0.87-0.99). Following further data collection and refinement, SOAR has promise to fully characterize sensory behaviors in autistic children and indicate useful supports.
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Affiliation(s)
- Katy L Unwin
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Mirko Uljarevic
- Faculty of Medicine, Dentistry, and Health Sciences, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Azul Hussain
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Madison Chetcuti
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Alison E Lane
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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Fucà E, Guerrera S, Valeri G, Casula L, Novello RL, Menghini D, Vicari S. Psychiatric Comorbidities in Children and Adolescents with High-Functioning Autism Spectrum Disorder: A Study on Prevalence, Distribution and Clinical Features in an Italian Sample. J Clin Med 2023; 12:jcm12020677. [PMID: 36675606 PMCID: PMC9864301 DOI: 10.3390/jcm12020677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
This study investigated the prevalence and distribution of psychiatric comorbidities in a group of 472 children and adolescents with ASD aged 3-18 years. We examined differences in age, sex, IQ, adaptive skills, and ASD symptom severity by comparing participants with ASD (ASD group) with participants with ASD and a psychiatric disorder (ASD/PSY group). Overall, 32.2% of participants had a comorbid psychiatric condition. Attention deficit/hyperactivity disorder (ADHD) was the most frequent diagnosis among preschoolers (20.4%); among school-age children, ADHD and anxiety/obsessive-compulsive disorders were the most frequent conditions (21% and 10.6%, respectively); finally, adolescents exhibit higher prevalence of anxiety/obsessive-compulsive disorders (21.8%). The ASD/PSY group showed a higher percentage of males, they were older and showed lower adaptive skills than the group with ASD; moreover, their mothers exhibited higher stress levels than mothers of participants in the ASD group. The comparison between age groups in participants within ASD/PSY group revealed that preschoolers had lower IQ than school-age children and adolescents, and worse adaptive skills, more repetitive behaviors, and restricted interests than adolescents. This study highlights the importance of an accurate diagnosis of psychiatric comorbidities in children and adolescents with ASD, also considering individual and family impairment.
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Affiliation(s)
- Elisa Fucà
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital (IRCCS), 00146 Rome, Italy
| | - Silvia Guerrera
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital (IRCCS), 00146 Rome, Italy
| | - Giovanni Valeri
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital (IRCCS), 00146 Rome, Italy
| | - Laura Casula
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital (IRCCS), 00146 Rome, Italy
| | - Roberta Lucia Novello
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital (IRCCS), 00146 Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital (IRCCS), 00146 Rome, Italy
- Correspondence:
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital (IRCCS), 00146 Rome, Italy
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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29
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Jeon M, Neoh MJY, Esposito G, Halstead E, Haghighatfard A, Dimitriou D. Cross-country comparison of parental reports and objective measures of sleep patterns of typically developing children and autistic children between the UK and South Korea. Sleep Med 2023; 101:162-177. [PMID: 36395721 DOI: 10.1016/j.sleep.2022.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/06/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Abstract
Sleep duration and disturbances in typically developing (TD) children have been found to vary across countries. Given the impact of culture on sleep patterns in TD children, it is also necessary to examine the impact of culture on sleep patterns in children with atypical development. However, previous studies have often relied only on parent reports of children's sleep. Hence, the present study conducted a cross-cultural comparison of sleep duration and disturbances of school-aged TD children and autistic children in the UK and South Korea (hereafter Korea) using both subjective and objective sleep measurements. Cultural differences were observed in both actigraphy measures and parent reports of children's sleep duration and disturbances. Both TD children and autistic children in Korea had a later bedtime, later getting up time and shorter nocturnal sleep duration than their peers in the UK (p < .05). Furthermore, greater parent-reported sleep disturbances were reported in TD children in Korea compared to TD children in the UK and in autistic children in the UK compared to autistic children in Korea. Correlational analyses indicated that most parent-reported measures of children's sleep did not significantly correlate with objective measures and child reports, suggesting that studies on children's sleep can benefit by collecting data from multiple sources. Taken together, these findings suggest a cultural influence on sleep duration and disturbances of both TD children and autistic children. This study raises questions for further research to identify factors underlying cultural differences in children's sleep duration and disturbances.
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Affiliation(s)
- Mina Jeon
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK.
| | - Michelle Jin Yee Neoh
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Elizabeth Halstead
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
| | - Arvin Haghighatfard
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, London, UK
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30
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Leung MHB, Ngan STJ, Cheng PWC, Chan FCG, Chang WC, Cheung HK, Ho C, Lee CKK, Tang YCV, Wong SMC, Chan KLP. Sleep problems in children with autism spectrum disorder in Hong Kong: a cross-sectional study. Front Psychiatry 2023; 14:1088209. [PMID: 37139314 PMCID: PMC10149766 DOI: 10.3389/fpsyt.2023.1088209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/17/2023] [Indexed: 05/05/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a growing prevalence of sleep problems associated with significant behavioral problems and more severe autism clinical presentation. Little is known about the relationships between autism traits and sleep problems in Hong Kong. Therefore, this study aimed to examine whether children with autism have increased sleep problems than non-autistic children in Hong Kong. The secondary objective was to examine the factors associated with sleep problems in an autism clinical sample. Methods This cross-sectional study recruited 135 children with autism and 102 with the same age range of non-autistic children, aged between 6 and 12 years. Both groups were screened and compared on their sleep behaviors using the Children's Sleep Habits Questionnaire (CSHQ). Results Children with autism had significantly more sleep problems than non-autistic children [t (226.73) = 6.20, p < 0.001]. Bed -sharing [beta = 0.25, t (165) = 2.75, p = 0.07] and maternal age at birth [beta = 0.15, t (165) = 2.05, p = 0.043] were significant factors associated with CSHQ score on the top of autism traits. Stepwise linear regression modeling identified that only separation anxiety disorder (beta = 4.83, t = 2.40, p = 0.019) best-predicted CSHQ. Conclusion In summary, autistic children suffered from significantly more sleep problems and co-occurring separation anxiety disorder brings greater sleep problems as compared to non-autistic children. Clinicians should be more aware of sleep problems to provide more effective treatments to children with autism.
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Affiliation(s)
- Man Ho Brian Leung
- Department of Psychiatry, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | | | - Pak Wing Calvin Cheng
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
- *Correspondence: Pak Wing Calvin Cheng
| | | | - Wing Chung Chang
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Hoi Kei Cheung
- Department of Psychiatry, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Chung Ho
- Department of Psychiatry, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Chi Kei Krystal Lee
- Department of Psychiatry, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
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31
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Saletin JM, Koopman-Verhoeff ME, Han G, Barker DH, Carskadon MA, Anders TF, Sheinkopf SJ. Sleep Problems and Autism Impairments in a Large Community Sample of Children and Adolescents. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01470-0. [PMID: 36515855 DOI: 10.1007/s10578-022-01470-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 12/15/2022]
Abstract
Sleep problems are common in individuals with autism spectrum disorder (ASD). How sleep problems reflect specific ASD phenotypes is unclear. We studied whether sleep problems indexed functional impairment in a heterogeneous community sample of individuals with ASD. We analyzed 977 probands (233 females; age = 11.27 ± 4.13 years) from the Rhode Island Consortium for Autism Research and Treatment dataset, a unique public-private-academic collaboration involving all major points of service for families in Rhode Island. We found that individuals with a confirmed diagnosis of ASD were more likely to have sleep problems. However, across the whole sample and above and beyond a formal diagnosis, sleep problems were dimensionally associated with worse social impairment and poorer adaptive functioning. By using a large dataset reflective of the diversity of presentations in the community, this study underscores the importance of considering sleep problems in clinical practice to improve adaptive functioning in individuals with ASD.
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Affiliation(s)
- Jared M Saletin
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
- Emma Pendleton Bradley Hospital, East Providence, RI, USA.
- Sleep Research Laboratory, Emma Pendleton Bradley Hospital, Providence, RI, USA.
| | - M Elisabeth Koopman-Verhoeff
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Emma Pendleton Bradley Hospital, East Providence, RI, USA
- Sleep Research Laboratory, Emma Pendleton Bradley Hospital, Providence, RI, USA
| | - Gloria Han
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Anesthesiology, Vanderbilt Medical Center, Nashville, TN, USA
| | - David H Barker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- The Bradley Hasbro Children's Research Center, Providence, RI, USA
| | - Mary A Carskadon
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Emma Pendleton Bradley Hospital, East Providence, RI, USA
- Sleep Research Laboratory, Emma Pendleton Bradley Hospital, Providence, RI, USA
| | - Thomas F Anders
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Stephen J Sheinkopf
- Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, RI, USA
- Thompson Center for Autism and Neurodevelopment, University of Missouri, Columbia, MO, USA
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Alenezi S, Alkhiri A, Hassanin W, AlHarbi A, Al Assaf M, Alzunaydi N, Alsharif S, Alhaidar M, Alnujide A, Alkathiri F, Alyousef A, Albassam R, Alkhamees H, Alyahya AS. Findings of a Multidisciplinary Assessment of Children Referred for Possible Neurodevelopmental Disorders: Insights from a Retrospective Chart Review Study. Behav Sci (Basel) 2022; 12:bs12120509. [PMID: 36546992 PMCID: PMC9774162 DOI: 10.3390/bs12120509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022] Open
Abstract
Children with ASD have a wide spectrum of functional deficits in multiple neurodevelopmental domains. A multidisciplinary team assessment (MDT) is required to assess those deficits to help construct a multimodal intervention plan. This is a retrospective chart review of the assessment for children who were referred for an assessment of potential neurodevelopmental disorders. We reviewed 221 participants' charts from January 2019 to January 2020. The mean age of the children was 7.95 ± 3.69, while the mean age of the fathers and mothers was 37.31 ± 8.57 and 31.95 ± 6.93, respectively. Consanguinity was as high as 37.9% for the referred children with developmental delay who were first-degree related, and 13.2% of the parents were second-degree relatives. Approximately 26.6% of children had a family history of mental illness in first-degree relatives. ASD was the most commonly reported diagnosis post-assessment, and ADHD was the most common reported comorbidity at 64.3% and 88.5%, respectively. The MDT findings showed that 58% of children required moderate or higher assistance with toileting, 79.2% were unable to answer yes/no questions, and 86.8% were unable to understand "wh" questions. Only 26% of the nonverbal children had average IQ testing results, and 31% of verbal children did. In conclusion, the mean age of the children when assessed was above that recommended for early screening and intervention. An increased paternal and maternal age was noticeable. Consanguinity and a family history of mental disorders in first-degree relatives were high, attesting to a possible genetic risk.
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Affiliation(s)
- Shuliweeh Alenezi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
- Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia
- SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
- Correspondence:
| | - Aqeel Alkhiri
- Department of Mental Health, Al Qunfudah General Hospital, Al Qunfudah 28821, Saudi Arabia
| | - Weaam Hassanin
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Amani AlHarbi
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Munirah Al Assaf
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Norah Alzunaydi
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Salma Alsharif
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Mohammad Alhaidar
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Abdulaziz Alnujide
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Fatimah Alkathiri
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Abdulaziz Alyousef
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Razan Albassam
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Hadeel Alkhamees
- Prince Mohammed Bin Salman Center for Autism and Developmental Disorders, Prince Sultan Military Medical City, Riyadh 12426, Saudi Arabia
| | - Ahmed S. Alyahya
- Department of Psychiatry, Eradah Complex for Mental Health, Riyadh 12571, Saudi Arabia
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33
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Barros F, Figueiredo C, Soares SC. Autism traits dimensionality and multivariate relationship with alexithymia and anxiety in the general population. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 131:104361. [PMID: 36240538 DOI: 10.1016/j.ridd.2022.104361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/01/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Autism is characterized by social and non-social alterations observed beyond the clinical diagnosis. Research analyzing the expression of autism traits in the general population helps to unravel the relationship between autism dimensions and other associated variables, such as alexithymia and anxiety. The Autism-Spectrum Quotient (AQ) was developed to assess autism traits in the general population; however, inconsistent results regarding its dimensionality have emerged. AIMS This study aimed to extend evidence about the AQ measurement model, and explore the multivariate relationship between autism traits, alexithymia, and trait anxiety. METHODS 292 adults of the general population were recruited. An Exploratory Factor Analysis and Confirmatory Factor Analysis were performed to assess the factorial structure of AQ. A path analysis was carried out to explore the relationship between autism traits, alexithymia, and trait anxiety. RESULTS The results supported a three-factor model of AQ. The path analysis model showed evidence of a significant role of alexithymia as a mediator of the relationship between autism traits and anxiety. CONCLUSIONS AND IMPLICATIONS The present study provides empirical support for a three-factor model of AQ in the general population. The association between autism traits, alexithymia, and anxiety dimensions highlights the multidimensional nature of these variables and the need to account for their distinct impact on autism-related variables.
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Affiliation(s)
- Filipa Barros
- William James Center for Research (WJCR), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal; Center for Health Technology and Services Research (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.
| | - Cláudia Figueiredo
- Science and Engineer Education Group (SEE), Centre for Mechanical Engineering and Automation (TEMA), Department of Mechanical Engineering, University of Aveiro, Aveiro, Portugal; Research Unit on Governance, Competitiveness and Public Policies (GOVCOPP), University of Aveiro, Aveiro, Portugal.
| | - Sandra C Soares
- William James Center for Research (WJCR), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.
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Pattison E, Mantilla A, Fuller-Tyszkiewicz M, Marks D, Sciberras E, McGillivray J, Papadopoulos N, Rinehart N. Acceptability of a behavioural sleep intervention for autistic children: A qualitative evaluation of Sleeping Sound. Sleep Med 2022; 100:378-389. [PMID: 36201889 DOI: 10.1016/j.sleep.2022.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of the current study was to evaluate parental perceptions of the acceptability of a brief behavioural sleep intervention for autistic children (aged 5-13 years) using the Theoretical Framework of Acceptability (TFA). METHODS Qualitative data were collected during a large randomised controlled trial evaluating the efficacy of the Sleeping Sound intervention: 123 families were randomised to the intervention group, of which 115 (93%) completed at least one intervention session and 82 (67%) provided qualitative evaluation data in the 3-month follow-up survey. Consultation records from intervention sessions and parent surveys were qualitatively analysed post hoc using a hybrid approach to thematic analysis. RESULTS Findings were categorised under the seven themes of the TFA (affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, self-efficacy) in addition to three themes that were defined following inductive and deductive coding (barriers to implementation, facilitators to implementation, suggestions for improvement). Participants spoke positively about their experience participating in the intervention and perceived the intervention to be appropriate and effective. Most parents (95.5%) reported that they would recommend the Sleeping Sound intervention to other families of autistic children. Barriers to implementation included child and parent anxiety, child health problems, parental preferences, family circumstances, and other (e.g., school holidays). Facilitators to implementation included family support and consistency with strategies. CONCLUSIONS The Sleeping Sound intervention was considered acceptable to parents of autistic children as evidenced by largely positive feedback regarding their experience. The results highlighted areas for improvement which can be used to inform future iterations of the intervention.
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Affiliation(s)
- Emily Pattison
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia
| | - Ana Mantilla
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, Victoria, 3800, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia.
| | - Deborah Marks
- Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, 3052, Australia
| | - Emma Sciberras
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia; Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia; Department of Paediatrics, University of Melbourne, Grattan Street, Parkville, Victoria, 3010, Australia
| | - Jane McGillivray
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia
| | - Nicole Papadopoulos
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, Victoria, 3800, Australia
| | - Nicole Rinehart
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, Victoria, 3800, Australia
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Daly G, Jackson J, Lynch H. Family life and autistic children with sensory processing differences: A qualitative evidence synthesis of occupational participation. Front Psychol 2022; 13:940478. [PMID: 36389552 PMCID: PMC9651035 DOI: 10.3389/fpsyg.2022.940478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Autistic children with sensory processing differences successfully navigate and engage in meaningful family daily occupations within home and community environments through the support of their family. To date however, much of the research on autistic children with sensory processing differences, has primarily been deficit focused, while much of the caregiver research has focused on issues of distress, burden, effort, and emotional trauma in coping with their child's diagnosis. This study aimed to conduct a qualitative evidence synthesis, using a meta-ethnographic approach to explore the gap identified in understanding successful occupational experiences of family participation and daily family routines when supporting an autistic child with sensory processing differences and to offer an alternative strengths-based perspective. Inclusion criteria were studies which were peer-reviewed qualitative design, published from 2000 to 2021, and that concerned parents/caregivers' perspectives of family occupations of children diagnosed with autism spectrum disorder. Studies were electronically searched in eight databases from October to December 2021 and 23 studies were identified which met the inclusion criteria. Noblit and Hare's seven step approach for conducting analysis in meta-ethnography was used, and three themes identified: (1) sensory processing differences in daily life, (2) what is hard about hard, and (3) orchestrating family life. Results identified the centrality of sensory experiences in understanding family life. Living with unpredictability while orchestrating certainty through routines was core to successful participation. This review provides insights into how parents negotiate the complexities of constructing family life when living with an autistic child. The results can inform the design of future interventions that specifically address the relationship between meaningful participation in family occupations and daily routines and sensory processing in autistic children.
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Interventions for Sensory Over-Responsivity in Individuals with Autism Spectrum Disorder: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101584. [PMID: 36291519 PMCID: PMC9601143 DOI: 10.3390/children9101584] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
Abstract
Individuals with autism spectrum disorder (ASD) often exhibit sensory over-responsivity (SOR), which is characterized by an overwhelmingly negative reaction to or avoidance of sensory stimulation. Despite the detrimental effects of SOR on people’s personal and social lives, the knowledge of and interventions for the issue remain limited. This paper collates and reviews studies on SOR and information on the potential for effective interventions for people with ASD. This review reveals evidence that SOR has a close relationship with anxiety, depression, insomnia, and family life impairment and an underlying mechanism related to SOR. Four interventions and their theoretical bases in sensory-motor processing are discussed in this paper, namely, physical activity (PA), sensory integration therapy (SIT), mindfulness-based cognitive therapy (MBCT), and cognitive behavioral therapy (CBT). These interventions focus on establishing coping strategies for regulating the emotional response to sensory information, and they have been found to be effective and to have the potential to help children with ASD reduce their SOR behaviors. This paper provides guidance for selecting appropriate interventions and for further investigation of more effective interventions in the future.
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Lazerwitz MC, Rowe MA, Trimarchi KJ, Garcia RD, Chu R, Steele MC, Parekh S, Wren-Jarvis J, Bourla I, Mark I, Marco EJ, Mukherjee P. Brief Report: Characterization of Sensory Over-Responsivity in a Broad Neurodevelopmental Concern Cohort Using the Sensory Processing Three Dimensions (SP3D) Assessment. J Autism Dev Disord 2022:10.1007/s10803-022-05747-0. [PMID: 36180667 PMCID: PMC9524317 DOI: 10.1007/s10803-022-05747-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 12/01/2022]
Abstract
Sensory Over-Responsivity (SOR) is an increasingly recognized challenge among children with neurodevelopmental concerns (NDC). To investigate, we characterized the incidence of auditory and tactile over-responsivity (AOR, TOR) among 82 children with NDC. We found that 70% of caregivers reported concern for their child's sensory reactions. Direct assessment further revealed that 54% of the NDC population expressed AOR, TOR, or both - which persisted regardless of autism spectrum disorder (ASD) diagnosis. These findings support the high prevalence of SOR as well as its lack of specificity to ASD. Additionally, AOR is revealed to be over twice as prevalent as TOR. These conclusions present several avenues for further exploration, including deeper analysis of the neural mechanisms and genetic contributors to sensory processing challenges.
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Affiliation(s)
- Maia C Lazerwitz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
- Cortica Healthcare, San Rafael, CA, USA
| | - Mikaela A Rowe
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | | | | | - Robyn Chu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
- Growing Healthy Children Therapy Services, Rescue, CA, USA
| | | | - Shalin Parekh
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Jamie Wren-Jarvis
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Ioanna Bourla
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Ian Mark
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | | | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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Neuronal gating of tactile input and sleep in 10-month-old infants at typical and elevated likelihood for autism spectrum disorder. Sci Rep 2022; 12:14188. [PMID: 35986046 PMCID: PMC9391390 DOI: 10.1038/s41598-022-18018-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/04/2022] [Indexed: 12/23/2022] Open
Abstract
Sleep problems in Autism Spectrum Disorder (ASD) emerge early in development, yet the origin remains unclear. Here, we characterise developmental trajectories in sleep onset latency (SOL) and night awakenings in infants at elevated likelihood (EL) for ASD (who have an older sibling with ASD) and infants at typical likelihood (TL) for ASD. Further, we test whether the ability to gate tactile input, using an EEG tactile suppression index (TSI), associates with variation in SOL and night awakenings. Parent-reported night awakenings and SOL from 124 infants (97 at EL for ASD) at 5, 10 and 14 months were analyzed using generalized estimating equations. Compared to TL infants, infants at EL had significantly more awakenings and longer SOL at 10 and 14 months. The TSI predicted SOL concurrently at 10 months, independent of ASD likelihood status, but not longitudinally at 14 months. The TSI did not predict night awakenings concurrently or longitudinally. These results imply that infants at EL for ASD wake up more frequently during the night and take longer to fall asleep from 10 months of age. At 10 months, sensory gating predicts SOL, but not night awakenings, suggesting sensory gating differentially affects neural mechanisms of sleep initiation and maintenance.
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Mignolli E, Scialpi A, Valente D, Berardi A, Galeoto G, Tofani M. Sleep Disturbance Scale for Children: Italian Validation in Autism Spectrum Disorder Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10163. [PMID: 36011798 PMCID: PMC9407824 DOI: 10.3390/ijerph191610163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Sleep disorders in children with autism spectrum disorders (ASDs) are well-described. However, there is a lack of specific assessment tools to investigate sleep disturbance in this target population. The present investigation reports the Italian validation of the Sleep Disturbance Scale for Children (SDSC) in the ASD population, also investigating the correlation between sleep disorders In both children and parents. Internal consistency and test−retest reliability were investigated using Cronbach’s alpha and intraclass correlation coefficient (ICC), respectively. Concurrent validity was analyzed by comparing the score of the SDSC with the Pittsburgh Sleep Quality Index (PSQI), while the correlation between the SDCS score and the General Sleep Disturbance Scale (GSDS) was used to analyze the correlation between sleep disorders in children and sleep disorders in their parents. In total, 99 children with a diagnosis of ASD participated in the study. Cronbach’s alpha revealed satisfactory value (0.853), as well as reliability (ICC 0.972) and concurrent validity (0.745). Our results also revealed a significant linear correlation between children’s and parents’ sleep disorders (p < 0.05). In conclusion, we found the SDSC to be a useful tool for measuring sleep disorders in ASD children. Our findings offer concrete inputs to achieve adequate pathways for taking care of children with ASDs and their parents.
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Affiliation(s)
- Ester Mignolli
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Alessia Scialpi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Donatella Valente
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Neuromed—Istituto Neurologico Mediterraneo, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS, 86077 Pozzilli, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Neuromed—Istituto Neurologico Mediterraneo, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS, 86077 Pozzilli, Italy
| | - Marco Tofani
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS, 00165 Rome, Italy
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Wodka EL, Parish-Morris J, Annett RD, Carpenter L, Dillon E, Michaelson J, Kim SH, Landa R, Kanne S. Co-occurring attention-deficit/hyperactivity disorder and anxiety disorders differentially affect males and females with autism. Clin Neuropsychol 2022; 36:1069-1093. [PMID: 34315336 PMCID: PMC9181886 DOI: 10.1080/13854046.2021.1942554] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine overlap and divergence of symptomatology in Autism Spectrum Disorder (ASD) with and without co-occurring Attention/Deficit Hyperactivity Disorder (ADHD) and/or Anxiety Disorder by age and sex. METHOD Participants included 25,078 individuals registered in the SPARK cohort, age 6-18 years. SPARK participation includes online consent and registration, as well as parent-reported ASD, ADHD, and Anxiety Disorder diagnoses, developmental, medical, and intervention history, and standardized rating scales. Individuals with ASD, ASD + ADHD, ASD + Anxiety, or ASD + ADHD + Anxiety were compared on measures assessing social communication, restricted and repetitive behaviors (RRBs), and motor functioning, and differences between male and female profiles were examined. RESULTS Significant differences in symptom presentation between females/males, school-age/adolescent individuals, and by co-occurring conditions (ASD/ADHD/Anxiety) are apparent, and the impact of co-occurring conditions differed by age and sex. Most notably, school-age femaleswith ASD without co-occurring conditions present with significantly fewer concerns about social communication skills and have better motor skills, but have more prominent RRBs as compared to same-aged males with ASD alone; co-occurring conditions were associated with increased social communication problems and motor concerns, most consistently for school-age females. CONCLUSIONS School-age females with ASD are at highest risk for underestimation of autism-related symptoms, including underestimation of symptoms beyond core ASD features (motor skills). Further, across ages, particular consideration should be given when probing for social communication symptoms, RRBs, and motor skills in females with ASD alone, as well as with co-occurring ADHD and/or Anxiety. For females with co-occurring symptoms and conditions, use of symptom-specific measures in lieu of omnibus measures should be considered.
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Affiliation(s)
- Ericka L. Wodka
- Department of psychiatry and Behavioral sciences, Johns hopkins university school of Medicine, Baltimore, Maryland, USA
- Center for autism and related Disorders, Kennedy Krieger institute, Baltimore, Maryland, USA
| | - Julia Parish-Morris
- Children’s hospital of philadelphia, Center for autism research, philadelphia, pennsylvania, USA
- Department of psychiatry, university of pennsylvania perelman school of Medicine, philadelphia, pennsylvania, USA
| | - Robert D. Annett
- Department of pediatrics, university of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Laura Carpenter
- Developmental-Behavioral pediatrics, Medical university of south Carolina, Charleston, south Carolina, USA
| | - Emily Dillon
- Department of psychiatry and Behavioral sciences, rush university Medical Center, Chicago, illinois, USA
| | - Jacob Michaelson
- Department of psychiatry, university of iowa, iowa City, iowa, USA
| | - So Hyun Kim
- Department of psychiatry, Weill Cornell Medicine, new york City, new york, USA
| | - Rebecca Landa
- Department of psychiatry and Behavioral sciences, Johns hopkins university school of Medicine, Baltimore, Maryland, USA
- Center for autism and related Disorders, Kennedy Krieger institute, Baltimore, Maryland, USA
| | | | - Stephen Kanne
- Department of psychiatry, Weill Cornell Medicine, new york City, new york, USA
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Hartman AG, McKendry S, Soehner A, Bodison S, Akcakaya M, DeAlmeida D, Bendixen R. Characterizing Sleep Differences in Children With and Without Sensory Sensitivities. Front Psychol 2022; 13:875766. [PMID: 35814144 PMCID: PMC9257069 DOI: 10.3389/fpsyg.2022.875766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/03/2022] [Indexed: 01/28/2023] Open
Abstract
Objectives Individuals register and react to daily sensory stimuli differently, which influences participation in occupations. Sleep is a foundational nightly occupation that impacts overall health and development in children. Emerging research suggests that certain sensory processing patterns, specifically sensory sensitivities, may have a negative impact on sleep health in children. In this study, we aimed to (i) characterize sleep in children with and without sensory sensitivities and (ii) examine the relationship between sensory processing patterns (using the Sensory Profile-2) and sleep using validated parent- and child-reported questionnaires. We hypothesized that children with sensory sensitivities will exhibit more difficulties with sleep. Methods We recruited 22 children (ages 6-10) with sensory sensitivities (SS) and 33 children without sensory sensitivities (NSS) to complete validated sleep and sensory processing questionnaires: the Children's Sleep Habits Questionnaire (CSHQ), Sleep Self-Report (SSR), and Sensory Profile-2. Results Children with SS had significantly more sleep behaviors reported by both parents (p < 0.001, g = 1.11) and children (p < 0.001, g = 1.17) compared to children with NSS. Specifically, children with SS had higher frequencies of sleep anxiety (p = 0.004, g = 0.79), bedtime resistance (p = 0.001, g = 0.83), and sleep onset delay (p = 0.003, g = 0.95). Spearman's ρ correlations indicated significant positive correlations between parent- and child-reported sleep. Children with SS showed a larger association and greater variability between sleep and sensory processing compared to their peers. Significant positive correlations between parent-reported sleep behaviors and sensory sensitive and avoiding patterns were identified for both children with SS and NSS. Child-reported sleep behaviors were most strongly associated with sensitive and avoiding patterns for children with NSS and seeking patterns for children with SS. Conclusion We present evidence that sleep is impacted for children with SS to a greater extent than children with NSS. We also identified that a child's sensory processing pattern may be an important contributor to sleep problems in children with and without sensory sensitivities. Sleep concerns should be addressed within routine care for children with sensory sensitivities. Future studies will inform specific sleep intervention targets most salient for children with SS and other sensory processing patterns.
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Affiliation(s)
- Amy G. Hartman
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sarah McKendry
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Adriane Soehner
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Stefanie Bodison
- Department of Occupational Therapy, University of Florida, Gainesville, FL, United States
| | - Murat Akcakaya
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dilhari DeAlmeida
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA, United States
| | - Roxanna Bendixen
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, United States
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Martinez-Cayuelas E, Gavela-Pérez T, Rodrigo-Moreno M, Merino-Andreu M, Vales-Villamarín C, Pérez-Nadador I, Garcés C, Soriano-Guillén L. Melatonin Rhythm and Its Relation to Sleep and Circadian Parameters in Children and Adolescents With Autism Spectrum Disorder. Front Neurol 2022; 13:813692. [PMID: 35775056 PMCID: PMC9237227 DOI: 10.3389/fneur.2022.813692] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/17/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Sleep problems are prevalent among individuals with autism spectrum disorder (ASD), and a role has been attributed to melatonin in this multifactorial comorbidity. Methods A cross-sectional study was conducted on 41 autistic children and adolescents (9.9 ± 3.02) and 24 children and adolescents with a normal intellectual function (8.42 ± 2.43) were used as controls. Subjects were matched for sex, body mass index, and pubertal stage, and all were drug-naive. Circadian and sleep parameters were studied using an ambulatory circadian monitoring (ACM) device, and saliva samples were collected around the onset of sleep to determine dim light melatonin onset (DLMO). Results Prepubertal individuals with ASD presented later DLMO and an earlier decline in melatonin during adolescence. A relationship was found between melatonin and both sleep and circadian parameters. Participants and controls with later DLMOs were more likely to have delayed sleep onset times. In the ASD group, subjects with the later daytime midpoint of temperature had a later DLMO. Later melatonin peak time and DLMO time were related to lower general motor activity and lower stability of its rhythms. Conclusion The melatonin secretion pattern was different in individuals with ASD, and it showed a relationship with sleep and circadian parameters. Alterations in DLMO have not been previously reported in ASD with the exception of more variable DLMO timing; however, high variability in the study design and sample characteristics prevents direct comparison. The ACM device enabled the measurement of circadian rhythm, a scarcely described parameter in autistic children. When studied in combination with other measures such as melatonin, ACM can offer further knowledge on sleep problems in ASD.
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Affiliation(s)
- Elena Martinez-Cayuelas
- Department of Pediatrics, Instituto de Investigaciones Sanitarias- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
- *Correspondence: Elena Martinez-Cayuelas
| | - Teresa Gavela-Pérez
- Department of Pediatrics, Instituto de Investigaciones Sanitarias- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Rodrigo-Moreno
- Department of Pediatrics, Instituto de Investigaciones Sanitarias- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Claudia Vales-Villamarín
- Lipid Laboratory, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Iris Pérez-Nadador
- Lipid Laboratory, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Carmen Garcés
- Lipid Laboratory, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Leandro Soriano-Guillén
- Department of Pediatrics, Instituto de Investigaciones Sanitarias- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
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Han GT, Trevisan DA, Abel EA, Cummings EM, Carlos C, Bagdasarov A, Kala S, Parker T, Canapari C, McPartland JC. Associations between sleep problems and domains relevant to daytime functioning and clinical symptomatology in autism: A meta-analysis. Autism Res 2022; 15:1249-1260. [PMID: 35635067 DOI: 10.1002/aur.2758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/25/2022] [Indexed: 12/16/2022]
Abstract
Autistic individuals experience significantly higher rates of sleep problems compared to the general population, which negatively impacts various aspects of daytime functioning. The strength of associations across domains of functioning has not yet been summarized across studies. The present meta-analysis examined the strength of associations between sleep problems and various domains of daytime functioning in autistic individuals. Searches were conducted in EMBASE, PubMed, Web of Science, and Google Scholar through May 2020. Inclusion criteria were: an index of sleep disturbance in individuals diagnosed with autism spectrum disorder (ASD); data collected prior to any sleep-related intervention; statistical data indicating relations between sleep problems and outcomes relevant to behavior, cognition, and physical or mental health. Exclusion criteria were: statistics characterizing the relationship between sleep disturbance and outcome variables that partialled out covariates; studies examining correlations between different measures of sleep disturbance. Participants totaled 15,074 from 49 published articles and 51 samples, yielding 209 effect sizes. Sleep problems were significantly associated with more clinical symptomatology and worse daytime functioning. Subgroup analyses demonstrated that sleep problems were most strongly associated with internalizing and externalizing symptoms and executive functioning, followed by core autism symptoms, family factors, and adaptive functioning. Findings highlight the far-reaching consequences of sleep problems on daytime functioning for autistic individuals and support the continued prioritization of sleep as a target for intervention through integrated care models to improve wellbeing. LAY SUMMARY: Autistic individuals experience higher rates of sleep problems, such as difficulty falling asleep and staying asleep, compared to the general population. We quantitatively summarized the literature about how sleep problems are related to different aspects of daytime functioning to identify areas that may be most affected by sleep. Sleep problems were related to all areas assessed, with the strongest associations for mood and anxiety symptoms. We recommend prioritizing sleep health in autistic individuals to improve wellbeing and quality of life.
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Affiliation(s)
- Gloria T Han
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA
| | - Dominic A Trevisan
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA
| | - Emily A Abel
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.,Human Development & Family Studies, Purdue University, West Lafayette, Indiana, USA
| | - Elise M Cummings
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.,Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Carter Carlos
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.,Department of Vision Science, Univeristy of California at Berkeley, Berkeley, California, USA
| | - Armen Bagdasarov
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.,Department of Psychology & Neuroscience, Duke University, Durham, North Carolina, USA
| | - Shashwat Kala
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA
| | - Termara Parker
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.,Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut, USA
| | - Craig Canapari
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA
| | - James C McPartland
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA
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Lane SJ, Leão MA, Spielmann V. Sleep, Sensory Integration/Processing, and Autism: A Scoping Review. Front Psychol 2022; 13:877527. [PMID: 35656493 PMCID: PMC9152214 DOI: 10.3389/fpsyg.2022.877527] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/15/2022] [Indexed: 01/09/2023] Open
Abstract
The prevalence of sleep dysfunction is considerably higher in the autistic population than in the non-autistic. Similarly, the incidence of sensory reactivity differences in autism exceeds that in the neurotypical population. The basis of sleep disorders in autism is multifactorial, but sensory integration/processing concerns may play a role. Research that investigates this interplay for autistic individuals is limited but vital. In this scoping review, we examined literature addressing the following research question: What is the relationship between sleep and sensory integration/processing in autism? We included articles if they were peer-reviewed, English or Spanish, purposefully addressed sensory integration/processing differences, were sleep focused and included autism as the primary diagnosis or population. Articles were excluded if the language was not English or Spanish, research was conducted with animals, they were non-peer-reviewed, the primary population was not autistic, the sensory focus reflected a specific sensorineural loss (e.g., blindness, or deafness), there was not a clear inclusion of sensory integration/processing or sleep. We searched six databases and included all citations from the inception of each database through June 2021. The search strategy identified 397 documents that were reduced to 24 included articles after exclusion criteria were applied. The majority of studies we identified characterized the relation between sleep and sensory integration/processing differences in autism. Investigators found multiple sleep concerns such as bedtime resistance, sleep anxiety, delayed sleep onset, night awaking, and short sleep duration in autistic individuals. Identified sensory concerns focused on reactivity, finding hyper- and hypo-reactivity as well as sensory seeking across sensory domains. Co-existence of sleep concerns and sensory integration/processing differences was frequently reported. Few intervention studies showed a clear sensory focus; those that did emphasized pressure, movement, touch, and individual sensory preferences/needs. Swimming programs and massage showed promising results. No studies were of high quality. At a minimum, there is a co-existence of sensory reactivity differences and sleep concerns in autistic children, and possibly autistic adults. The relationship between poor sleep and sensory integration/processing differences is complex and multi-faceted, requiring additional research. Interventions that purposefully include a central sensory component have not been well studied in autistic children or adults. Overall studies with greater rigor and purposeful use of sensation and sensorimotor supports as a component of intervention are needed. This study was not funded.
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Affiliation(s)
- Shelly J. Lane
- Sensory Integration, Play, and Occupational Therapy Research Lab, Department of Occupational Therapy, Colorado State University, Fort Collins, CO, United States
| | - Marco A. Leão
- Sensory Integration, Play, and Occupational Therapy Research Lab, Department of Occupational Therapy, Colorado State University, Fort Collins, CO, United States
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Levante A, Petrocchi S, Colombi C, Keller R, Narzisi A, Masi G, Lecciso F. The Effect of Sleep-Wake Routines on the Negative Emotional States and Aggressive Behaviors in Adults with Autism Spectrum Disorders (ASD) during the COVID-19 Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094957. [PMID: 35564352 PMCID: PMC9100330 DOI: 10.3390/ijerph19094957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 12/28/2022]
Abstract
Disruption in routine may be related to experiencing negative emotional states and to aggressive behaviors in individuals with Autism Spectrum Disorder (ASD). The lockdown because of COVID-19 contributed to the disruption of individuals’ routines, including the sleep−wake cycle. The current study tested a relationship between the adherence to the sleep−wake routine and aggressive behaviors via the mediation role of negative emotional states (i.e., anxiety and anger). Forty-three parents of adults with ASD completed a web-based questionnaire about their life condition during the first lockdown (April−May 2020). Preliminary analyses showed a worsening in the adults’ aggressive behaviors during the lockdown in comparison to before it (Z = −3.130; p = 0.002). In the mediation models, the relationship between the adherence to the sleep−wake routines and aggressive behaviors was significant. The models showed the hypothesized mediated relationships among the adherence to the sleep−wake routines, negative emotional states, and aggressive behaviors (Model 1: F (1, 41) = 10.478, p < 0.001; Model 2: F(1, 41) = 9.826, p = 0.003). The findings confirmed the potential protective role of the adherence to the sleep−wake routines for the emotional and behavioral adjustment of adults with autism. Theoretical and practical contributions of the study were discussed; indeed, our results may inform parent-coaching as well as intervention programs for individuals with ASD given that adequate sleep hygiene may contribute to improvements in internalizing/externalizing behaviors.
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Affiliation(s)
- Annalisa Levante
- Department of History, Society and Human Studies, University of Salento, 73100 Lecce, Italy;
- Laboratory of Applied Psychology, Department of History, Society and Human Studies, University of Salento, 73100 Lecce, Italy;
- Correspondence:
| | - Serena Petrocchi
- Laboratory of Applied Psychology, Department of History, Society and Human Studies, University of Salento, 73100 Lecce, Italy;
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Via Buffi 13, 6900 Lugano, Switzerland
| | - Costanza Colombi
- IRCCS Stella Maris Foundation, 56018 Pisa, Italy; (C.C.); (A.N.); (G.M.)
| | - Roberto Keller
- Adult Autism Center, Mental Health Department, Local Health Unit ASL Città di Torino, 10138 Turin, Italy;
| | - Antonio Narzisi
- IRCCS Stella Maris Foundation, 56018 Pisa, Italy; (C.C.); (A.N.); (G.M.)
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, 56018 Pisa, Italy; (C.C.); (A.N.); (G.M.)
| | - Flavia Lecciso
- Department of History, Society and Human Studies, University of Salento, 73100 Lecce, Italy;
- Laboratory of Applied Psychology, Department of History, Society and Human Studies, University of Salento, 73100 Lecce, Italy;
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Abstract
PURPOSE OF REVIEW To summarize recent findings regarding anxiety and trauma-related disorders in children diagnosed with autism spectrum disorder (autism), focusing on the distinct ways in which these conditions may be expressed, as well as advances in evidence-based assessment and treatment. RECENT FINDINGS Current findings suggest both anxiety and trauma-related disorders may be more prevalent, yet more complicated to address in autistic relative to non-autistic children. Overlapping symptoms and distinct manifestations of these disorders pose challenges for the accurate identification, assessment, and treatment of anxiety and trauma-related disorders in autistic children. Emerging evidence recommends adapting traditional assessment and treatment approaches to better meet the needs of autistic children. Recent research suggests autism-centered conceptualizations, which accommodate complexity in how anxiety and trauma-related disorders are experienced and expressed by autistic people, are needed to enhance the psychiatric care of this population.
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Taylor MJ, Larsson H, Lundström S, Lichtenstein P, Butwicka A. Etiological links between autism and difficulties in initiating and maintaining sleep: a familial co-aggregation and twin study. J Child Psychol Psychiatry 2022; 63:315-323. [PMID: 34213012 DOI: 10.1111/jcpp.13473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Difficulties initiating and maintaining sleep (DIMS) are frequent features of autism, yet little is known about why these conditions co-occur. One possibility is that they share etiological factors, yet this hypothesis remains to be tested using quantitative genetic designs. We thus investigated etiological links between autism and DIMS using familial co-aggregation and twin methods. METHODS Twins, siblings, half-siblings, and cousins of 50,097 individuals with autism were identified from Swedish population registries. Their risk of DIMS, defined through diagnoses of insomnia and/or melatonin prescriptions, was then estimated. Twin analyses conducted on 15,279 child and adolescent twin pairs investigated etiological links between DIMS and ASD. RESULTS 22.8% of autistic individuals had DIMS. Monozygotic co-twins of individuals with autism were most at risk of DIMS compared to the reference group (OR = 6.6 [2.5-17.4]), followed by dizygotic co-twins (OR = 2.6 [1.5-4.5]) and full siblings (OR = 2.5 [2.4-2.6]). Half-siblings and cousins of individuals with autism were least likely to have DIMS relative to the reference group (OR range = 1.3-1.5). Twin analyses estimated a correlation of 0.57 (0.53-0.61) between autism and DIMS, with a genetic correlation of 0.62 (0.60-0.68). These overlapping genetic factors explained 94% of the covariance between these conditions. Autistic traits also showed genetic overlap with DIMS. CONCLUSIONS Our results suggest that shared genetic mechanisms underlie autism and DIMS, which may lead them to co-occur. Untangling the etiological overlap between these conditions has potential to assist in understanding the etiology of each condition, as well as their associated outcomes.
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Affiliation(s)
- Mark J Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Örebro University, Örebro, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden.,Sweden Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Agnieszka Butwicka
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland.,Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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Effects of Sensory Garments on Sleep of Children with Autism Spectrum Disorder. Occup Ther Int 2022; 2022:2941655. [PMID: 35241995 PMCID: PMC8858038 DOI: 10.1155/2022/2941655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/15/2022] [Indexed: 11/30/2022] Open
Abstract
Objective The purpose of this study is to assess the effectiveness of the use of sensory garments for improving sleep in children with autism spectrum disorder. Method Using a single-subject ABAB reversal design, the researchers evaluated the effectiveness of a sensory garment on sleep duration, sleep latency, and parental stress related to a child's sleep. Four children aged 4–10 participated. We measured sleep duration and sleep latency using the Garmin watches and parent-report sleep logs, parent stress using the Parenting Stress Index Short Form, and sleep behaviors using the Children's Sleep Habits Questionnaire. Results/Discussion. Data showed variable effects on sleep duration and latency across children. The oldest child with the hyposensitive sensory patterns experienced the greatest sleep improvements. All parents experienced stress from daily life, and some reported increased stress due to study participation. Future research is recommended to further investigate the effectiveness of sensory garments on sleep for children with ASD. Therapists are encouraged to evaluate children's development and sensory preferences prior to recommending sensory garments for sleep.
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Kirby AV, Bilder DA, Wiggins LD, Hughes MM, Davis J, Hall-Lande JA, Lee LC, McMahon WM, Bakian AV. Sensory features in autism: Findings from a large population-based surveillance system. Autism Res 2022; 15:751-760. [PMID: 35040592 PMCID: PMC9067163 DOI: 10.1002/aur.2670] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/12/2021] [Accepted: 12/16/2021] [Indexed: 12/29/2022]
Abstract
Sensory features (i.e., atypical responses to sensory stimuli) are included in the current diagnostic criteria for autism spectrum disorder. Yet, large population‐based studies have not examined these features. This study aimed to determine the prevalence of sensory features among autistic children, and examine associations between sensory features, demographics, and co‐occurring problems in other areas. Analysis for this study included a sample comprised of 25,627 four‐ or eight‐year‐old autistic children identified through the multistate Autism and Developmental Disabilities Monitoring Network (2006–2014). We calculated the prevalence of sensory features and applied multilevel logistic regression modeling. The majority (74%; 95% confidence interval: 73.5%–74.5%) of the children studied had documented sensory features. In a multivariable model, children who were male and those whose mothers had more years of education had higher odds of documented sensory features. Children from several racial and ethnic minority groups had lower odds of documented sensory features than White, non‐Hispanic children. Cognitive problems were not significantly related to sensory features. Problems related to adaptive behavior, emotional states, aggression, attention, fear, motor development, eating, and sleeping were associated with higher odds of having documented sensory features. Results from a large, population‐based sample indicate a high prevalence of sensory features in autistic children, as well as relationships between sensory features and co‐occurring problems. This study also pointed to potential disparities in the identification of sensory features, which should be examined in future research. Disparities should also be considered clinically to avoid reduced access to supports for sensory features and related functional problems.
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Affiliation(s)
- Anne V Kirby
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, Utah, USA.,Huntsman Mental Health Institute, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Deborah A Bilder
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Lisa D Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michelle M Hughes
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John Davis
- Department of Educational Psychology, University of Utah, Salt Lake City, Utah, USA
| | - Jennifer A Hall-Lande
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Li-Ching Lee
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - William M McMahon
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Amanda V Bakian
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
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50
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Barbier A, Chen JH, Huizinga JD. Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory. Front Psychiatry 2022; 13:830234. [PMID: 35370829 PMCID: PMC8964964 DOI: 10.3389/fpsyt.2022.830234] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/10/2022] [Indexed: 12/20/2022] Open
Abstract
The quest to understand the pathophysiology of autism spectrum disorder (ASD) has led to extensive literature that purports to provide evidence for autonomic dysfunction based on heart rate and heart rate variability (HRV), in particular respiratory sinus arrhythmia (RSA), a measure of parasympathetic functioning. Many studies conclude that autism is associated with vagal withdrawal and sympathetic hyperactivation based on HRV and electrodermal analyses. We will argue that a critical analysis of the data leads to the hypothesis that autonomic nervous system dysfunction is not a dominant feature of autism. Most children with ASD have normal parasympathetic baseline values and normal autonomic responses to social stimuli. The existing HRV and electrodermal data cannot lead to the conclusion of an over-excitation of the sympathetic nervous system. A small subgroup of ASD children in experimental settings has relatively low RSA values and relatively high heart rates. The data suggest that this is likely associated with a relatively high level of anxiety during study conditions, associated with co-morbidities such as constipation, or due to the use of psychoactive medication. Many studies interpret their data to conform with a preferred hypothesis of autonomic dysfunction as a trait of autism, related to the polyvagal theory, but the HRV evidence is to the contrary. HRV analysis may identify children with ASD having autonomic dysfunction due to co-morbidities.
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Affiliation(s)
- Ashley Barbier
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Ji-Hong Chen
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Jan D Huizinga
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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