Assessment & Research

Factor analysis of the children's sleep habits questionnaire among preschool children with autism spectrum disorder.

Zaidman-Zait et al. (2020) · Research in developmental disabilities 2020
★ The Verdict

Use the five-factor CSHQ to link specific sleep problems to the dysregulation you see during the day.

✓ Read this if BCBAs assessing preschoolers with ASD who also have sleep problems.
✗ Skip if Clinicians working only with school-age or non-autistic populations.

01Research in Context

01

What this study did

Parents of preschoolers with autism filled out the Children’s Sleep Habits Questionnaire. The team ran a factor analysis on the answers. They wanted a shorter, cleaner set of sleep factors that map onto day-time behavior problems.

02

What they found

A new five-factor model fit the data well. The factors are bedtime resistance, sleep anxiety, night wakings, parasomnias, and sleep-disordered breathing. Each factor lined up with a dysregulation domain like aggression or attention problems.

03

How this fits with other research

Camodeca et al. (2020) also used factor analysis on the Child Behavior Checklist in autistic youth. Both studies show that parent checklists split into clear dysregulation factors.

Mutluer et al. (2016) found more sleep problems in autistic children, but used the old CSHQ scoring. Zaidman-Zait et al. (2020) now gives you a tighter five-factor version that links each sleep cluster to specific behavior issues.

Lillis et al. (2007) did the same factor work on the Aberrant Behavior Checklist. Together these papers build a toolkit: ABC for self-injury, CBCL-DP for mood, and the new CSHQ for sleep-linked dysregulation.

04

Why it matters

Switch to the five-factor CSHQ and you can tell parents exactly which sleep problem feeds their child’s aggression, anxiety, or attention issues. Pinpoint the factor, target the treatment, and track change with a one-page checklist.

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→ Action — try this Monday

Re-score last week’s CSHQ using the five factors and note which factor aligns with the child’s top daytime concern.

02At a glance

Intervention
not applicable
Design
other
Sample size
281
Population
autism spectrum disorder
Finding
positive

03Original abstract

BACKGROUND: Sleep problems are prevalent among young children with autism spectrum disorders (ASD). The Children's Sleep Habits Questionnaire (CSHQ) is commonly used for assessment, but there are outstanding questions regarding its optimal measurement model. AIMS: To examine the factor structure of the CSHQ in preschool children with ASD, and relationships between CSHQ factors and children's emotional, cognitive, and behavioral dysregulation. METHODS AND PROCEDURES: Participants included 4- to 5-year-olds with ASD (n = 281). Confirmatory factor analysis was used to examine whether two previously reported CSHQ factor structures provided adequate fit to the sample data. Exploratory Factor Analysis (EFA) was used examine alternative models. Regression analyses were used to examine how CSHQ factor scores explained variance in dysregulation symptoms, measured by the Child Behavior Checklist. RESULTS: Previously reported factor models in children with ASD were not confirmed, but a novel five-factor model identified using EFA provided excellent fit to the sample data. Sleep factors were generally not correlated with autism symptoms but were associated with aggression, anxiety/depression and attention problems, with evidence of specificity in these relationships. CONCLUSIONS: The proposed CSHQ five-factor model may be useful in future studies of sleep problems in young children with ASD.

Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2019.103548