Factor Structure of the Sleep Disturbance Scale for Children in a Cohort of Youth With Autism.
The SDSC keeps its five-factor shape in autistic youth and links to behavior problems, so use it at intake.
01Research in Context
What this study did
The team gave the Sleep Disturbance Scale for Children (SDSC) to parents of 513 autistic youth.
They ran a factor analysis to see if the same five sleep problems the test was built for show up in this group.
Kids were clinic patients; no extra sleep treatment was given.
What they found
The five-factor model fit the data very well.
Higher scores on each factor lined up with more internalizing and externalizing behavior problems reported on other forms.
The SDSC works as a quick sleep screen for autistic youth.
How this fits with other research
Le Donne et al. (2025) did the same kind of factor work on the Italian CSHQ-r and also found a clear multi-factor sleep structure in autistic kids.
Ferraiolo et al. (2026) and Howard et al. (2023) later showed poor sleep predicts later depression in autistic teens and young adults, backing the idea that early SDSC scores matter.
Adams et al. (2022) tested the SRAS-R factor model in autism and got a bad fit with parent push-back, showing not every questionnaire survives the autism lens—yet the SDSC did.
Why it matters
You now have a free, parent-friendly tool that flags bedtime resistance, sleep anxiety, night waking, sleep-disordered breathing, and abnormal sleepiness in one page.
Add the SDSC to your intake packet, score it in five minutes, and use high sub-scale scores to start sleep interviews or referrals before problem behavior grows.
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02At a glance
03Original abstract
Despite the substantial evidence base for poor sleep in autism, sleep problems are frequently under-identified and inefficiently managed. This is, in part, due to the fact that available tools do not comprehensively capture the specific sleep phenotypes in autism. The Sleep Disturbance Scale for Children (SDSC) is one of the highest ranked pediatric sleep assessment tools, yet it is scarcely used in autism research. Consequently, the utility of the SDSC for characterizing sleep disturbances in autism remains unknown. This study explored the factor structure of the SDSC in a sample of 513 autistic youth, aged 3-18 years (mean: 10.5 years; SD: 3.7; 18.7% female) drawn from the Healthy Brain Network secondary dataset. Fit of the previously derived SDSC factor structure was appraised using the confirmatory application of the exploratory structural equation modeling. Results indicated a five-factor solution comprising disorders of initiating and maintaining sleep, disorders of arousal, disorders of excessive somnolence (DoES), sleep breathing disorders, and sleep-wake transition disorders (SWTD) provided an excellent fit for the data. The derived factor solution was stable across sex and age. Notably, all sleep subscales were significantly positively associated with internalizing and externalizing behaviors, while age was significantly associated with DoES (r = 0.15) and SWTD (r = -0.18). This study provides the first validation of the SDSC in a large sample of well-characterized autistic youth showing distinct patterns of associations with key clinical correlates. Findings are consistent with independent reviews, suggesting the SDSC may provide a more effective way to screen for sleep disturbances in autistic individuals.
Autism research : official journal of the International Society for Autism Research, 2026 · doi:10.1002/aur.70140