Autism & Developmental

A cross-cultural comparison of sleep patterns between typically developing children and children with ASD living in Saudi Arabia and the United Kingdom.

Bin Eid et al. (2022) · Research in developmental disabilities 2022
★ The Verdict

Autistic kids sleep worse than peers in both Saudi Arabia and the UK, but the type of problem depends on culture.

✓ Read this if BCBAs working with autistic children who have bedtime issues.
✗ Skip if Practitioners focused only on daytime behavior with no sleep concerns.

01Research in Context

01

What this study did

Researchers asked parents in Saudi Arabia and the United Kingdom to fill out sleep surveys. They compared children with autism to typically developing children in each country.

The goal was to see if culture changes how autism affects sleep.

02

What they found

Kids with autism slept worse in both countries. Saudi children with autism took longer to fall asleep and woke up more often. UK children with autism had more night fears and scary dreams.

Typical children in both places slept about the same.

03

How this fits with other research

Tse et al. (2020) ran a matched study and saw the same poor sleep in autistic kids. Their result lines up here, giving the finding more weight.

Tyagi et al. (2019) worked in India and also found worse sleep in autistic kids. That paper looked at links to hyperactivity and sensory issues, while this one adds culture, so the two studies complement each other.

Morrison et al. (2017) tracked kids for a year and saw parent sleep reports improve as anxiety dropped. Their focus on change over time blends with this snapshot across cultures to show both how sleep varies and how it can shift.

04

Why it matters

If you serve autistic clients, ask parents where the family comes from and what sleep looks like there. A Saudi child may need help with long sleep onset, while a UK child may need a plan for night fears. Use this quick cultural check to pick the right bedtime tools, then track the data just like Cy et al. did.

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Add one parent question: 'Does your child take a long time to fall asleep, wake often, or seem scared at night?' Use the answer to pick a culturally-tuned sleep intervention.

02At a glance

Intervention
not applicable
Design
survey
Sample size
244
Population
autism spectrum disorder, neurotypical
Finding
negative

03Original abstract

BACKGROUND: Sleep is crucial for child development, especially for children with ASD. While it is known that children with ASD experience more severe sleep problems and that these problems tend to persist compared to their typically developing counterparts, these findings tend to come from only Western countries. A cross-cultural study is important to understand if the prevailing understanding of sleep in children with ASD can be extended to different cultural backgrounds. AIM: A cross-cultural study is conducted, involving typically developing children and children with ASD aged 5-12 across two countries: Saudi Arabia and the United Kingdom. METHODS AND PROCEDURES: Using a combination of questionnaires measuring ASD severity (CARS-2), sleep quality (CSHQ), sociodemographic and lifestyle variables and sleep diaries, 244 children were sampled using a mixture of snowball and convenience sampling methods. OUTCOMES AND RESULTS: Children with ASD experience more sleep problems compared to typically developing children in Saudi Arabia, and these problems similarly persist across time. Specifically, it was found that children with ASD in Saudi Arabia experience greater sleep onset latency and a greater number of night awakenings. Additionally, across the ASD groups, it was found that children from Saudi Arabia generally experienced poorer sleep than children in the United Kingdom in terms of shorter sleep duration, although children in the United Kingdom tended to report more instances of sleep anxiety and parasomnias. CONCLUSIONS AND IMPLICATIONS: Several reasons such as parental education about sleep hygiene, cultural influences and social hours were put forward as potential explanations for cross-cultural differences. Findings served to emphasise the importance of culturally-appropriate interventions and public education regarding child sleep.

Research in developmental disabilities, 2022 · doi:10.1016/j.ridd.2022.104290