Behavior and sleep problems in children with a family history of autism.
Preschoolers with an autistic sibling often look typical yet already show more anxiety, aggression, and sleep trouble.
01Research in Context
What this study did
Schwichtenberg et al. (2013) watched preschoolers who have an older brother or sister with autism. These kids have no autism diagnosis themselves.
The team compared their behavior and sleep to same-age peers with no family history of autism.
What they found
High-risk siblings showed more worry, sadness, and hitting even though they were not autistic.
Poor sleep predicted worse behavior in both groups, but the link was strongest in the high-risk kids.
How this fits with other research
Zhang et al. (2026) followed the same type of toddlers and found one in three already had mild autism signs by age three. Together the papers show the broader autism phenotype starts early and shows up as both social and emotional issues.
Laposa et al. (2017) looked at the same preschool group and saw stronger empathy in the high-risk siblings. This seems opposite to Jo's finding of more aggression, but the kids can be both caring and quick to anger; the measures capture different slices of behavior.
Garrido et al. (2025) later showed that sleep loss in diagnosed autistic children drags down the whole family's quality of life. Jo's preschool data hint the damage may begin before an ASD diagnosis is even on the table.
Why it matters
Screen every new client sibling for sleep habits and emotional outbursts, even when autism is not suspected. A simple bedtime checklist and a brief behavior rating can flag kids who need extra support before problems snowball.
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02At a glance
03Original abstract
The present study explores behavioral and sleep outcomes in preschool-age siblings of children with autism spectrum disorders (ASD). This study focuses on behavior problems that are common in children with ASD, such as emotional reactivity, anxiety, inattention, aggression, and sleep problems. Infant siblings were recruited from families with at least one older child with ASD (high-risk group, n = 104) or families with no history of ASD (low-risk group, n = 76). As part of a longitudinal prospective study, children completed the Mullen Scales of Early Learning and the Autism Diagnostic Observation Schedule, and parents completed the Child Behavior Checklist (CBCL) and the Social Communication Questionnaire at 36 months of age. This study focuses on developmental concerns outside of ASD; therefore, only siblings who did not develop an ASD were included in analyses. Negative binomial regression analyses revealed that children in the high-risk group were more likely to have elevated behavior problems on the CBCL Anxious/Depressed and Aggression subscales. To explore sleep problems as a correlate of these behavior problems, a second series of models was specified. For both groups of children, sleep problems were associated with elevated behavior problems in each of the areas assessed (reactivity, anxiety, somatic complaints, withdrawal, attention, and aggression). These findings support close monitoring of children with a family history of ASD for both behavioral and sleep issues.
Autism research : official journal of the International Society for Autism Research, 2013 · doi:10.1002/aur.1278