Autism & Developmental

Course and Predictors of Sleep and Co-occurring Problems in Children with Autism Spectrum Disorder.

Mazurek et al. (2019) · Journal of autism and developmental disorders 2019
★ The Verdict

Sleep in autism is a moving target that foretells ADHD and somatic issues, so keep checking and act early.

✓ Read this if BCBAs working with autistic clients under 10 in clinic or home programs.
✗ Skip if Practitioners serving only adults or clients without sleep concerns.

01Research in Context

01

What this study did

Mazurek et al. (2019) tracked sleep problems in children with autism for about four years. They asked parents to fill out the same sleep forms many times. The team also noted each child’s ADHD signs, tummy aches, and sensory issues.

The goal was to see if early sleep could predict later behavior or medical complaints.

02

What they found

Sleep was not stable. Roughly one in four kids got worse, while about one in three got better. Baseline sleep trouble forecast later ADHD and somatic complaints. Kids who were extra sensitive to sounds or textures were more likely to develop new sleep issues.

03

How this fits with other research

Carter Leno et al. (2021) say up to 86 % of kids with autism have sleep issues. Their big-picture review fits with O’s finding that sleep is common and changeable.

Scior et al. (2023) zoomed in day-by-day. They saw that longer sleep cut next-day parent stress. O’s four-year view and K’s daily view stack together: sleep matters on both clocks.

Martinez-Cayuelas et al. (2024) added a twist. They measured wrist temperature and movement. Kids with autism plus ADHD had the most broken circadian rhythms. O showed sleep predicts later ADHD; Elena shows the biological clock may be why.

04

Why it matters

You can’t assume last year’s sleeper will stay the same. Re-screen at every intake. If a young client has new sensory over-responsivity, plan for possible sleep loss ahead. When sleep is poor, watch for emerging ADHD or somatic complaints and loop in medical partners early.

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→ Action — try this Monday

Add one question about sleep to your session note and track it monthly.

02At a glance

Intervention
not applicable
Design
other
Sample size
437
Population
autism spectrum disorder
Finding
mixed

03Original abstract

The chronicity of sleep disturbance and its relation to co-occurring symptoms in children with autism spectrum disorder (ASD) are not well understood. The current study examined longitudinal relations among sleep and co-occurring symptoms in a large well-characterized sample of 437 children with ASD assessed at baseline and follow-up (M = 3.8 years later). Twenty-three percent experienced worsening sleep problems over time, while 31.5% showed improvement. Path analysis indicated that sleep problems at baseline predicted later development of ADHD symptoms in younger children and somatic complaints in older children. For younger children, sensory over-responsivity predicted future sleep problems. Findings suggest that sensory over-reactivity may contribute to sleep problems in some children with ASD, and that sleep problems may result in poor daytime functioning.

Journal of autism and developmental disorders, 2019 · doi:10.1007/s10803-019-03894-5