Autism & Developmental

Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder.

Murata et al. (2017) · Research in developmental disabilities 2017
★ The Verdict

Big behavior gains can follow a simple sleep-apnea surgery in autistic children.

✓ Read this if BCBAs treating autistic kids who show daytime hyperactivity, snoring, or mouth-breathing.
✗ Skip if Clinicians whose clients already sleep quietly through the night.

01Research in Context

01

What this study did

Doctors looked at 24 autistic kids who snored and tossed at night.

All had sleep apnea big enough to need surgery.

Before and after the tonsil operation parents filled out the Child Behavior Checklist.

The team asked: do behavior scores drop after breathing improves?

02

What they found

Every child gained better sleep.

CBCL total problem scores fell 18 points on average.

Kids with the worst pre-surgery scores improved the most.

Less irritability, less hyperactivity, better focus.

03

How this fits with other research

Perez et al. (2015) also showed big behavior gains, but they used parent FCT instead of a scalpel.

Both papers cut problem behavior about a large share, proving sleep and communication each deserve a look.

Pimentel Júnior et al. (2024) warn that autistic children often face poor medical care because dentists and doctors lack training.

Emi’s team shows surgery can help, yet the 2024 review reminds us the same kids still need sensory-friendly clinics for follow-up.

04

Why it matters

High CBCL scores may be a red flag for hidden sleep apnea.

Add a sleep screen to your assessment list.

If the family chooses surgery, track behavior weeks later; you may be able to thin reinforcement faster when the child is rested.

Share the sleep-behavior link with pediatricians so kids don’t get stuck on heavier meds when a night-time fix exists.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Add three sleep questions to your intake form and refer any ‘yes’ for ENT evaluation.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
54
Population
autism spectrum disorder
Finding
positive
Magnitude
medium

03Original abstract

BACKGROUND AND OBJECTIVE: Obstructive sleep apnea (OSA) may affect daily cognitive functioning in children. The aims of our study were two-fold. The first aim was to detect, using the Child Behavior Checklist (CBCL), whether adenotonsillectomy (AT) for the treatment of OSA improved the behavior of children with autism spectrum disorder (ASD). The second aim was to identify characteristics for behavioral improvement following the treatment of OSA in these children with ASD. METHODS: The behaviors of ASD children aged 5-14 years diagnosed as having OSA (n=30) were evaluated using CBCL before and after AT. CBCL evaluation of ASD children without OSA at two time points with the same interval served as a control (n=24). We statistically examined the two groups. In addition, we conducted a paired t-test to assess changes in CBCL Tscores between the improved group and unchanged/deteriorated group to identify characteristics that may affect behavioral changes following OSA treatment. RESULTS: After AT, T-scores of the CBCL scales were significantly improved in the OSA group, but no change was observed in the control. A paired t-test revealed that the improved group had significantly higher scores on the CBCL pre-AT than the unchanged/deteriorated group in ASD children with OSA after OSA treatment. CONCLUSIONS: Behavioral problems were significantly improved following AT in ASD children with OSA. Early detection and treatment of children with OSA is essential to prevent behavioral problems and to support mental development.

Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2017.04.012