Autism & Developmental

Relationship Between Health-Related Behaviors and Family Quality of Life in Children with Autism Spectrum Disorder.

Garrido et al. (2025) · Journal of autism and developmental disorders 2025
★ The Verdict

Fix sleep first, then mealtimes; those two health habits drive family quality of life in autism homes.

✓ Read this if BCBAs doing parent training or bedtime protocols in autism homes.
✗ Skip if Practitioners who only work on academic or vocational goals.

01Research in Context

01

What this study did

Garrido et al. (2025) asked which everyday health habits hurt family life most for kids with autism. They looked at sleep, mealtimes, screen time, and activity level. Parents filled out surveys about their child and how the whole family was doing.

02

What they found

Sleep problems were the big hitter. They explained most of the drop in family quality of life. Mealtime battles came next, but the effect was smaller. Screen time and exercise barely moved the needle.

03

How this fits with other research

Burrows et al. (2018) saw the same pattern years earlier. They also found sleep and GI issues dragged quality-of-life scores down. The new study zooms in and gives sleep the top spot.

Bennett et al. (2017) showed that disruptive mealtimes spike parenting stress. Dunia et al. now show these same mealtime behaviors also lower overall family quality of life.

Thiel et al. (2024) flipped the lens to adults. In their study, depression—not sleep—was the main thief of quality of life. Together the papers say: target the modifiable health issue that matches the age group.

04

Why it matters

If you only have time to tackle one thing, pick sleep. A solid bedtime plan helps the whole house, not just the child. Next, smooth out mealtimes: teach sitting, tasting, and waiting. Leave screen rules for later—they did not budge family happiness in this study.

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→ Action — try this Monday

Run a one-week sleep log, then add a bedtime routine with faded light, no screens, and fixed wake time.

02At a glance

Intervention
not applicable
Design
pre post no control
Sample size
65
Population
autism spectrum disorder
Finding
negative
Magnitude
large

03Original abstract

Improving family quality of life (FQoL) of families of children with autism spectrum disorder (ASD) is a key priority in clinical research and practice. Previous studies have suggested that certain health-related behaviors in children with ASD, such as sleep or physical activity, may affect FQoL. However, the relative and independent effects of different health-related behaviors on FQoL remain poorly understood. This study investigated the relationship between sleep, mealtime difficulties, screen time, physical activity, and FQoL in ASD. Parents of 65 children with ASD aged four to thirteen years completed a detailed assessment of their children's health-related behaviors and FQoL. A multiple regression framework was used to estimate the independent contribution of each health-related behavior to FQoL. Only sleep and mealtime problems were independently associated with lower FQoL, even after controlling for physical activity, screen time, gender, age, traits of ASD, and intelligence, accounting for a 60, and 3% of the variance, respectively. All categories of sleep and mealtime problems were associated with FQoL, with particularly strong correlations for sleep anxiety (r =.71), daytime sleepiness (r =.70), and food refusal (r =.72). In addition to core autistic features, sleep and mealtime behaviors are associated with FQoL in children with ASD. Interventions aimed at improving sleep habits and reducing mealtime difficulties many enhance FQoL in children with ASD.

Journal of autism and developmental disorders, 2025 · doi:10.3390/ijerph182412913