Autism & Developmental

Sleep patterns in children with and without autism spectrum disorders: developmental comparisons.

Hodge et al. (2014) · Research in developmental disabilities 2014
★ The Verdict

Sleep in autistic kids stays worse than typical peers and does not improve with age, so keep checking and intervene early.

✓ Read this if BCBAs working with school-age autistic clients who show daytime irritability or attention problems.
✗ Skip if Practitioners serving only toddlers or adults.

01Research in Context

01

What this study did

Hodge et al. (2014) compared sleep in autistic and typical children. They tracked how sleep changed as kids got older.

The study looked at both how long kids slept and how well they slept.

02

What they found

Autistic children slept worse than typical peers. The gap did not close with age.

Problems were biggest in the 6-9 year group. Sleep issues stuck around instead of fading.

03

How this fits with other research

Allik et al. (2008) seems to disagree. They also followed autistic kids and saw sleep problems stay flat, but said the 'trajectory parallels typical peers.' The difference is in the lens: Hiie looked at the slope of change, while Danelle looked at the raw gap. Both are true—autistic sleep does not drop further, yet it stays far worse.

Berenguer et al. (2024) adds ADHD to the mix. They show poor sleep hurts communication in both ASD and ADHD. Danelle's pure ASD versus TD picture sets the baseline that Carmen later extends.

Tse et al. (2019) gives hope. A 30-minute weekday activity program raised sleep efficiency for autistic kids. Danelle proves the need; Andy shows a fix.

04

Why it matters

Do not assume a child will 'grow out' of poor sleep. Screen early and re-check at 6-9 years. Break sleep into pieces—duration, night wakings, latency—instead of one global score. If a family wants a low-cost first step, borrow Andy's weekday active-play plan while you wait for specialist care.

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→ Action — try this Monday

Add three quick sleep questions to your intake: 'How long to fall asleep?', 'How many night wakings?', 'What time wake for good?'

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
216
Population
autism spectrum disorder, neurotypical
Finding
negative

03Original abstract

The present study examined age-related changes in the sleep of children with autism spectrum disorders (ASD) compared to age-related changes in the sleep of typically developing (TD) children. Participants were 108 mothers of children with ASD and 108 mothers of TD children. Participants completed a questionnaire on children's overall sleep quality that also tapped specific sleep-domains (i.e., bedtime resistance, sleep onset delay, sleep duration, sleep anxiety, night wakings, parasomnias, disordered breathing, daytime sleepiness). Results confirm significantly poorer sleep quantity and quality in children with ASD, particularly children age 6-9 years. Unlike TD children, the sleep problems of children with ASD were unlikely to diminish with age. Our findings suggest that it is important to exam specific domains of sleep as well as overall sleep patterns. Finding of significant age-related interactions suggests that the practice of combining children from wide age-ranges into a single category obfuscates potentially important developmental differences.

Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.03.037