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Updated: Feb 13, 2026
Testing Sensory and Multisensory Function in Children with Autism Spectrum Disorder
Published on: April 22, 2015
Exploring sleep quality of young children with autism spectrum disorder and disruptive behaviors
Cynthia R Johnson1, Tristram Smith2, Alexandra DeMand3
1University of Florida, Department of Clinical & Health Psychology, USA.
Insights
Sleep disturbances are common in young children with autism spectrum disorder (ASD) and are linked to more daytime behavioral problems and higher parental stress. These sleep issues do not improve with age or cognitive level, highlighting the need for early screening in ASD.
Area of Science:
- Pediatric neurology
- Developmental psychology
- Autism spectrum disorder research
Background:
- Sleep disturbances are prevalent in children with autism spectrum disorder (ASD).
- These sleep issues can negatively impact daily functioning and increase caregiver burden.
- Disruptive behaviors are common in young children with ASD.
Purpose of the Study:
- To investigate the association between age and IQ with sleep disturbances in young children with ASD.
- To determine if poor sleep correlates with increased daytime behavioral problems.
- To examine the relationship between disruptive behaviors, sleep disturbances, and parental stress.
Main Methods:
- Utilized the modified Child Sleep Habits Questionnaire for ASD (CSHQ-ASD) in a sample of 177 children with ASD.
- Categorized children into 'poor sleepers' (upper quartile CSHQ-ASD score) and 'good sleepers' (lower quartile).
- Analyzed group differences in age, IQ, daytime disruptive behavior, social disability, and parental stress.
Main Results:
- No significant differences in age or IQ were found between good and poor sleepers.
- Children with poor sleep exhibited significantly higher daytime behavioral problems (irritability, hyperactivity, social withdrawal, stereotypies).
- Parents of poor sleepers reported significantly higher levels of stress.
Conclusions:
- Sleep problems in young children with ASD and disruptive behaviors do not appear to resolve with age or differ by cognitive level.
- Screening for sleep disturbances is crucial for all children with ASD, irrespective of age or IQ.
- Poor sleep quality significantly exacerbates daytime behavioral issues and increases stress for both the child and parents.
Background And Purpose:
Sleep disturbances in autism spectrum disorder (ASD) are common and may impair daytime functioning as well as add to parental burden. In this well characterized sample of young children with ASD and disruptive behaviors, we examine the association of age and IQ in sleep disturbances using the Child Sleep Habits Questionnaire modified for ASD (CSHQ-ASD). We also test whether children with poor sleep have greater daytime behavioral problems than those with better sleep. Finally, we examine whether parental stress is higher in children with greater disruptive behaviors and sleep disturbances.
Participants And Methods:
One hundred and seventy-seven children with complete data out of 180 (mean age 4.7) with ASD participated in a randomized clinical trial. Parents completed the CSHQ-ASD and several other measures at study enrollment. The sample was divided into "poor sleepers" (upper quartile on the total score of the CSHQ-ASD) and "good sleepers" (lower quartile) for comparisons. Analyses were conducted to evaluate group differences on age, IQ, daytime disruptive behavior, social disability and parental stress.
Results:
The two groups of young children with ASD, good sleepers versus poor sleepers, were not different on age or cognitive level. Children in the poor sleeping group had significantly higher daytime behavioral problems including irritability, hyperactivity, social withdrawal and stereotypical behaviors. Parents in this group reported significantly higher levels of stress.
Conclusions:
The finding of no age difference between good and poor sleepers in young children with ASD and disruptive behaviors suggests that sleep problems are unlikely to resolve as might be expected in typically developing children. Likewise, the good and poor sleepers did not significantly differ in IQ. These findings add strong support for the need to screen for sleep disturbances in all children with ASD, regardless of age and cognitive level. Poor sleepers exhibited significantly greater daytime behavioral problems and parents of children in this group reported significantly higher levels of stress. Above and beyond the co-occurring disruptive behavior, poor sleep quality appears to pose substantial additive burden on child and parents.
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