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Sleep Problems and Trajectories of Restricted and Repetitive Behaviors in Children with Neurodevelopmental

Katherine E MacDuffie1, Jeffrey Munson2, Jessica Greenson1

  • 1Department of Speech and Hearing Science, UW Autism Center, University of Washington, Box 957920, Seattle, WA, 98195, USA.

Journal of Autism and Developmental Disorders
|March 7, 2020
PubMed

Insights

Sleep problems in children with autism spectrum disorder (ASD) and developmental delay (DD) are linked to the development of higher-order restricted and repetitive behaviors (RRBs). These associations persist even when controlling for other factors.

Area of Science:

  • Child Psychology
  • Neurodevelopmental Disorders
  • Sleep Science

Background:

  • Sleep problems are common in children with neurodevelopmental disabilities.
  • Restricted and repetitive behaviors (RRBs) are characteristic of conditions like autism spectrum disorder (ASD) and developmental delay (DD).
  • The relationship between sleep issues and RRB expression requires further investigation.

Purpose of the Study:

  • To examine the association between sleep problems and the developmental trajectories of RRBs in children with ASD and DD.
  • To differentiate the impact of sleep problems on higher-order versus lower-order RRBs.
  • To investigate these relationships in a transdiagnostic sample.

Main Methods:

  • Longitudinal study involving 57 children (38 with ASD, 19 with DD).
  • Assessed intellectual ability, ASD symptoms, and RRBs at multiple time points.
  • Parent-reported sleep problems at age 4 were analyzed in relation to RRB trajectories from age 2 to 6.

Main Results:

  • Sleep problems at age 4 were associated with trajectories of higher-order RRBs (sameness/ritualistic/compulsive behaviors) in both ASD and DD groups.
  • This association remained significant after controlling for intellectual ability, social-affective symptoms, and anxiety.
  • Trajectories of stereotyped/restricted behaviors were not associated with sleep problems.

Conclusions:

  • Sleep problems are specifically linked to the development of higher-order RRBs in children with neurodevelopmental disabilities.
  • Findings suggest sleep disruption may play a role in the emergence of specific types of repetitive behaviors.
  • Interventions targeting sleep may potentially influence higher-order RRBs in this population.

Keywords:
AnxietyAutism spectrum disorderDevelopmental delayNeurodevelopmental disabilityRepetitive behaviorsRestricted behaviorsSleep

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