Related Experiment Video
Updated: Nov 21, 2025
Testing Sensory and Multisensory Function in Children with Autism Spectrum Disorder
Published on: April 22, 2015
Links between parent-reported measures of poor sleep and executive function in childhood autism and attention deficit
Calliope Holingue1, Heather Volk2, Deana Crocetti3
1Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA; Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA.
Insights
Poor sleep is linked to executive dysfunction in children with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and typical development (TD). Addressing anxiety may help improve executive function in children with ASD.
Area of Science:
- Neurodevelopmental Disorders
- Pediatric Psychology
- Sleep Medicine
Background:
- Executive function (EF) is crucial for daily functioning.
- Sleep disturbances are common in children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).
- The relationship between sleep and EF in these populations requires further investigation.
Purpose of the Study:
- To examine the association between poor sleep and executive function (EF) in children with ASD, ADHD, and typical development (TD).
- To explore the mediating roles of anxiety, inattention, and hyperactivity in the sleep-EF relationship.
Main Methods:
- Cross-sectional study of 735 children (aged 8-12 years): 323 TD, 177 ASD, 235 ADHD.
- Parent-reported sleep quality (Children's Sleep Habits Questionnaire - CSHQ).
- Parent-reported executive function (Behavior Rating Inventory of EF - BRIEF) and processing speed (Wechsler Intelligence Scale for Children).
Main Results:
- Poor sleep was associated with poorer EF across all groups, even after adjusting for covariates.
- Anxiety partially mediated the sleep-EF link in ASD, while inattention and hyperactivity fully accounted for it in all groups.
- Poor sleep was not associated with processing speed.
Conclusions:
- Significant associations exist between poor sleep and executive dysfunction in children, including those with ASD and ADHD.
- Interventions targeting anxiety may benefit EF in children with ASD.
- Addressing sleep problems is important for improving EF in children.
Objectives:
This study sought to assess whether poor sleep is associated with aspects of executive function (EF) among children with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), or typical development (TD), after adjusting for demographic variables, stimulant medications, intelligence, anxiety, inattention, and hyperactivity.
Design:
Cross-sectional.
Setting:
Children recruited through ongoing studies at the Kennedy Krieger Institute.
Participants:
We studied 735 children (323 TD; 177 ASD; 235 ADHD) aged 8 to 12 years.
Measurements:
We investigated associations of parent-reported sleep measures from the Children's Sleep Habits Questionnaire (CSHQ) with parent-report measures of EF and performance-based processing speed with each clinical population. EF was measured using 8 clinical T scores that fall under 2 domains (behavioral regulation and metacognition) from the Behavior Rating Inventory of EF (BRIEF) and the processing speed index from the Wechsler Intelligence Scale for Children-IV or -V.
Results:
Higher CSHQ scores were associated with poorer EF on all BRIEF scales, across all child groups, after adjustment for demographic factors, stimulant medications, and IQ. Among children with ADHD, these associations largely remained after adjusting for anxiety. Among those ASD, anxiety partially accounted for these associations, especially for behavioral regulation EF outcomes. Co-occurring symptoms of inattention and hyperactivity/impulsivity further accounted for the associations between sleep and EF. Poor sleep was not significantly associated with processing speed.
Conclusions:
Strong links exist between parent-reported poor sleep and executive dysfunction in children with typical development. Targeting anxiety may alleviate executive dysfunction, especially among children with ASD.
More Related Videos
12:21Probing the Brain in Autism Using fMRI and Diffusion Tensor Imaging
Published on: September 12, 2011
10:02Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD
Published on: March 12, 2020
Related Concept Videos
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:19Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
01:13Insufficient Sleep and Sleep Deprivation
Sleep deprivation is a more severe form of sleep loss...
01:24Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...