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Evaluating Sleep in Autism Using CSHQ and CSHQ-Autism - A Perspective Through the Cultural Lens
Nishant Prabhakaran1, Ann Moncy Maria1, Roopa N1
1Centre for Advanced Research and Excellence in Autism and Developmental Disorders, St. John's Medical College Hospital and St. John's Research Institute, Bengaluru, Karnataka, 560034, India.
Insights
The Child Sleep Hygiene Questionnaire (CSHQ) and CSHQ-Autism are valuable for pediatric sleep studies. However, cultural factors like co-sleeping in India may inflate scores, impacting accurate sleep disturbance assessment.
Area of Science:
- Pediatric Sleep Research
- Autism Spectrum Disorder (ASD) Sleep Studies
Background:
- The Child Sleep Hygiene Questionnaire (CSHQ) and its adapted version, CSHQ-Autism, are utilized for assessing pediatric sleep patterns in children, including those with autism.
- A study involved 67 autistic children, with 52 screening positive on the CSHQ and 18 on the CSHQ-Autism.
Discussion:
- Both CSHQ and CSHQ-Autism demonstrated elevated scores in sleep anxiety and co-sleeping domains.
- These elevated scores may potentially impede the precise differentiation of sleep disturbances.
- Cultural norms in India, particularly regarding sleep anxiety and co-sleeping, are associated with more severe sleep disorders.
Key Insights:
- Sleep anxiety and co-sleeping prevalence in Indian culture can be linked to increased sleep disorder severity.
- These cultural factors may also offer protection against separation anxiety and Sudden Infant Death Syndrome (SIDS).
- Scores from CSHQ and CSHQ-Autism might be inflated due to ingrained cultural practices in the Indian context.
Outlook:
- Further research is needed to refine the interpretation of CSHQ and CSHQ-Autism scores within specific cultural contexts.
- Investigating culturally adapted sleep assessment tools is crucial for accurate diagnosis in diverse populations.
- Understanding the interplay between cultural norms and pediatric sleep is essential for effective intervention strategies.
Abstract:
The Child Sleep Hygiene Questionnaire (CSHQ) and its adapted version for autistic children, known as CSHQ-Autism, have gained recognition as essential tools for studying pediatric sleep patterns. 67 autistic children were evaluated using these questionnaires. 52 children screened positive on the CSHQ while 18 were screened positive on the CSHQ-Autism. Notably, both tools showed elevated ratings in the domains of sleep anxiety and co-sleeping, which may hinder their ability to accurately distinguish sleep disturbances. However, the prevalence of sleep anxiety/co-sleeping in Indian culture was found to be linked to more severe sleep disorders, while also serving as a protective factor against separation anxiety and sudden infant death syndrome (SIDS). Therefore, while the CSHQ and CSHQ-Autism serve as valuable assessment tools, their scores may be inflated by ingrained cultural norms in the Indian context.
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