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Published on: April 22, 2015
Clinical Correlates of Insomnia Symptoms in Young Children with Autism Spectrum Disorder
Megan L Wenzell1, Stormi L Pulver1, Lawrence Scahill1
1Department of Pediatrics, Marcus Autism Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA.
Insights
Insomnia symptoms in children with autism spectrum disorder are linked to disruptive mealtime behaviors, parent well-being, and specific behavioral checklist scores. The Pediatric Autism Insomnia Rating Scale (PAIRS) helps assess these issues.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Sleep Medicine
Background:
- Insomnia is prevalent in children with autism spectrum disorder (ASD).
- Understanding clinical correlates is crucial for targeted interventions.
- The Pediatric Autism Insomnia Rating Scale (PAIRS) is used to assess insomnia in this population.
Purpose of the Study:
- To investigate the clinical factors associated with insomnia symptoms in children with ASD.
- To identify predictors of significant insomnia symptoms using the PAIRS.
Main Methods:
- Analysis of 103 children (2-10 years) with ASD from an outpatient clinic.
- Assessment using parent-reported scales including PAIRS, Aberrant Behavior Checklist (ABC), and others.
- Logistic regression and best subset modeling to identify significant correlates of high PAIRS scores (≥ 22).
Main Results:
- Disruptive mealtime behaviors, parent quality of life/family functioning, and ABC subscales were significantly associated with insomnia symptoms (PAIRS ≥ 22).
- Dietary supplements also showed a significant association.
- ABC hyperactivity/noncompliance, dietary supplements, and mealtime behaviors were the strongest predictors (AUC = 0.842).
Conclusions:
- The PAIRS is a valuable tool for characterizing insomnia in autistic children.
- Clinical factors like mealtime behaviors and parent well-being are important considerations in managing childhood ASD insomnia.
Objective:
To examine clinical correlates of insomnia symptoms in children with autism spectrum disorder ascertained from a general outpatient autism clinic.
Study Design:
This analysis included 103 children with autism spectrum disorder (mean age = 5.8 ± 2.2 years; range 2-10, 77.7% male). A multidisciplinary team assessed medical and psychosocial histories using parent ratings from the Pediatric Autism Insomnia Rating Scale (PAIRS), Aberrant Behavior Checklist (ABC), Brief Autism Mealtime Behavior Inventory, and the Parent Health-Related Quality of Life and Family Functioning and Family Functioning Surveys. Height and weight were collected. Children in the current sample with scores on the PAIRS ≥ 22 were compared with those with a mean PAIRS score < 22. Univariable and multivariable logistic regression modeling was used to evaluate clinical correlates with insomnia symptoms ≥ 22. Best subset selection approach identified the most important predictors.
Results:
The PAIRS mean was 18.39 ± 14.54 (range 0 to 58); 33% scored ≥ 22. After adjusting for confounders, disruptive mealtime behaviors (P < .001), parent health-related quality of life and family functioning (P < .001 to .001), ABC subscales (P < .001 to .022), and dietary supplements (P = .019) were significantly associated with PAIRS ≥ 22. There were no group differences in height, weight, constipation, or demographics. Best subset modeling showed ABC hyperactivity/noncompliance, dietary supplements, and mealtime behaviors as the most significant predictors (receiver operating characteristic = 0.842, χ2(df) = 32.84 (3), χ2Diff. = 4.80,P < .001).
Conclusions:
The PAIRS appears useful for characterizing the nature and severity of current insomnia symptoms in autistic children.
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