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Comparative accuracy of sleep disturbance questionnaires in children with autism spectrum disorder: a receiver

Batuhan Yüksel1, Mert Dogan2, Koray Kara3

  • 1Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Akdeniz University, Antalya, Turkey.

BMJ Paediatrics Open
|May 6, 2026
PubMed

Insights

Several sleep and wakefulness scales are effective for assessing sleep disorders in children with autism spectrum disorder (ASD). The Children's Sleep Habits Questionnaire (CSHQ) and Sleep Disturbance Scale for Children (SDSC) showed high diagnostic accuracy.

Area of Science:

  • Pediatric Psychiatry
  • Sleep Medicine
  • Neurodevelopmental Disorders

Background:

  • Sleep disturbances are prevalent in children with autism spectrum disorder (ASD).
  • Accurate assessment of sleep-wake disorders is crucial for effective intervention in this population.
  • Various validated questionnaires exist to evaluate sleep patterns in children.

Purpose of the Study:

  • To compare the effectiveness of different sleep and wakefulness scales in children.
  • To determine the utility of these scales specifically for children diagnosed with ASD.
  • To identify reliable tools for assessing sleep problems in pediatric ASD.

Main Methods:

  • Cross-sectional observational study involving 230 children (155 with ASD, 75 typically developing), aged 4-18 years.
  • Utilized five caregiver-reported questionnaires: Children's Sleep Habits Questionnaire (CSHQ), Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), Paediatric Daytime Sleepiness Scale (PDSS), Paediatric Sleep Questionnaire (PSQ), and Sleep Disturbance Scale for Children (SDSC).
  • Assessed sleep patterns, daytime sleepiness, and behavioral problems related to sleep.

Main Results:

  • All five scales (CSHQ, ESS-CHAD, PDSS, PSQ, SDSC) demonstrated discriminant validity and internal consistency for assessing sleep-wake disorders in children with ASD (p<0.05, Cronbach's alpha >0.60).
  • The CSHQ and SDSC exhibited similar diagnostic accuracy in identifying sleep disorders.
  • The PSQ showed high positive predictive value, PDSS high negative predictive value, and ESS-CHAD high agreement.

Conclusions:

  • The CSHQ, ESS-CHAD, PDSS, PSQ, and SDSC are valuable tools for assessing sleep-wake disorders in children with ASD.
  • A combination of these scales may provide a comprehensive evaluation of sleep issues in pediatric ASD.
  • These validated instruments support clinical assessment and research in childhood ASD sleep disturbances.
Abstract

Keywords:
Child HealthChild PsychiatryRehabilitationSleep

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