Authors (including presenting author) :
Ip YT(1), Lee SL(2), Li SX(3)
Affiliation :
(1)Department of Clinical Psychology, DKCH, (2)Department of Paediatrics & Adolescent Medicine, QMH, (3)Department of Psychology, HKU
Introduction :
Behavioral sleep problems, such as insomnia symptoms including bedtime resistance, sleep-onset delay, and night waking, are common in children with Autism Spectrum Disorder (ASD) and may result in various negative impacts. Nonetheless, the research on the role of sleep problems, especially insomnia, in relation to executive function (EF) in preschool children with ASD was limited.
Objectives :
(1) to examine the relationship between parent-reported sleep problems, especially insomnia symptoms, and EF in preschool children with ASD. (2) to explore the associations of parent-reported sleep problems with child’s daytime behavioral and emotional problems, parental sleep and mood, parenting stress, and sense of competence.
Methodology :
A cross-sectional design was employed. Preschool children aged 3 to 6 years old with a clinical diagnosis of ASD and their parents were recruited from Duchess of Kent Child Assessment Centre. Parents were asked to complete a set of questionnaires on demography and the child’s sleep problems (Children’s Sleep Habit Questionnaire, CSHQ), executive function (Behavior Rating Inventory of Executive Function-Preschool version, BRIEF-P), and emotional and behavioral problems (Strengths and Difficulties Questionnaire, SDQ). They were also assessed for their own sleep (Pittsburg Sleep Quality Inventory, PSQI; Insomnia Severity Index, ISI), emotional states (Depression Anxiety Stress Scale, DASS-21), parenting stress (Parental Stress Scale, PSS), and satisfaction and efficacy in parenting (Parenting Sense of Competence scale, PSOC). Relevant clinical information of the child was retrieved from the medical records.
Result & Outcome :
A total of 197 children were recruited (85.8%boys, mean=4.75 years, s.d.=1.08) and 90.4% were identified as having sleep problems (CSHQ score>41). The average sleep duration was 9.68 hours; only 10.7% of the sample obtained recommended sleep duration of 11-12 hours. Sleep problems were found to be significantly associated with daytime emotional and behavioral problems, as well as parental sleep and mood problems after controlling for socio-demographic factors. Hierarchical multiple regression analysis showed that Night Wakings were significantly associated with EF deficits (standardized coefficient beta=.16-19, p<.05), after controlling for socio-demographic factors and other sleep problems. The findings suggested the independent effect of insomnia on EF in young children with ASD, and indicated the need of enhanced clinical attention in identification and intervention of sleep issues in this vulnerable group.
