Skip to main content
SpringerLink
Log in

Relationship Between Subtypes of Restricted and Repetitive Behaviors and Sleep Disturbance in Autism Spectrum Disorder

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

We examined the association of two types of restricted and repetitive behaviors, repetitive sensory motor (RSM) and insistence on sameness (IS), with sleep problems in children with autism spectrum disorder (ASD). Participants included 532 children (aged 2–17) who participated in the Autism Speaks Autism Treatment Network research registry. Confirmatory factor analysis of the Autism Diagnostic Interview-Revised detected the presence of RSM and IS. RSM behaviors were positively associated with parent-reported sleep problems, and this relationship remained significant after controlling for anxiety symptoms. IS was not significantly associated with sleep problems. Better understanding of the relationship between specific types of repetitive behaviors and sleep problems may allow providers to tailor interventions to the individual presentations of their patients with ASD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

  • Achenbach, T. M. (1991). Manual for the child behavior checklist 4–18 and 1991 profile. Burlington, VT: University of Vermont, Department of Psychiatry.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.

    Book  Google Scholar 

  • Bentler, P. M. (2006). On tests and indices for evaluating structural models. Personality and Individual Differences, 42, 825–829.

    Article  Google Scholar 

  • Bentler, P. M., & Chou, C. P. (1987). Practical issues in structural modeling. Sociological Methods and Research, 16, 78–117.

    Article  Google Scholar 

  • Bishop, S. L., Hus, V., Duncan, A., Huerta, M., Gotham, K., Pickles, A., et al. (2013). Subcategories of restricted and repetitive behaviors in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 3, 1287–1297.

    Article  Google Scholar 

  • Bishop, S. L., Richler, J., & Lord, C. (2006). Association between restricted and repetitive behaviors and nonverbal IQ in children with autism spectrum disorders. Child Neuropsychology, 4(5), 247–267.

    Article  Google Scholar 

  • Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30(3), 237–243.

    Article  PubMed  Google Scholar 

  • Chan, A. S., Sze, S. L., Nicolson, Y. S., Lau, E. M., & Cheung, M.-c. (2013). A Chinese mind-body exercise improves self-control of children with autism: A randomized controlled trial. PLoS One, 8(7), e68184. doi:10.1371/journal.pone.0068184.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chorpita, B. F. (2007). Modular cognitive-behavioral therapy for childhood anxiety disorders. New York, NY: The Guilford Press.

    Google Scholar 

  • Christensen, D. L., Baio, J., Braun, K. V., et al. (2016). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 sites, United States, 2012. Morbidity and Mortality Weekly Report, 65(3), 1–23.

    Google Scholar 

  • Couturier, J. L., Speechley, K. N., Steele, M., Norman, R., Stringer, B., & Nicholson, R. (2005). Parental perception of sleep problems in children of normal intelligence with pervasive developmental disorders: Prevalence, severity, and pattern. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 815–822.

    Article  PubMed  Google Scholar 

  • Cuccaro, M., Shao, Y., Grubber, J., Slifer, M., Wolpert, C. M., Donnelly, S. L., et al. (2003). Factor analysis of restricted and repetitive behaviors in autism using the autism diagnostic interview-r. Child Psychiatry and Human Development, 34(1), 3–17.

    Article  PubMed  Google Scholar 

  • Goldman, S. E., McGrew, S., Johnson, K. P., Richdale, A. L., Clemons, T., & Malow, B. A. (2011). Sleep is associated with problem behaviors in children and adolescents with autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 1223–1229.

    Article  Google Scholar 

  • Goldman, S. E., Richdale, A. L., Clemons, T., & Malow, B. A. (2012). Parental sleep concerns in autism spectrum disorders: Variations from childhood into adolescence. Journal of Autism and Developmental Disorders, 42, 531–538.

    Article  PubMed  Google Scholar 

  • Goldman, S. E., Surdyka, K., Cuevas, R., Adkins, K., Wang, L., & Malow, B. A. (2009). Defining the sleep phenotype in children with autism. Developmental Neuropsychology, 34, 560–573.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goodlin-Jones, B. L., Sitnick, S. L., Tang, K., Liu, J., & Anders, T. F. (2008). The children’s sleep habits questionnaire in toddlers and preschool children. Journal of Developmental and Behavioral Pediatrics, 29, 82–88.

    Article  PubMed  Google Scholar 

  • Goodlin-Jones, B., Tang, K., Liu, J., & Anders, T. F. (2009). Sleep problems, sleepiness and daytime behavior in preschool-age children. Journal of Child Psychology and Psychiatry, 50, 1532–1540.

    Article  PubMed  Google Scholar 

  • Gotham, K., Bishop, S. L., Hus, V., Huerta, M., Lund, S., Buja, A., et al. (2013). Exploring the relationship between anxiety and insistence on sameness in autism spectrum disorders. Autism Research, 6, 33–41.

    Article  PubMed  Google Scholar 

  • Hollway, J. A., & Aman, M. G. (2011). Sleep correlates of pervasive developmental disorders: A review of the literature. Research in Developmental Disabilities, 32, 1399–1421.

    Article  PubMed  Google Scholar 

  • Hollway, J. A., Aman, M. G., & Butter, E. (2013). Correlates and risk markers for sleep disturbance in participants of the autism treatment network. Journal of Autism and Developmental Disorders, 43, 2830–2843.

    Article  PubMed  Google Scholar 

  • Honey, E., McConachie, H., Turner, M., & Rodgers, J. (2012). Validation of the repetitive behavior questionnaire for use with children with autism spectrum disorder. Research in Autism Spectrum Disorder, 6, 355–364.

    Article  Google Scholar 

  • Hu, L.-T., & Bentler, P. M. (1999). Cutoff criteria for fix indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Article  Google Scholar 

  • IBM Corp. (2013). IBM SPSS Statistics for windows 22.0. Armonk, NY: IBM Corp.

    Google Scholar 

  • Krakowiak, P., Goodlin-Jones, B., Hertz-Piccotto, I., Croen, L. A., & Hansen, R. L. (2008). Sleep problems in children with autism spectrum disorders, developmental delays, and typical development: A population-based study. Journal of Sleep Research, 17(2), 197–206.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lam, K. S. L., & Aman, M. G. (2007). The repetitive behavior scale-revised: Independent validation in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(5), 855–866.

    Article  PubMed  Google Scholar 

  • Lam, K. S. L., Bodfish, J. W., & Piven, J. (2008). Evidence for three subtypes of repetitive behaviors in autism that differ in familiality and association with other symptoms. Journal of Child Psychology and Psychiatry, 49(11), 1193–1200.

    Article  PubMed  PubMed Central  Google Scholar 

  • Langen, M., Durston, S., Kas, M. J. H., van Engeland, H., & Staal, W. G. (2011). The neurobiology of repetitive behavior. Neuroscience and Biobehavioral Review, 35, 356–365.

    Article  Google Scholar 

  • Lidstone, J., Uljaravic, M., Sullivan, J., Rodgers, J., McConachie, H., Freeston, M., et al. (2014). Relations among restricted and repetitive behaviors, anxiety, and sensory features in children with autism spectrum disorder. Research in Autism Spectrum Disorders, 8, 82–92.

    Article  Google Scholar 

  • Lord, C., Rutter, M., DiLavoe, P. C., & Risi, S. (1999). Autism diagnostic observation schedule (WSP ed.). Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Lord, C., Rutter, M., & LeCouteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individual with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.

    Article  PubMed  Google Scholar 

  • Malow, B. A., Adkins, K. W., McGrew, S. G., Wang, L., Goldman, S. E., Fawkes, D., et al. (2012). Melatonin for sleep in children with autism: A controlled trial examining dose, tolerability, and outcomes. Journal of Autism and Developmental Disorders, 42(8), 1729–1737.

    Article  PubMed  PubMed Central  Google Scholar 

  • Malow, B. A., Adkins, K. W., Reynolds, A., Weiss, S. K., Loh, A., Fawkes, D., et al. (2014). Parent-based sleep education for children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(1), 216–228.

    Article  PubMed  Google Scholar 

  • Malow, B. A., Marzec, M., McGrew, S. G., Wang, L., & Stone, W. (2006). Characterizing sleep in children with autism spectrum disorders: A multidimensional approach. Sleep, 29(12), 1563–1571.

    PubMed  Google Scholar 

  • Malow, B. A., & McGrew, S. G. (2008). Sleep disturbances and autism. Sleep Medicine Clinics, 3, 479–488.

    Article  Google Scholar 

  • Mayes, S. D., & Calhoun, S. L. (2009). Variables related to sleep problems in children with autism. Research in Autism Spectrum Disorders, 3, 931–941.

    Article  Google Scholar 

  • Mazurek, M. O., & Petroski, G. F. (2015). Sleep problems in children with autism spectrum disorder: Examining the contributions of sensory over-responsivity and anxiety. Sleep Medicine, 16, 270–279.

    Article  PubMed  Google Scholar 

  • Mirenda, P., Smith, I. M., Vaillancourt, T., Georgiades, S., Duke, E., Szatmari, P., et al. (2010). Validating the repetitive behavior scale-revised in young children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 40, 1521–1530.

    Article  PubMed  Google Scholar 

  • Mooney, E., Gray, K., Tonge, B., Sweeney, D., & Taffe, J. (2009). Factor analytic study of repetitive behavior in young children with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 39, 765–774.

    Article  PubMed  Google Scholar 

  • Owens, J. A. (2015). Behavioral sleep problems in children. In R. D. Chervin & A. G. Hoppin (Eds.), UptoDate. Waltham, MA. Accessed 26 June 2015.

  • Owens, J. A., Spirito, A., & Mcguinn, M. (2000). The children’s sleep habits questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep, 23, 1043–1051.

    PubMed  Google Scholar 

  • Richdale, A. L., & Schreck, K. A. (2009). Sleep problems in autism spectrum disorders: Prevalence, nature and possible biopsychosocial aetiologies. Sleep Medicine Reviews, 13, 403–411.

    Article  PubMed  Google Scholar 

  • Richler, J., Bishop, S. L., Kleinke, J. R., & Lord, C. (2007). Restricted and repetitive behaviors in young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 73–85.

    Article  PubMed  Google Scholar 

  • Richler, J., Huerta, M., Bishop, S. L., & Lord, C. (2010). Developmental trajectories of restricted and repetitive behaviors and interests in children with autism spectrum disorders. Developmental Psychopathology, 22(1), 55–69.

    Article  Google Scholar 

  • Rodgers, J., Glod, M., Connolly, B., & McConachie, H. (2012). The relationship between anxiety and repetitive behaviors in autism spectrum disorder. Journal of Autism and Developmental Disorders, 42, 2404–2409.

    Article  PubMed  Google Scholar 

  • SAS Institute Inc. (2014). SAS for windows, Version 9.4.. Cary, NC: SAS Institute Inc.

    Google Scholar 

  • Schreck, K. A., Mulick, J. A., & Smith, A. F. (2004). Sleep problems as possible predictors of intensified symptoms of autism. Research in Developmental Disabilities, 25(1), 57–66.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Georgiades, S., Bryson, S., et al. (2006). Investigating the structure of the restricted, repetitive behaivours and interests domain of autism. Journal of Child Psychology and Psychiatry, 47(6), 582–590.

    Article  PubMed  Google Scholar 

  • Wood, J. J., Drahota, A., Sze, K., Har, K., Chiu, A., & Langer, D. A. (2008). Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: A randomized controlled trial. Journal of Child Psychology and Psychiatry, 50(3), 224–234.

    Article  Google Scholar 

Download references

Acknowledgments

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under cooperative agreement UA3 MC11054—Autism Intervention Research Network on Physical Health. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. This work was conducted through the Autism Speaks Autism Treatment Network serving as the autism intervention research network on physical health.

Author Contributions

RH and BM conceived of the study, participated in its design and coordination. The data was previously collected and all authors were involved in the analysis and interpretation of the data, the drafting of the manuscript and its critical revision. All authors read and approved the final manuscript.

Author information

Authors and Affiliations

  1. Division of Developmental Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, 11101 Doctors’ Office Tower, Nashville, TN, 37232-9003, USA

    Rachel J. Hundley

  2. Biostatistics Center, Massachusetts General Hospital, 50 Staniford St, Suite 560, Boston, MA, 02114-2540, USA

    Amy Shui

  3. Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, A-0118 MCN, Vanderbilt University Medical Center, Nashville, TN, 37232, USA

    Beth A. Malow

Authors
  1. Rachel J. Hundley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amy Shui
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Beth A. Malow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rachel J. Hundley.

Ethics declarations

Conflict of interest

Rachel Hundley declares that she has no conflicts of interest. Amy Shui declares that she has no conflicts of interest. Beth Malow declares that she has no conflicts of interest.

Informed Consent

Informed consent was obtained from all individual participants when they enrolled into the ASATN registry database. As the current study involved retrospective review formal consent was not required.

Ethical Approval

All procedures performed in this study were in accordance with the institutional research committee and with the 1964 Helsinki declaration and its later amendments/comparable ethical standards.

Animal Rights

This article does not contain any studies with animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hundley, R.J., Shui, A. & Malow, B.A. Relationship Between Subtypes of Restricted and Repetitive Behaviors and Sleep Disturbance in Autism Spectrum Disorder. J Autism Dev Disord 46, 3448–3457 (2016). https://doi.org/10.1007/s10803-016-2884-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-016-2884-4

Keywords

Search

Navigation