Sleep and Challenging Behaviors in the Context of Intensive Behavioral Intervention for Children with Autism

Abstract

This study examined the associations between sleep and challenging behaviors for average and night-to-night fluctuations in sleep, in 39 children with autism spectrum disorder (ASD) receiving intensive behavioral intervention (IBI). Child sleep was recorded (via actigraphy) for five nights in conjunction with clinician-reported observations of challenging behaviors. Results indicated that on average, poor sleep was associated with higher rates of repetitive behavior, negative affect, and a composite of overall challenging behaviors. These findings suggest that average sleep patterns are important within the context of IBI (rather than night-to-night fluctuations). Interventions aimed at improving overall patterns of sleep may have important cascading effects on challenging behaviors and developmental outcomes for children with ASD and their families.

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Acknowledgments

First and foremost, we thank the families who generously participated in this study. We also thank Cornerstone Autism Center, Little Start Center, and the Indiana Behavior Analysis Academy for their incredible assistance with both recruitment and data collection. Finally, we thank Kathleen Welling, Amy Barton, and Amelia Reising for their hours of assistance with project management and data entry/preparation.

Funding

This Research was supported in part by grants from the Gadomski Foundation, the Purdue University Center for Families, and the Purdue University Graduate Student Government.

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EA participated in the design of the study, collected data, conducted analyses, and drafted the manuscript. AJS participated in the design of the study, provided expertise in sleep methodology, drafted sections of the manuscript, and reviewed/edited the manuscript. MB participated in the design of the study, provided expertise in behavior analysis, and reviewed the manuscript. SC advised in the plan of analyses and interpretation of the data and reviewed the manuscript. All authors read and approved the final manuscript.

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Correspondence to Emily A. Abel.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all parents or legal guardians at time of enrollment in the study.

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Abel, E.A., Schwichtenberg, A.J., Brodhead, M.T. et al. Sleep and Challenging Behaviors in the Context of Intensive Behavioral Intervention for Children with Autism. J Autism Dev Disord 48, 3871–3884 (2018). https://doi.org/10.1007/s10803-018-3648-0

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Keywords

  • Autism spectrum disorder
  • Sleep
  • Actigraphy
  • Challenging behavior
  • Repetitive behavior