Skip to main content

Aggression in Toddlers with Autism Spectrum Disorder as Predicted by Sleep Problems

Abstract

Previous studies have examined the relationship between sleep problems and challenging behaviors in school-aged children and adolescents with autism spectrum disorder (ASD). However, literature has not examined this relationship in the context of toddlers or, more specifically, toddlers with aggression. The present study was conducted to examine the relationship between ASD severity, sleep problems, and aggression in toddlers (aged 24 to 36 months) with a diagnosis of ASD. Sleep problems were measured by the Childhood Sleep Habits Questionnaire (CSHQ; NICHD SECCYD-Wisconsin, 2017) and aggression was measured by part 3 of the Baby and Infant Screen for Children with aUtism Traits (BISCUIT; Matson et al., 2007). A hierarchical multiple regression was conducted with a sample of 28 toddlers and the results indicated sleep problems statistically significantly predicted aggression over and above ASD severity. Implications of these findings and future research directions are discussed.

This is a preview of subscription content, access via your institution.

Availability of Data and Material

Not applicable.

Code Availability

Not applicable.

References

  1. Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA School-Age Forms & Profiles. University of Vermont, Research Center for Children, Youth, & Families.

    Google Scholar 

  2. Adams, H. L., Matson, J. L., Cervantes, P. E., & Goldin, R. L. (2014a). The relationship between autism symptom severity and sleep problems: Should bidirectionality be considered? Research in Autism Spectrum Disorders, 8(3), 193–199.

    Article  Google Scholar 

  3. Adams, H. L., Matson, J. L., & Jang, J. (2014b). The relationship between sleep problems and challenging behavior among children and adolescents with autism spectrum disorder. Research in Autism Spectrum Disorders, 8(9), 1024–1030.

    Article  Google Scholar 

  4. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). APA.

    Google Scholar 

  5. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). APA.

    Book  Google Scholar 

  6. Constantino, J. N., & Gruber, C. P. (2012). Social responsiveness scale: SRS-2. Torrance, CA: Western Psychological Services.

  7. Fitzpatrick, S. E., Srivorakiat, L., Wink, L. K., Pedapati, E. V., & Erickson, C. A. (2016). Aggression in autism spectrum disorder: Presentation and treatment options. Neuropsychiatric Disease and Treatment, 12, 1525–1538.

    PubMed  PubMed Central  Google Scholar 

  8. 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(2), 82–88.

    Article  Google Scholar 

  9. Guénolé, F., Godbout, R., Nicolas, A., Franco, P., Claustrat, B., & Baleyte, J. M. (2011). Melatonin for disordered sleep in individuals with autism spectrum disorders: Systematic review and discussion. Sleep Medicine Reviews, 15(6), 379–387.

    Article  Google Scholar 

  10. Hill, A. P., Zuckerman, K. E., Hagen, A. D., Kriz, D. J., Duvall, S. W., Van Santen, J., & Fombonne, E. (2014). Aggressive behavior problems in children with autism spectrum disorders: Prevalence and correlates in a large clinical sample. Research in Autism Apectrum Disorders, 8(9), 1121–1133.

    Article  Google Scholar 

  11. Humphreys, J. S., Gringras, P., Blair, P. S., Scott, N., Henderson, J., Fleming, P. J., & Emond, A. M. (2014). Sleep patterns in children with autistic spectrum disorders: A prospective cohort study. Archives of Disease in Childhood, 99(2), 114–118.

    Article  Google Scholar 

  12. Hunter, J. E., McLay, L. K., France, K. G., & Blampied, N. M. (2021). Sleep and stereotypy in children with autism: Effectiveness of function-based behavioral treatment. Sleep Medicine, 80, 301–304.

    Article  Google Scholar 

  13. Kanne, S. M., & Mazurek, M. O. (2011). Aggression in children and adolescents with ASD: Prevalence and risk factors. Journal of Autism and Developmental Disorders, 41(7), 926–937.

    Article  Google Scholar 

  14. Kozlowski, A. M., Matson, J. L., Belva, B., & Rieske, R. (2012). Feeding and sleep difficulties in toddlers with autism spectrum disorders. Research in Autism Spectrum Disorders, 6(1), 385–390.

    Article  Google Scholar 

  15. Krakowiak, P., Goodlin-Jones, B. E. T. H., Hertz-Picciotto, I. R. V. A., 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  Google Scholar 

  16. Lindor, E., Sivaratnam, C., May, T., Stefanac, N., Howells, K., Rinehart, N. (2019). Problem behavior in autism spectrum disorder: Considering core symptom severity and accompanying sleep disturbance. Frontiers in Psychiatry 10. https://doi.org/10.3389/fpsyt.2019.00487

  17. Maenner, M. J., Shaw, K. A., & Baio, J. (2020). Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2016. MMWR Surveillance Summaries, 69(4), 1.

    Article  Google Scholar 

  18. Matson, J. L., Ancona, M. N., & Wilkins, J. (2008a). Sleep disturbances in adults with autism spectrum disorders and severe intellectual impairments. Journal of Mental Health Research in Intellectual Disabilities, 1(3), 129–139.

    Article  Google Scholar 

  19. Matson, J. L., Wilkins, J., & Macken, J. (2008b). The relationship of challenging behaviors to severity and symptoms of autism spectrum disorders. Journal of Mental Health Research in Intellectual Disabilities, 2(1), 29–44.

    Article  Google Scholar 

  20. Matson, J. L., Boisjoli, J. A., Rojahn, J., & Hess, J. (2009a). A factor analysis of challenging behaviors assessed with the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT-Part 3). Research in Autism Spectrum Disorders, 3(3), 714–722.

    Article  Google Scholar 

  21. Matson, J.L., Boisjoli, J., & Wilkins, J. (2007). The baby and infant screen for children with aUtIsm traits (BISCUIT). Baton Rouge, LA: Disability Consultants, LLC.

  22. Matson, M. L., Matson, J. L., & Beighley, J. S. (2011). Comorbidity of physical and motor problems in children with autism. Research in Developmental Disabilities: A Multidisciplinary Journal, 32(6), 2304–2308.

    Article  Google Scholar 

  23. Matson, J. L., Wilkins, J., Sevin, J. A., Knight, C., Boisjoli, J. A., & Sharp, B. (2009b). Reliability and item content of the baby and infant screen for children with aUtIsm traits (BISCUIT): Parts 1–3. Research in Autism Spectrum Disorders, 3(2), 336–344.

    Article  Google Scholar 

  24. Mazurek, M. O., Dovgan, K., Neumeyer, A. M., & Malow, B. A. (2019). Course and predictors of sleep and co-occurring problems in children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 49(5), 2101–2115.

    Article  Google Scholar 

  25. Mazurek, M. O., Kanne, S. M., & Wodka, E. L. (2013). Physical aggression in children and adolescents with autism spectrum disorders. Research in Autism Spectrum Disorders, 7(3), 455–465.

    Article  Google Scholar 

  26. Mazurek, M. O., & Sohl, K. (2016). Sleep and behavioral problems in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(6), 1906–1915.

    Article  Google Scholar 

  27. McLay, L., France, K., Blampied, N., van Deurs, J., Hunter, J., Knight, J., & Lang, R. (2021). Function-based behavioral interventions for sleep problems in children and adolescents with autism: Summary of 41 clinical cases. Journal of Autism and Developmental Disorders, 51, 418–432.

    Article  Google Scholar 

  28. National Institute of Child Health and Development (NICHD) Study of Early Child Care and Youth Development (SECCYD) -Wisconsin. (2017). Children’s Sleep Habits Questionnaire (Abbreviated). The National Institute of Child Health and Development (NICHD) Study of Early Child Care and Youth Development (SECCYD). Retrieved from: http://www.education.uci.edu/childcare/pdf/i

  29. 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(8), 1043–1052.

    Article  Google Scholar 

  30. Richdale, A. L., & Schreck, K. A. (2009). Sleep problems in autism spectrum disorders: Prevalence, nature, & possible biopsychosocial aetiologies. Sleep Medicine Reviews, 13(6), 403–411.

    Article  Google Scholar 

  31. Rojahn, J., Matson, J. L., Mahan, S., Fodstad, J. C., Knight, C., Sevin, J. A., & Sharp, B. (2009). Cutoffs, norms, and patterns of problem behaviors in children with ASD on the baby and infant screen for children with aUtIsm traits (BISCUIT—part 3). Research in Autism Spectrum Disorders, 3(4), 989–998.

    Article  Google Scholar 

  32. Rzepka-Migut, B., & Paprocka, J. (2020). Efficacy and Safety of Melatonin Treatment in Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder—A Review of the Literature. Brain Sciences, 10(219), 219. https://doi.org/10.3390/brainsci10040219

    Article  PubMed Central  Google Scholar 

  33. Sannar, E. M., Palka, T., Beresford, C., Peura, C., Kaplan, D., Verdi, M., & Grados, M. (2018). Sleep problems and their relationship to maladaptive behavior severity in psychiatrically hospitalized children with autism spectrum disorder (ASD). Journal of Autism and Developmental Disorders, 48(11), 3720–3726.

    Article  Google Scholar 

  34. Schopler, E., Reichler, R., & Renner, B. (1988). The childhood autism rating scale. Los Angeles: Western Psychological Services.

  35. Schopler, E., Van Bourgondien, M. E., Wellman, G. J., & Love, S. R. (2010). CARS-2: Childhood Autism Rating Scale-Second Edition. Los Angeles: Western Psychological Services.

  36. Shui, A. M., Katz, T., Malow, B. A., & Mazurek, M. O. (2018). Predicting sleep problems in children with autism spectrum disorders. Research in Developmental Disabilities, 83, 270–279.

    Article  Google Scholar 

  37. Vaughan, C. A. (2011). Test review: E. Schopler, ME Van Bourgondien, GJ Wellman, & SR Love childhood autism rating scale. Los Angeles, CA: Western Psychological Services, 2010. Journal of Psychoeducational Assessment29(5), 489–493.

  38. Verhoeff, M. E., Blanken, L. M., Kocevska, D., Mileva-Seitz, V. R., Jaddoe, V. W., White, T., ... & Tiemeier, H. (2018). The bidirectional association between sleep problems and autism spectrum disorder: a population-based cohort study. Molecular Autism, 9(1), 1–9.

  39. Vriend, J. L., Corkum, P. V., Moon, E. C., & Smith, I. M. (2011). Behavioral interventions for sleep problems in children with autism spectrum disorders: Current findings and future directions. Journal of Pediatric Psychology, 36(9), 1017–1029.

    Article  Google Scholar 

  40. Williams, D. L., Siegel, M., & Mazefsky, C. A. (2018). Problem behaviors in autism spectrum disorder: Association with verbal ability and adapting/coping skills. Journal of Autism and Developmental Disorders, 48(11), 3668–3677.

    Article  Google Scholar 

Download references

Funding

Not applicable.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Megan Callahan.

Ethics declarations

Informed Consent

Informed consent was obtained by parents or caregivers at the initial diagnostic assessment.

Ethical Approval

The use of data in this study was approved by the Louisiana State University Institutional Review Board (IRB) and with the 1964 Helsinki declaration.

Conflicts of Interest

Mrs. Deann Matson, Dr. Johnny L. Matson’s spouse, is the sole owner of the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT) and sells the scale. Megan Callahan, Celeste Tevis, and Michaela Brown declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Callahan, M., Matson, J., Tevis, C. et al. Aggression in Toddlers with Autism Spectrum Disorder as Predicted by Sleep Problems. J Dev Phys Disabil (2021). https://doi.org/10.1007/s10882-021-09818-5

Download citation

Keywords

  • Autism spectrum disorder
  • Sleep problems
  • ASD severity
  • Aggression