Autism Spectrum Disorder

  • Margaret C. SoudersEmail author
  • Whitney T. Eriksen
  • Amanda E. Bennett
  • Raghuram Prasad
  • Stefanie Zavodny


The aims of this chapter are to present the state of the science of sleep in children with autism spectrum disorder (ASD), hypotheses for the high prevalence of insomnia in children with ASD, and an ecological approach for promoting optimal sleep. An ecological approach includes environmental, sensory, culturally sensitive, and behavioral strategies. About two-thirds of children with ASD have chronic insomnia. The strongest evidence on promoting sleep in children with ASD is on sleep education, ecological changes, behavioral interventions, and exogenous melatonin. In 2012, the Sleep Committee of the Autism Treatment Network (ATN) developed a practice pathway, based on expert consensus, to capture best practices for screening, identification, and treatment for sleep problems in ASD. An exemplar case is presented to integrate key constructs of the practice pathway and address arousal dysregulation in a child with ASD and anxiety disorder. This chapter concludes with recommendations for dissemination of the practice pathway and future directions for research on insomnia in ASD.


Autism Autism spectrum disorder Sleep Insomnia Hyperarousal Practice pathway Behavioral intervention Biological rhythms Melatonin Calming activities Norepinephrine 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Margaret C. Souders
    • 1
    • 2
    Email author
  • Whitney T. Eriksen
    • 3
  • Amanda E. Bennett
    • 4
  • Raghuram Prasad
    • 5
    • 6
  • Stefanie Zavodny
    • 3
  1. 1.Biobehavioral and Health Sciences DepartmentUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Child and Adolescent Psychiatry, The Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  3. 3.School of NursingUniversity of PennsylvaniaPhiladelphiaUSA
  4. 4.Developmental and Behavioral PediatricsThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  5. 5.Clinical Psychiatry, Perelman School of Medicine, University of PennsylvaniaPhiladelphiaUSA
  6. 6.Department of Child and Adolescent Psychiatry and Behavioral SciencesAutism Integrated Care Program, The Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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