Skip to main content
Book cover

Clinical Handbook of Behavioral Sleep Treatment in Children on the Autism Spectrum pp 47–58Cite as

Direct and Indirect Sleep Assessment in Children with Autism Spectrum Disorder

  • 110 Accesses

Abstract

There are number of direct and indirect sleep measures for children with autism spectrum disorder (ASD) to aid in the differential diagnosis and development of an effective treatment plan. Suggestions are provided for clinical screening and taking a clinical sleep history. The chapter also describes objective measures including polysomnography (PSG), the multiple sleep latency test (MSLT), actigraphy, videosomnography, and laboratory testing, in addition to subjective measures such as standardized questionnaires and sleep–wake diaries. Because no single measure captures all aspects of sleep, clinicians must obtain information on the unique aspects of each presenting problem to form a comprehensive sleep plan for children and adolescents with ASD.

Keywords

  • Sleep
  • Autism spectrum disorder
  • Sleep measures
  • Sleep screening
  • Sleep assessment

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

Chapter
USD   29.95
Price excludes VAT (Canada)
  • DOI: 10.1007/978-3-030-99134-0_4
  • Chapter length: 12 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   269.00
Price excludes VAT (Canada)
  • ISBN: 978-3-030-99134-0
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Hardcover Book
USD   349.99
Price excludes VAT (Canada)
Learn about institutional subscriptions

References

  • Adkins, K. W., Goldman, S. E., Fawkes, D., Surdyka, K., Wang, L., Song, Y., & Malow, B. A. (2012). A pilot study of shoulder placement for actigraphy in children. Behavioral Sleep Medicine, 10(2), 138–147.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Allik, H., Larsson, J. O., & Smedje, H. (2006). Sleep patterns of school-age children with Asperger syndrome or high-functioning autism. Journal of Autism and Developmental Disorders, 36(5), 585–595.

    CrossRef  PubMed  Google Scholar 

  • Ancoli-Israel, S., Cole, R., Alessi, C., Chambers, M., Moorcroft, W., & Pollak, C. P. (2003). The role of actigraphy in the study of sleep and circadian rhythms. Sleep, 26(3), 342–392.

    CrossRef  PubMed  Google Scholar 

  • ANDERS, T. F. & SOSTEK, A. M. 1976. The use of time lapse video recording of sleep-wake behavior in human infants. Psychophysiology, 13, 155–8.

    Google Scholar 

  • Arand, D. L., & Bonnet, M. H. (2019). The multiple sleep latency test. Handbook of Clinical Neurology, 160, 393–403.

    CrossRef  PubMed  Google Scholar 

  • Aurora, R. N., Lamm, C. I., Zak, R. S., Kristo, D. A., Bista, S. R., Rowley, J. A., & Casey, K. R. (2012). Practice parameters for the non-respiratory indications for polysomnography and multiple sleep latency testing for children. Sleep, 35(11), 1467–1473.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Aurora, R. N., Zak, R. S., Karippot, A., Lamm, C. I., Morgenthaler, T. I., Auerbach, S. H., Bista, S. R., Casey, K. R., Chowdhuri, S., Kristo, D. A., & Ramar, K. (2011). Practice parameters for the respiratory indications for polysomnography in children. Sleep, 34(3), 379–388.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Baker, E., Richdale, A., Short, M., & Gradisar, M. (2013). An investigation of sleep patterns in adolescents with high-functioning autism spectrum disorder compared with typically developing adolescents. Developmental Neurorehabilitation, 16(3), 155–165.

    CrossRef  PubMed  Google Scholar 

  • Bruni, O., Ottaviano, S., Guidetti, V., Romoli, M., Innocenzi, M., Cortesi, F., & Giannotti, F. (1996). The Sleep Disturbance Scale for Children (SDSC): Construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. Journal of Sleep Research, 5(4), 251–261.

    CrossRef  PubMed  Google Scholar 

  • Burnham, M. M., Goodlin-Jones, B. L., Gaylor, E. E., & Anders, T. F. (2002). Nighttime sleep-wake patterns and self-soothing from birth to one year of age: A longitudinal intervention study. Journal of Child Psychology and Psychiatry, 43(6), 713–725.

    CrossRef  PubMed  Google Scholar 

  • Buysse, D. J., Ancoli-Israel, S., Edinger, J. D., Lichstein, K. L., & Morin, C. M. (2006). Recommendations for a standard research assessment of insomnia. Sleep, 29(9), 1155–1173.

    CrossRef  PubMed  Google Scholar 

  • Carskadon, M. A., & Dement, W. C. (1982). The multiple sleep latency test: What does it measure? Sleep, 5(Suppl 2), 67–72.

    CrossRef  Google Scholar 

  • Corkum, P., Tannock, R., Moldofskey, H., Hogg-Johnson, S., & Humphries, T. (2001). Actigraphy and parental ratings of sleep in children with attention-deficit/hyperactivity disorder (ADHD). Sleep, 24(3), 303–312.

    CrossRef  PubMed  Google Scholar 

  • DelRosso, L. M., Silvestri, R., & Ferri, R. (2021). Restless sleep disorder. Sleep Medicine Clinics, 16(2), 381–387. https://doi.org/10.1016/j.jsmc.2021.03.003

    CrossRef  PubMed  Google Scholar 

  • DeMore, M., Cataldo, M., Tierney, E., & Slifer, K. (2009). Behavioral approaches to training developmentally disabled children for an overnight EEG procedure. Journal of Developmental and Physical Disabilities, 21(4), 245–251.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Elrod, M. G., & Hood, B. S. (2015). Sleep differences among children with autism spectrum disorders and typically developing peers: A meta-analysis. Journal of Developmental & Behavioral Pediatrics, 36(3), 166–177.

    CrossRef  Google Scholar 

  • Goldman, S. E., Alder, M. L., Burgess, H. J., Corbett, B. A., Hundley, R., Wofford, D., Fawkes, D. B., Wang, L., Laudenslager, M. L., & Malow, B. A. (2017). Characterizing sleep in adolescents and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 47(6), 1682–1695.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Goldman, S. E., Richdale, A. L., Clemons, T., & Malow, B. A. (2012). Parental sleep concerns in autism spectrum disorders: Variations from childhood to adolescence. Journal of Autism and Developmental Disorders, 42(4), 531–538.

    CrossRef  PubMed  Google Scholar 

  • Goodlin-Jones, B. L., Tang, K., Liu, J., & Anders, T. F. (2008). Sleep patterns in preschool-age children with autism, developmental delay, and typical development. Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), 930–938.

    CrossRef  Google Scholar 

  • Gorski, J. A., Slifer, K. J., Kelly-Suttka, J., & Lowery, K. (2004). Behavioral interventions for pediatric patients’ acute pain and anxiety: Improving health regimen compliance and outcome. Children’s Health Care, 33(1), 1–20.

    CrossRef  Google Scholar 

  • Green, G. (2011). Behavior analytic instruction for learners with autism: Advances in stimulus control technology. Focus on Autism and Other Developmental Disabilities, 16(2), 72–85.

    CrossRef  Google Scholar 

  • Hare, D. J., Jones, S., & Evershed, K. (2006). A comparative study of circadian rhythm functioning and sleep in people with Asperger syndrome. Autism, 10(6), 565–575.

    CrossRef  PubMed  Google Scholar 

  • Hering, E., Epstein, R., Elroy, S., Iancu, D. R., & Zelnik, N. (1999). Sleep patterns in autistic children. Journal of Autism and Developmental Disorders, 29(2), 143–147.

    CrossRef  PubMed  Google Scholar 

  • Hodge, D., Parnell, A. M., Hoffman, C. D., & Sweeney, D. P. (2012). Methods for assessing sleep in children with autism spectrum disorders: A review. Research in Autism Spectrum Disorders, 6(4), 1337–1344.

    CrossRef  Google Scholar 

  • Hoffses, K. W., Honaker, S. M., Riley, A. R., & Meadows, T. J. (2018). Screening and assessment of sleep disturbance. In M. E. Maruish (Ed.), Handbook of pediatric psychological screening and assessment in primary care (pp. 358–380). Routledge.

    Google Scholar 

  • Jennett, H. K., & Hagopian, L. P. (2008). Identifying empirically supported treatments for phobic avoidance in individuals with intellectual disabilities. Behavior Therapy, 39(2), 151–161.

    CrossRef  PubMed  Google Scholar 

  • Jin, C. S., Hanley, G. P., & Beaulieu, L. (2013). An individualized and comprehensive approach to treating sleep problems in young children. Journal of Applied Behavior Analysis, 46(1), 161–180.

    CrossRef  PubMed  Google Scholar 

  • Johnson, C. R., Turner, K. S., Foldes, E., Brooks, M. M., Kronk, R., & Wiggs, L. (2013). Behavioral parent training to address sleep disturbances in young children with autism spectrum disorder: A pilot trial. Sleep Medicine, 14(10), 995–1004.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Johnson, C. R., Turner, K. S., Foldes, E. L., Malow, B. A., & Wiggs, L. (2012). Comparison of sleep questionnaires in the assessment of sleep disturbances in children with autism spectrum disorders. Sleep Medicine, 13(7), 795–801. https://doi.org/10.1016/j.sleep.2012.03.005

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Johnson, K. P., & Zarrinnegar, P. (2021). Autism spectrum disorder and sleep. Child and Adolescent Psychiatric Clinics of North America, 30(1), 195–208.

    CrossRef  PubMed  Google Scholar 

  • Kaat, A. J., & Lecavalier, L. (2013). Disruptive behavior disorders in children and adolescents with autism spectrum disorders: A review of the prevalence, presentation, and treatment. Research in Autism Spectrum Disorders, 7(12), 1579–1594.

    CrossRef  Google Scholar 

  • Kales, A., Soldatos, C. R., & Kales, J. D. (1980). Taking a sleep history. American Family Physician, 22(2), 101–107.

    PubMed  Google Scholar 

  • Kanney, M. L., Durmer, J. S., Trotti, L. M., & Leu, R. (2020). Rethinking bedtime resistance in children with autism: Is restless legs syndrome to blame? Journal of Clinical Sleep Medicine, 16(12), 2029–2035. https://doi.org/10.5664/jcsm.8756

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Katz, T., Shui, A. M., Johnson, C. R., Richdale, A. L., Reynolds, A. M., Scahill, L., & Malow, B. A. (2018). Modification of the children’s sleep habits questionnaire for children with autism spectrum disorder. Journal of Autism and Developmental Disabilities, 48(8), 2629–2641.

    CrossRef  Google Scholar 

  • Kirk, V., Baughn, J., D’Andrea, L., Friedman, N., Galion, A., Garetz, S., Hassan, F., Wrede, J., Harrod, C. G., & Malhorta, R. K. (2017). American Academy of Sleep Medicine position paper for the use of a home sleep apnea test for diagnosis of OSA in children. Journal of Clinical Sleep Medicine, 13(10), 1199–1203.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Kuhn, B. R. (2007). Sleep disorders. In M. Hersen & J. C. Thomas (Eds.), Handbook of clinical interviewing with children (pp. 420–447). Sage.

    CrossRef  Google Scholar 

  • Lesser, A. D., Luczynski, K. C., & Hood, S. A. (2019). Evaluating motion detection to score sleep disturbance for children: A translational approach to developing a measurement system. Journal of Applied Behavior Analysis, 52(2), 580–599.

    CrossRef  PubMed  Google Scholar 

  • Lichtblau, K. R., Romani, P. W., Greer, B. D., Fisher, W. W., & Bragdon, A. K. (2018). Remote treatment of sleep-related trichotillomania and trichophagia. Journal of Applied Behavior Analysis, 51(2), 255–262.

    CrossRef  PubMed  Google Scholar 

  • Littner, M. R., Kushida, C., Wise, M., Davila, D. G., Morgenthaler, T., Lee-Chiong, T., Hirshkowitz, M., Daniel, L. L., Bailey, D., Berry, R. B., Kapen, S., & Kramer, M. (2005). Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep, 28(1), 113–121.

    CrossRef  PubMed  Google Scholar 

  • Lockley, S. W., Skene, D. J., & Arendt, J. (1999). Comparison between subjective and actigraph measurement of sleep and sleep rhythms. Journal of Sleep Research, 8(3), 175–183.

    CrossRef  PubMed  Google Scholar 

  • Loring, W. A., Johnston, R., Gray, L., Goldman, S., & Malow, B. (2016). A brief behavioral intervention for insomnia in adolescents with autism spectrum disorders. Clinical Practice in Pediatric Psychology, 4(2), 112–124.

    CrossRef  Google Scholar 

  • Luiselli, J. K. (2021). Applied behavior analysis measurement, assessment, and treatment of sleep and sleep-related problems. Journal of Applied Behavior Analysis, 54(2), 654–667.

    CrossRef  PubMed  Google Scholar 

  • Malow, B. A., Connolly, H. V., Weiss, S. K., Halbower, A., Goldman, S., Hyman, S. L., Katz, T., Madduri, N., Shui, A., Macklin, E., & Reynolds, A. M. (2016). The Pediatric Sleep Clinical Global Impressions Scale-a new tool to measure pediatric insomnia in autism spectrum disorders. Journal of Developmental and Behavioral Pediatrics, 37(5), 370–376.

    CrossRef  PubMed  Google Scholar 

  • Marcus, C., et al. (2002). Clinical practice guideline: Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 109(4), 704–712.

    CrossRef  Google Scholar 

  • Marriner, A. M., Pestell, C., Bayliss, D. M., McCann, M., & Bucks, R. S. (2017). Confirmatory factor analysis of the sleep disturbance scale for children (SDSC) in a clinical sample of children and adolescents. Journal of Sleep Research, 26(5), 587–594.

    CrossRef  PubMed  Google Scholar 

  • McLay, L., France, K., Blampied, N., van Deurs, J., Hunter, J., Knight, J., Hastie, B., Carnett, A., Woodford, E., Gibbs, R., & Lang, R. (2020). 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.

    Google Scholar 

  • Mindell, J. A., & Durand, V. M. (1993). Treatment of childhood sleep disorders: Generalizing across disorders and effects on family members. Journal of Pediatric Psychology, 18(6), 731–750.

    CrossRef  PubMed  Google Scholar 

  • Moon, E. C., Corkum, P., & Smith, I. M. (2011). Case study: A case-series evaluation of a behavioral sleep intervention for three children with autism and primary insomnia. Journal of Pediatric Psychology, 36(1), 47–54.

    CrossRef  PubMed  Google Scholar 

  • Owens, J. A., & Dalzell, V. P. (2001). The “BEARS”: Screening for pediatric sleep problems in the primary care setting. Sleep, 24(Suppl), A216.

    Google Scholar 

  • 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.

    CrossRef  PubMed  Google Scholar 

  • Reynolds, A. M., Connolly, H. V., Katz, T., Goldman, S. E., Weiss, S. K., Halbower, A. C., Shui, A. M., Macklin, E. A., Hyman, S. L., & Malow, B. A. (2020). Randomized, placebo-controlled trial of ferrous sulfate to treat insomnia in children with autism spectrum disorders. Pediatric Neurology, 104, 30–39.

    CrossRef  PubMed  Google Scholar 

  • Romeo, D. M., Bruni, O., Brogna, C., Ferri, R., Galluccio, C., De Clemente, V., Di Jorio, M., Quintiliani, M., Ricci, D., & Mercuri, E. (2013). Application of the sleep disturbance scale for children (SDSC) in preschool age. European Journal of Paediatric Neurology, 17(4), 374–382.

    CrossRef  PubMed  Google Scholar 

  • Sadeh, A. (2015). lii. Sleep assessment methods. Monographs of the Society for Research in Child Development, 80(1), 33–48.

    CrossRef  PubMed  Google Scholar 

  • Sadeh, A., Sharkey, M., & Carskadon, M. A. (1994). Activity-based sleep-wake identification: An empirical test of methodological issues. Sleep, 17(3), 201–207.

    CrossRef  PubMed  Google Scholar 

  • Sanberg, S. A., Kuhn, B. R., & Kennedy, A. E. (2018). Outcomes of a behavioral intervention for sleep disturbances in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(12), 4250–4277. https://doi.org/10.1007/s10803-018-3644-4

    CrossRef  PubMed  Google Scholar 

  • Sen, T., & Spruyt, K. (2020). Pediatric sleep tools: An updated literature review. Frontiers in Psychiatry, 11, 317. https://doi.org/10.3389/fpsyt.2020.00317

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Sitnick, S. L., Goodlin-Jones, B. L., & Anders, T. F. (2008). The use of actigraphy to study sleep disorders in preschoolers: Some concerns about detection of nighttime awakenings. Sleep, 31(3), 395–401.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Souders, M. C., Mason, T. B., Valladares, O., Bucan, M., Levy, S. E., Mandell, D. S., … Pinto-Martin, J. (2009). Sleep behaviors and sleep quality in children with autism spectrum disorders. Sleep, 32(12), 1566–1578.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Spielman, A. J., Caruso, L. S., & Glovinsky, P. B. (1987). A behavioral perspective on insomnia treatment. Psychiatric Clinics of North America, 10(4), 541–553.

    CrossRef  PubMed  Google Scholar 

  • van Deurs, J. R., McLay, L. K., France, K. G., & Blampied, N. M. (2021). Sequential implementation of functional behavior assessment-informed treatment components for sleep disturbance in autism: A case study. Behavioral Sleep Medicine, 19(3), 333–351.

    CrossRef  PubMed  Google Scholar 

  • Veatch, O. J., Reynolds, A., Katz, T., Weiss, S. K., Loh, A., Wang, L., & Malow, B. A. (2016). Sleep in children with autism spectrum disorders: How are measures of parent report and actigraphy related and affected by sleep education? Behavioral Sleep Medicine, 14(6), 665–676.

    CrossRef  PubMed  Google Scholar 

  • Werner, H., Molinari, L., Guyer, C., & Jenni, O. G. (2008). Agreement rates between actigraphy, diary, and questionnaire for children’s sleep patterns. Archives of Pediatrics & Adolescent Medicine, 162(4), 350–358.

    CrossRef  Google Scholar 

  • Wiggs, L., & Stores, G. (2004). Sleep patterns and sleep disorders in children with autistic spectrum disorders: Insights using parent report and actigraphy. Developmental Medicine & Child Neurology, 46(6), 372–380.

    CrossRef  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA

    Brett R. Kuhn

  2. School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA

    Zachary C. LaBrot

Authors
  1. Brett R. Kuhn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zachary C. LaBrot
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brett R. Kuhn .

Editor information

Editors and Affiliations

  1. Faculty of Health - Te Kaupeka Oranga, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, New Zealand

    Laurie K McLay

  2. Faculty of Health - Te Kaupeka Oranga, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, New Zealand

    Karyn G France

  3. School of Psychology, Speech & Hearing - Te Kura Mahi ā-Hirikapo, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, New Zealand

    Neville M Blampied

Rights and permissions

Reprints and Permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Verify currency and authenticity via CrossMark

Cite this chapter

Kuhn, B.R., LaBrot, Z.C. (2022). Direct and Indirect Sleep Assessment in Children with Autism Spectrum Disorder. In: McLay, L.K., France, K.G., Blampied, N.M. (eds) Clinical Handbook of Behavioral Sleep Treatment in Children on the Autism Spectrum. Springer, Cham. https://doi.org/10.1007/978-3-030-99134-0_4

Download citation