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

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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.

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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.

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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
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  2. Amy Shui
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Correspondence to Rachel J. Hundley.

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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.

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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

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

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