Abstract
Sleep problems are prevalent in children with neurodevelopmental disabilities and are associated with the expression of restricted and repetitive behaviors (RRBs). Children (n = 57) with autism spectrum disorder (ASD, n = 38) or developmental delay (DD, n = 19) participated in multiple assessments of intellectual ability, ASD symptoms, and RRBs (3 timepoints for ASD, 2 for DD). Sleep problems assessed at age 4 via parent report were associated with trajectories of higher-order RRBs (sameness/ritualistic/compulsive behaviors) from age 2–6 in the ASD group, and from age 2–4 in the DD group, even after controlling for intellectual ability, social-affective symptoms, and anxiety. Trajectories of stereotyped/restricted behaviors were unrelated to sleep problems. Sleep problems were associated with trajectories of higher-order (but not lower-order) RRBs in a transdiagnostic sample.
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Notes
We use the term trajectory throughout given our interest in patterns of RRBs over time. The DD group only had data at 2 timepoints, which is not the typical structure for a trajectory analysis; however, for ease of communication we have elected to use the term trajectory to describe the results for both groups.
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Acknowledgments
The authors thank the children and parents who participated in this research. We additionally thank Dr. Brian Flaherty and Kevin Donovan for their input on statistical analyses and Dr. Jason Wolff and for his comments on an earlier version of the manuscript. Some of these data were collected as part of a clinical trial, supported by a National Institute of Mental Health grant U54MH066399 (Dawson, PI), and registered at www.clinicaltrials.gov with identifier NCT00090415. The follow-up study was supported by the National Institute of Mental Health and the National Institute of Child Health and Human Development (U19HD34565, P50HD066782, R01HD-55741).
Funding
Some of these data were collected as part of a clinical trial, supported by National Institute of Mental Health grant U54MH066399, and registered at www.clinicaltrials.gov with identifier NCT00090415. The follow-up study was supported by the National Institute of Mental Health and the National Institute of Child Health and Human Development (U19HD34565, P50HD066782, R01HD-55741).
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AE, KM made substantial contributions to the conception of the project. Acquisition of data was done by GD, JG, JM, SJR. Analysis and interpretation of data was done by KM, JM, AE, TMW. AE, KM, TMW drafted and revised the work for intellectual content. All authors approved the version to be published.
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Drs. Rogers and Dawson receive royalties from Guilford Press Early Start Denver Model materials. Dr. Dawson is on the Scientific Advisory Boards of Janssen Research and Development, Akili, Inc., and Roche Pharmaceutical Company, has received grant funding from Janssen Research and Development, L.L.C. and PerkinElmer, speaker fees from ViaCord, and receives royalties from Guilford Press and Oxford University Press. Drs. MacDuffie, Munson, Greenson, Ward and Estes report no potential conflicts of interest.
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MacDuffie, K.E., Munson, J., Greenson, J. et al. Sleep Problems and Trajectories of Restricted and Repetitive Behaviors in Children with Neurodevelopmental Disabilities. J Autism Dev Disord 50, 3844–3856 (2020). https://doi.org/10.1007/s10803-020-04438-y
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DOI: https://doi.org/10.1007/s10803-020-04438-y