Objectives: 1) Elucidate the relationship(s) between responses to sensory stimuli and problem sleep behaviors in children with ASD; 2)identify which behavioral, neuroendocrine, and physiological variables best predict good sleepers and poor sleepers.
Methods: Participants were fifty five children, 6-12 years of age (ASD=27, TYP=28). All children were screened for normal intelligence using the Leiter-R non-verbal scale of intelligence. ASD diagnosis was made by using the ADOS or ADI-R and confirmed through proof of documentation. A cross sectional repeated measures design was used. Statistical analysis included bivariate correlations, multiple analysis of variance (MANCOVA) models, and logistic regression.
The Sensory Challenge Protocol (SCP)6, a series of eight sensory stimuli in six sensory domains presented in a laboratory setting while physiological data is collected, was administered. Tonic arousal was measured using baseline electrodermal activity (EDA) and baseline/diurnal salivary cortisol. Electrodermal response magnitude (EDR) and post-challenge salivary cortisol reflected response to SCP. Sensory Profile (SP) quadrant scores (Sensory Sensitivity/SS, Sensory Avoiding/SA, Sensation Seeking/SSk, Low Registration/LR) reflected sensory processing abilities. A sleep index was calculated from questions related to sleep behaviors (nightmares, overtired, sleeps less than most kids, sleeps more than most kids, talks or walks in sleep, and trouble sleeping) on the Child Behavior Checklist.
Results: Children with ASD had a higher prevalence of atypical sensory responses and sleep disturbances. SA correlated most strongly with sleep problems in children with ASD; SS and SSk behaviors correlated most strongly with sleep difficulties in TYP children. Looking across groups, poor sleepers demonstrated higher afternoon salivary cortisol, greater EDR magnitude, and higher cortisol post-sensory challenge. Cortisol, EDR, and SP measures predicted good sleepers from poor sleepers with 85.7% accuracy.
Conclusions: Sleep constitutes an area of concern for ASD. This research documents specific sensory processing behaviors linked to sleep disturbances in ASD and TYP, and characterizes poor sleep physiologically. Further examination of a sleep/sensory processing link may inform both intervention and future studies.
References
1. Krakowiak, P., et al. J Sleep Res, 17(197), 206, 2008.
2. Ben-Sasson, A., et al. JADD, 39(1), 1-11, 2009.
3. Milner, C. E., et al. Neuroreport, 20(3), 331-336, 2009
4. Reynolds, S., et al. JAD, doi:10.1177/1087054708329906, 2009.
5. Schoen, S. A., et al. Front Int Neurosci, 3(29), 2009.
6. Miller, L. J., et al. In Understanding the nature of sensory integration with diverse populations (Schaaf, Smith-Roley, Blanche, eds) (pp. 57-88) Therapy Skill Builders, 2001.
See more of: Medical Co-Morbid Conditions
See more of: Symptoms, Diagnosis & Phenotype