Sleep and Challenging Behaviors in the Context of Intensive Behavioral Intervention for Children with Autism.
Emily A Abel, A J Schwichtenberg, Matthew T Brodhead and 1 others
PMID 29931436WHAT IT FOUND
Children with autism who slept less on average showed more challenging behavior and repetitive behavior during intensive behavioral therapy.
Night-to-night sleep changes mostly did not predict next-day behavior, except more night waking preceded self-injury.
Key findings
01Children who slept less on average engaged in more challenging behavior and more repetitive behavior during treatment.
02Children who woke more at night on average engaged in more negative affect.
03Children who spent more of their night awake were more likely to engage in self-injurious behavior the following day.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was an observational study, so it cannot show that sleep problems caused challenging behaviors. The children came from intensive behavioral intervention centers, so the sample may not apply to children in other settings. ASD diagnoses were supported by a parent questionnaire rather than standardized diagnostic assessment. Level of functioning was judged from caregiver report and informal observations, not standardized cognitive testing. Behavior observers were not checked with direct interobserver agreement during treatment. Family compensation may have affected which families agreed to take part.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not conclude that treating sleep will reduce challenging behavior. The study observed associations, not a treatment effect, and night-to-night sleep changes did not predict most next-day behaviors.