Six-Month Persistence of Sleep Problems in Young Children With Autism, Developmental Delay, and Typical Development

Objective: This study examined the persistence of sleep problems in preschool children with autism and two matched comparison groups: children with developmental delay without autism and typically developing children. Sleep problems were defined subjectively by parent report, by the Children's Sleep Habits Questionnaire (CSHQ), and objectively by quantitative Research Diagnostic Criteria (RDC) derived from actigraphic recordings. Method: Children were studied on three occasions, each separated by a 3-month interval. At each assessment, the children were recorded actigraphically for 1 week, and parents completed sleep-wake diaries and the CSHQ. Descriptive statistics and odds ratios were used to assess the occurrence and stability of sleep problems within children and across groups and to explore how actigraph- and CSHQ-defined sleep problems affect parental sleep problem reports. Results: Parent reports of a generic sleep problem were more prevalent than RDC- and CSHQ-defined sleep problems, especially for children with neurodevelopmental disorders. For all groups, objectively measured sleep problems were rarely persistent during the 6-month period. The children in both neurodevelopmental groups, however, had more sleep problems on one or two occasions, using actigraph and the CSHQ, than typically developing children. Conclusions: Objective and subjective measures of sleep problems in preschool-aged children produce different results. In a community sample, the rate of actigraph- and CSHQ-defined sleep problems in children with autism did not differ from rates for typically developing children, although the parent report of a generic sleep problem was significantly greater.