Addressing sleep problems in young autistic children can help regulate behaviour difficulties as they grow older, according to a new study.

The study - Investigating longitudinal associations between parent reported sleep in early childhood and teacher reported executive functioning in school-aged children with autism - was published in Sleep and examined whether early childhood sleep disturbances are associated with worsening executive functioning (EF) trajectories in school-aged children with autism spectrum disorder (ASD).

The study analysed a sub sample of 217 autistic children participating in Pathways in ASD, a longitudinal study that started in 2005. They evaluated the participants’ sleep issues using the Children’s Sleep Habits Questionnaire, a survey parents completed when their children were 2 to 4 years old and again roughly three years later. The researchers also assessed the children’s executive functioning four times from about age 7 to 12 by using questionnaires filled out by parents and teachers.

Sleep and severe behavioral regulation

Up to 80% of children with ASD experience sleep disturbance and evidence suggests that poor sleep exacerbates executive functioning difficulties.

The Children’s Sleep Habits Questionnaire captured sleep duration, onset, and night awakenings before age 5 years. Metacognition (MI) and Behavioral Regulation (BRI) indices, on the Teacher Behavior Rating Inventory of Executive Functioning, were used to measure cognitive and affective components of EF respectively at four time-points between the ages of 7 to 11.8 years.

More severe sleep difficulties in early childhood were associated with less behavioral regulation, researchers found. Other types of executive function, such as children’s ability to manage their own thoughts, showed no association with sleep difficulties.

Children who took a long time to fall asleep at ages 2 to 4 showed only mild behavioral regulation difficulties about four years later. However, children who took a long time to fall asleep around the age of 6 or 7 showed more severe behavioral regulation difficulties about a year later.