Search

We aimed to compare sleep problems in autistic and non-autistic adults with co-occurring depression and anxiety. The primary research question was whether autism status influences sleep quality, after accounting for the effects of depression and anxiety. We hypothesized that autistic adults would report higher levels of depression, anxiety, and sleep problems compared to non-autistic adults, after controlling for these covariates. We recruited 208 adults (109 non-autistic, 99 autistic) through a crowdsourcing platform, Prolific. Participants completed the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, and the Generalized Anxiety Disorder 7-item scale. Statistical analyses included Mann-Whitney U tests to compare group scores and a generalized linear model to assess the effect of autism status on sleep problems while controlling for depressive and anxiety symptoms. Autistic adults reported significantly higher levels of depressive and anxiety symptoms compared to non-autistic adults. However, after controlling for depression and anxiety, autism status alone did not have a statistically significant effect on overall sleep quality. The findings suggest that while autistic adults experience more severe sleep problems, these issues are closely related to higher levels of depression and anxiety rather than autism status itself. This study contributes to the understanding of sleep difficulties in autistic individuals, highlighting the importance of addressing co-occurring mental health conditions. Further research should explore the specific factors that exacerbate sleep problems in this population., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Lay Abstract: Insomnia, trouble falling asleep or staying asleep, is common in autistic children. In a previous report, we described the results of focus groups with parents of autistic children toward the development of the Pediatric Autism Insomnia Rating Scale. In this article, we report on the steps taken to complete the Pediatric Autism Insomnia Rating Scale. With help from the Simons Foundation registry, we collected information from parents on 1185 children with autism spectrum disorder to test the new measure. These results were evaluated using standard statistical methods such as factor analysis. To confirm the validity of the new measure, we enrolled a separate sample of 134 autistic children for a detailed assessment by video conference. This step showed that the Pediatric Autism Insomnia Rating Scale is clearly measuring symptoms of insomnia in children with autism spectrum disorder and not related problems such as hyperactivity, repetitive behavior, or anxiety. We also showed that the total score on the Pediatric Autism Insomnia Rating Scale is stable when repeated over a brief period of time. This is important because a measure that is not stable over a brief period of time would not be suitable as an outcome measure. In summary, the Pediatric Autism Insomnia Rating Scale is a brief and valid measure of insomnia in children with autism spectrum disorder that provides reliable scores., Competing Interests: Declaration of Conflicting InterestsDr. Scahill has received royalties from American Psychological Association, Guilford and Oxford University Press and licensing Fees Cogstate, Abbvie, Yamo. Dr. Lecavalier has received licensing Fees Cogstate, Abbvie, Yamo and royalties from Oxford University Press. Dr. Edwards is a partner in Vector Psychometrics. Dr. Cynthia Johnson has received royalties from American Psychological Association and Oxford University Press. All other authors declare no financial interests.

Aim: The aim of this study was to develop an outcome measure for caregivers of children with food allergy., Methods: A community-informed measure development process was utilised to generate a novel parent-reported outcome tool for caregivers of children with food allergy. We conducted focus groups with parents and caregivers of food-allergic (n = 18) children, following which a team of coders identified themes and generated an initial set of candidate items. These items were reviewed by content-area experts (n = 10) using content validity indices. We then conducted a series of cognitive interviews with parents of children with food allergy (n = 12) validating the instrument draft., Results: We describe the results of these development steps as well as future steps to produce the final, validated form of the measure. The resultant 91-item measure is intended for parents of children ages two to 12 years., Conclusion: This measure fills a unique need in the field by leveraging key stakeholders' perspectives to develop and subsequently validate a novel parent-reported measure of parent and family food allergy impacts of children ages two to 12 years old., (© 2024 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Objective/background: Insomnia is common in children with autism spectrum disorder (ASD). We recently developed and validated the 21-item Pediatric Autism Insomnia Rating Scale (PAIRS). This report explores the associations and agreements between actigraphy and PAIRS., Participants Methods: Children with ASD, with and without sleep problems, were assessed with a battery of parent-rated and clinician measures (N = 134). In a subset (n = 70), a wrist-worn actigraph measured sleep for five consecutive nights. Parents completed logs for scoring sleep intervals. Spearman correlations evaluated associations with the PAIRS and actigraphy indices (sleep onset latency = SOL, wake after sleep onset = WASO, total sleep time = TST, sleep efficiency = SE%). Agreements on "poor sleepers" based on PAIRS total score (≥33) and conventional thresholds for TST and SE% were evaluated with Cohen's Kappa and McNemar's test., Results: Actigraphy data were averaged over 4.64 ± 0.68 nights in 70 children (mean age = 7.3 ± 2.9, 74.3 % male). There were no significant correlations between PAIRS and any actigraphy indices. On TST, 48.6 % (n = 34) and on SE% 52.9 % (n = 37) were classified as "poor sleepers" compared to 32.9 % (n = 23) on PAIRS (kappa = 0.11 for TST and 0.27 for SE%). P-values on McNemar's Chi square test for PAIRS with TST and with SE% were 0.072 and 0.011, respectfully., Conclusions: These results suggest that actigraphy and PAIRS do not agree. Actigraphy TST captures movement and an estimate of specific sleep parameters. PAIRS is a broader measure that incorporates sleep disturbance and sleep-related impairment., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Dr. Scahill has served as a consultant to Yamo Pharmaceuticals and Cogstate. He receives book royalties from Oxford, Guilford and American Psychological Association and license fees from Yamo, Roche and Abbvie. Dr. Lecavalier receives book royalties from Oxford and license fees from Yamo, Roche and Abbvie. Dr. Johnson receives book royalties from Oxford and American Psychological Association. The authors have no other financial interests to disclose., (Copyright © 2024. Published by Elsevier B.V.)

Objective/background: Bedtime and sleep disturbances are ubiquitous in children with autism. The telehealth delivery of a behavior analytic parent training program was earlier reported to be efficacious in improving child sleep and parent sense of competency. Our aim in this brief report was to determine the durability of the telehealth delivered sleep parent training program (SPT) compared to the control condition in this randomized controlled trial. Telehealth delivery could be a means to expand access to such early treatment if efficacious., Participants/methods: Parents of young children, ages 2-7 years, with autism and co-occurring sleep disturbances were enrolled in this study. Participants were randomized to either SPT or a comparison arm that included non-sleep related parent education except for one session Sleep Parent Education; SPE). Each participant was individually administered a 5 session program delivered over 10 weeks. Outcome measures were collected at weeks 5 and 10 and at post-treatment follow-up at 16 weeks., Results: Follow-up week 16 data were available for 30 participants randomized to SPT and 24 participants randomized to SPE. Demographics for this follow-up cohort were similar to the full sample. At week 16 follow-up, there was a significant group difference between SPT and SPE the Modified Simonds & Parraga Sleep Questionnaire-Composite Sleep Index (MSPSQ - CSI) (p = 0.011) with an effect size of 0.68. Further, 8 of the 10 children in SPT who were negative responders at the week 10 endpoint were rated as positive responders at week 16 by the treatment masked IE compared to 2 out of 12 in the SPE group (p = 0.008)., Conclusions: Post-treatment follow-up data suggests SPT is durable over time compared to SPE, the active control group. Further, for some participants in SPT, a positive responsive emerged after the treatment endpoint. This brief report adds to the efficacy of SPT as a time-limited intervention for insomnia in young autistic children., Competing Interests: Declaration of competing interest The first author was award Department of Defense, Autism Research Program Award (AR170155) to conduct this study. Dr. Johnson receives royalties from American Psychological Association and Oxford Publishing. The authors declare no conflicts of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: To examine clinical correlates and prevalence of food selectivity (FS) - ie, self-restricted diet, reluctance to try new foods - in children with autism spectrum disorder (ASD) ascertained from a general outpatient autism clinic., Study Design: A multidisciplinary team (pediatric nurse practitioner, psychologist and dietitian) assessed medical and psychosocial histories and dietary habits in 103 children with ASD (mean age = 5.8 ± 2.2 years; range 2-10). Parents rated child mealtime behavior on the Brief Autism Mealtime Behavior Inventory (BAMBI) and disruptive behavior on the Aberrant Behavior Checklist (ABC). Height and weight measurements were collected. Children were classified as FS or no FS based on parent reported intake and mealtime behavior. A 24-hour dietary recall was used to record intake percentages < 80%. Logistic regression and multivariable modeling were used to evaluate clinical correlates with FS., Results: Of 103 children, 45.6% (n = 47) were classified as FS; 54.4% (n = 56) no FS. After adjusting for potential confounders, the odds of FS increased by 1.91 (95% CI: 1.38, 2.64, P < .001) for every half-SD increase in BAMBI total score and by 1.35 (95% CI: 1.05, 1.74, P = .020) for every half-SD increase in ABC Hyperactivity/Noncompliance. No group differences in anthropometrics or nutritional intake were identified., Conclusions: Food selectivity (FS) in children with ASD was strongly associated with greater severity of disruptive mealtime and hyperactivity/noncompliance behaviors. FS was not associated with anthropometrics or nutritional intake., Competing Interests: Declaration of Competing Interest Dr. Scahill has served as a consultant to Roche, Janssen, Impel, and Finch. Dr. Scahill receives book royalties from Oxford, Guilford and American Psychological Association and license fees from Roche, Yamo, and AbbVie. We have no other conflicts of interest to disclose. Preliminary findings from this work were presented as a poster presentation at the Annual Southeastern Pediatric Research Conference in Atlanta, GA., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Although research has largely focused on the effects of physical activity (PA) on the brain, less is known about the influence of the brain on engagement in healthy-living behaviors, such as regular PA. In this secondary analysis of a study of brain activity and participation in healthy-living behaviors, we examined relationships between the activation of selected brain networks and PA in persons self-managing chronic conditions. Fifty-eight individuals with chronic conditions underwent functional magnetic resonance imaging while exposed to a protocol consisting of listening to emotion-focused and analytic-focused information and measures of activation of three neuromarkers were obtained: default mode network (DMN), task-positive network (TPN), and ventromedial prefrontal cortex (vmPFC). In an exploratory analysis, we assessed differences in neuromarker activation between two PA levels (representing higher and lower accelerometry-measured PA levels) of 1 ) moderate-to-vigorous physical activity (MVPA) minutes, 2 ) metabolic equivalents expended (METs), and 3 ) daily steps. Results showed positive associations between MVPA and DMN ( r = 0.31, P = 0.018), steps and DMN ( r = 0.28, P = 0.035), and MVPA and vmPFC ( r = 0.29, P = 0.026). No associations were found between the TPN and any of the PA measures. Individuals with high MVPA and METs had higher DMN values compared with those with low MVPA ( t = -2.17, P = 0.035) and METs ( t = -2.02, P = 0.048). No differences in TPN and vmPFC were found among PA levels. These results suggest that providing health information that activates the emotion-focused brain network may be more useful than analytic-focused information (centered on logic and reasoning) to assist people with chronic conditions to engage in more PA. NEW & NOTEWORTHY The influence of the brain on engagement in regular physical activity (PA) has not been well studied. We examined relationships between the activation of three neuromarkers and two PA levels in 58 persons self-managing chronic conditions. Findings suggest that individuals who optimally process health-information when the emotional tone is high (Empathic Network; DMN) may engage in more PA compared with individuals who respond to health information when the emotional tone is low (Analytic Network; TPN).