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Problem behavior in autism spectrum disorder: considering core symptom severity and accompanying sleep disturbance

Lindor, Ebony, Sivaratnam, Carmel, May, Tamara, Stefanac, Nicole, Howells, Katherine and Rinehart, Nicole 2019, Problem behavior in autism spectrum disorder: considering core symptom severity and accompanying sleep disturbance, Frontiers in psychiatry, vol. 10, pp. 1-10, doi: 10.3389/fpsyt.2019.00487.

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Title Problem behavior in autism spectrum disorder: considering core symptom severity and accompanying sleep disturbance
Author(s) Lindor, EbonyORCID iD for Lindor, Ebony orcid.org/0000-0001-6935-047X
Sivaratnam, CarmelORCID iD for Sivaratnam, Carmel orcid.org/0000-0002-0841-1344
May, TamaraORCID iD for May, Tamara orcid.org/0000-0001-8705-4180
Stefanac, Nicole
Howells, KatherineORCID iD for Howells, Katherine orcid.org/0000-0002-4419-2134
Rinehart, NicoleORCID iD for Rinehart, Nicole orcid.org/0000-0001-6109-3958
Journal name Frontiers in psychiatry
Volume number 10
Article ID 487
Start page 1
End page 10
Total pages 10
Publisher Frontiers
Place of publication Lausanne, Switzerland
Publication date 2019-07
ISSN 1664-0640
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Psychiatry
autism spectrum disorder
symptom severity
sleep
accompanying disturbance
problem behavior
RISK-FACTORS
CHALLENGING BEHAVIOR
CHILDREN
Summary In addition to the core symptoms that define autism spectrum disorder (ASD), many individuals experience broader problem behavior at a level significant enough for families to seek further clinical assessment and intervention. We define “problem behavior” as any significant emotional or behavioral issue captured by the Child Behavior Checklist (CBCL) including anxiety, depression, withdrawal, somatic complaints, problems with socialization, thought or attention, rule-breaking, and aggression. While greater ASD symptom severity and accompanying sleep disturbance have each been linked with more severe problem behavior, there is little understanding about how these two key factors interact; that is, it is unclear whether the severity and type of sleep disturbance an individual experiences differentially influences the relationship between ASD symptom severity and problem behavior. The aim of the current study was, thus, to explore whether the link between greater ASD symptom severity and clinically elevated problem behavior is moderated by the presence/degree of accompanying sleep disturbance. Forty males with ASD, aged 5-12, participated in the study. The Social Responsiveness Scale, CBCL, and Children's Sleep Habits Questionnaire were administered to obtain information about ASD symptom severity, problem behavior, and sleep habits, respectively. Results indicated that the relationship between ASD symptom severity and problem behavior differed among individuals with ASD depending on the degree of sleep disturbance they experienced. Specifically, there was a significant positive relationship between ASD symptom severity and problem behavior for individuals with no sleep disturbance or milder sleep disturbance (i.e., in these cases, individuals with severe ASD symptoms experienced clinically elevated problem behavior, while those with milder ASD symptoms experienced milder problem behavior). In contrast, there was no significant relationship between ASD symptom severity and problem behavior for individuals with moderate-to-severe sleep disturbance; rather, clinically significant problem behavior was apparent across all individuals irrespective of ASD symptom severity. Follow-up analyses indicated that disturbances in sleep duration, disordered breathing, and daytime sleepiness were related to clinically elevated problem behavior even among those with milder ASD symptoms. These findings emphasize the importance of routinely assessing for accompanying sleep disturbance in this population regardless of whether individuals present with mild, moderate, or severe ASD.
Language eng
DOI 10.3389/fpsyt.2019.00487
Indigenous content off
Field of Research 170199 Psychology not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30128396

Document type: Journal Article
Collections: Faculty of Health
School of Psychology
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.