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Eaton C, Roarty K, Doval N, Shetty S, Goodall K, Rhodes SM. The Prevalence of Attention Deficit/Hyperactivity Disorder Symptoms in Children and Adolescents With Autism Spectrum Disorder Without Intellectual Disability: A Systematic Review. J Atten Disord 2023; 27:1360-1376. [PMID: 37287320 PMCID: PMC10498659 DOI: 10.1177/10870547231177466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE ADHD commonly co-occurs with ASD without ID in young people. It has been difficult to obtain accurate prevalence estimates of ADHD in this population, as a dual-diagnosis was not permitted until DSM-V. We systematically reviewed the literature on the prevalence of ADHD symptoms in young people with ASD without ID. METHOD 9,050 articles were identified through six databases. Articles were reviewed against inclusion and exclusion criteria and 23 studies were included. RESULTS ADHD symptom prevalence varied from 2.6% to 95.5%. We discuss these findings according to the ADHD assessment measure, informant, diagnostic criteria, risk of bias rating and recruitment pool. CONCLUSION ADHD symptoms are common in young people with ASD without ID, but there is substantial variance in study reporting. Future studies should recruit participants from community sources, provide information on key sociodemographic sample characteristics and assess ADHD with standardized diagnostic criteria, using both parent/carer and teacher report.
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Affiliation(s)
- Christopher Eaton
- University of Edinburgh, UK
- Cardiff University School of Medicine, UK
| | - Kayley Roarty
- University of Edinburgh, UK
- Neurodevelopment Service for Children and Young People, Newmains Health Centre, Lanarkshire, UK
| | - Nimisha Doval
- Child and Adolescent Mental Health Services, NHS Grampian, UK
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2
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[Influence of sleep quality on symptoms in children with attention deficit hyperactivity disorder: the mediating role of working memory]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:1365-1370. [PMID: 36544420 PMCID: PMC9785091 DOI: 10.7499/j.issn.1008-8830.2206147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To study the mediating role of working memory between sleep quality and symptoms in children with attention deficit hyperactivity disorder (ADHD). METHODS The cluster random sampling method was used to select 110 ADHD children and 124 normal children as subjects from grade 3-5 students in two primary schools in Kashgar, Xinjiang Uygur Autonomous Region, China. SNAP-IV, Pittsburgh Sleep Quality Index (PSQI), and visual-spatial working memory paradigm were used for investigation and comparison. RESULTS Compared with the normal group, the ADHD group had a significantly higher total score of PSQI and scores of subjective sleep quality, sleep latency, sleep efficiency, sleep disturbance, and a higher incidence of sleep quality problems (P<0.001). The working memory score in the ADHD group was significantly lower than that in the normal group (P<0.001). In the ADHD group, the working memory score was negatively correlated with the total score of PSQI (rs=-0.271, P<0.001) and the score of symptoms (rs=-0.439, P<0.001), and the total score of PSQI was positively correlated with the score of symptoms (rs=0.540, P<0.001). Working memory had a partial mediating effect in the influence of sleep quality on symptoms in children with ADHD, accounting for 18.10% of the total effect. CONCLUSIONS Sleep quality issues are observed in some children with ADHD, and working memory plays a mediating role between sleep quality and symptoms in ADHD children.
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Han GT, Trevisan DA, Abel EA, Cummings EM, Carlos C, Bagdasarov A, Kala S, Parker T, Canapari C, McPartland JC. Associations between sleep problems and domains relevant to daytime functioning and clinical symptomatology in autism: A meta-analysis. Autism Res 2022; 15:1249-1260. [PMID: 35635067 DOI: 10.1002/aur.2758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/25/2022] [Indexed: 12/16/2022]
Abstract
Autistic individuals experience significantly higher rates of sleep problems compared to the general population, which negatively impacts various aspects of daytime functioning. The strength of associations across domains of functioning has not yet been summarized across studies. The present meta-analysis examined the strength of associations between sleep problems and various domains of daytime functioning in autistic individuals. Searches were conducted in EMBASE, PubMed, Web of Science, and Google Scholar through May 2020. Inclusion criteria were: an index of sleep disturbance in individuals diagnosed with autism spectrum disorder (ASD); data collected prior to any sleep-related intervention; statistical data indicating relations between sleep problems and outcomes relevant to behavior, cognition, and physical or mental health. Exclusion criteria were: statistics characterizing the relationship between sleep disturbance and outcome variables that partialled out covariates; studies examining correlations between different measures of sleep disturbance. Participants totaled 15,074 from 49 published articles and 51 samples, yielding 209 effect sizes. Sleep problems were significantly associated with more clinical symptomatology and worse daytime functioning. Subgroup analyses demonstrated that sleep problems were most strongly associated with internalizing and externalizing symptoms and executive functioning, followed by core autism symptoms, family factors, and adaptive functioning. Findings highlight the far-reaching consequences of sleep problems on daytime functioning for autistic individuals and support the continued prioritization of sleep as a target for intervention through integrated care models to improve wellbeing. LAY SUMMARY: Autistic individuals experience higher rates of sleep problems, such as difficulty falling asleep and staying asleep, compared to the general population. We quantitatively summarized the literature about how sleep problems are related to different aspects of daytime functioning to identify areas that may be most affected by sleep. Sleep problems were related to all areas assessed, with the strongest associations for mood and anxiety symptoms. We recommend prioritizing sleep health in autistic individuals to improve wellbeing and quality of life.
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Affiliation(s)
- Gloria T Han
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA
| | - Dominic A Trevisan
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA
| | - Emily A Abel
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.,Human Development & Family Studies, Purdue University, West Lafayette, Indiana, USA
| | - Elise M Cummings
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.,Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Carter Carlos
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.,Department of Vision Science, Univeristy of California at Berkeley, Berkeley, California, USA
| | - Armen Bagdasarov
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.,Department of Psychology & Neuroscience, Duke University, Durham, North Carolina, USA
| | - Shashwat Kala
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA
| | - Termara Parker
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.,Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut, USA
| | - Craig Canapari
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA
| | - James C McPartland
- Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA
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4
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Carpena MX, Matijasevich A, Loret de Mola C, Santos IS, Munhoz TN, Tovo-Rodrigues L. The effects of persistent sleep disturbances during early childhood over adolescent ADHD, and the mediating effect of attention-related executive functions: Data from the 2004 Pelotas Birth Cohort. J Affect Disord 2022; 296:175-182. [PMID: 34607058 DOI: 10.1016/j.jad.2021.09.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/16/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Investigate effects of persistent sleep disturbances during early childhood over ADHD during the adolescence, and the potential attention-related executive functions mediating this effect. METHODS We used data from the 2004 Pelotas Birth Cohort. Children's Sleep disturbances were reported by their mothers at 12, 24, and 48 months of age, whereas the Test-of-Everyday-Attention-for-Children (TEA-Ch) and the Development and Well Being Assessment (DAWBA) were applied at 11 years of age to evaluate attention-related executive functions and ADHD, respectively. Persistent sleep problems were defined as reporting have two or more points of difficulty to sleep, nightmares, restless sleeps, and/or <10h/24h sleep duration. Logistic regression and mediation models were used, adjusting for maternal and child sociodemographic, behavior and health related variables. RESULTS The highest prevalence of adolescent ADHD (15.4%) was on the group who reported having nightmares at 2,4 and 6 years. In adjusted models, we observed an odd of ADHD in the adolescence 2.26 higher in those who reported persistent nightmares (CI95% 1.33, 4.01) compared to those reported transitory or no nightmares. Persistent difficulty to sleep (OR=1.74 CI95% 1.13, 2.66) and restless sleep (OR=1.80, CI95% 1.23, 2.64) during childhood also increased ADHD odds at 11 years. No indirect effect through attention related executive functions was found using mediating models. DISCUSSION Persistent early sleep disturbances may increase odds of ADHD among adolescents and could be consider as early marker of such disorder, specially nightmares problems. These effects were not mediated by attention-related executive functions. Nevertheless, we had 75% of cohort inception response.
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Affiliation(s)
- Marina Xavier Carpena
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Alicia Matijasevich
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brasil
| | - Christian Loret de Mola
- Programa de Pós-Graduação em Saúde Pública, FURG, Rio Grande, RS, Brazil; Grupo de Pesquisa e Inovação em Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil
| | - Ina S Santos
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Postgraduate Program Pediatrics Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tiago N Munhoz
- Faculty of Psychology, Federal University of Pelotas, Brazil
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Schwichtenberg AJ, Janis A, Lindsay A, Desai H, Sahu A, Kellerman A, Chong PLH, Abel EA, Yatcilla JK. Sleep in Children with Autism Spectrum Disorder: A Narrative Review and Systematic Update. CURRENT SLEEP MEDICINE REPORTS 2022; 8:51-61. [PMID: 36345553 PMCID: PMC9630805 DOI: 10.1007/s40675-022-00234-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Purpose of Review Sleep problems are a common comorbidity for children with autism spectrum disorder (ASD), and research in this area has a relatively long history. Within this review, we first outline historic patterns in the field of sleep and ASD. Second, we conducted a systematic update and coded these studies based on their alignment with historic patterns. Research on ASD and sleep over the past two decades has primarily focused on four principal areas: (1) documenting the prevalence and types of sleep problems; (2) sleep problem treatment options and efficacy; (3) how sleep problems are associated with other behavioral, contextual, or biological elements; and (4) the impact of child sleep problems on families and care providers. The systematic update in this paper includes empirical studies published between 2018 and 2021 with terms for sleep and ASD within the title, keywords, or abstract. Recent Findings In sum, 60 studies fit the inclusion/exclusion criteria and most fit within the historic patterns noted above. Notable differences included more global representation in study samples, studies on the impacts of COVID-19, and a growing body of work on sleep problems as an early marker of ASD. The majority of studies focus on correlates of sleep problems noting less optimal behavioral, contextual, and biological elements are associated with sleep problems across development for children with ASD. Summary Recommendations for future directions include continued expansion of global and age representation across samples, a shift toward more treatment and implementation science, and studies that inform our mechanistic understanding of how sleep and ASD are connected. Supplementary Information The online version contains supplementary material available at 10.1007/s40675-022-00234-5.
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Affiliation(s)
- A. J. Schwichtenberg
- Department of Human Development and Family Studies at Purdue University, West Lafayette, IN USA
| | - Amy Janis
- Department of Human Development and Family Studies at Purdue University, West Lafayette, IN USA
| | - Alex Lindsay
- Department of Human Development and Family Studies at Purdue University, West Lafayette, IN USA
| | - Hetvi Desai
- Department of Human Development and Family Studies at Purdue University, West Lafayette, IN USA
| | - Archit Sahu
- Department of Human Development and Family Studies at Purdue University, West Lafayette, IN USA
| | - Ashleigh Kellerman
- Department of Human Development and Family Studies at Purdue University, West Lafayette, IN USA
| | - Pearlynne Li Hui Chong
- Department of Human Development and Family Studies at Purdue University, West Lafayette, IN USA
| | - Emily A. Abel
- Department of Human Development and Family Studies at Purdue University, West Lafayette, IN USA
| | - Jane Kinkus Yatcilla
- Libraries and School of Information Studies at Purdue University, West Lafayette, IN USA
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Elkhatib Smidt SD, Ghorai A, Taylor SC, Gehringer BN, Dow HC, Langer A, Rawot E, Zhang J, Mitchell JA, Rader DJ, Almasy L, Brodkin ES, Bućan M. The relationship between autism spectrum and sleep-wake traits. Autism Res 2021; 15:641-652. [PMID: 34967137 DOI: 10.1002/aur.2660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 12/16/2022]
Abstract
Autistic children and adults often have sleep disturbances, which may affect their and their family's quality of life. Yet, the relationship between sleep-wake patterns and autism spectrum traits is understudied. Identifying such relationships could lead to future research elucidating common mechanistic underpinnings. Thus, we aimed to determine whether sleep-wake patterns, specifically related to sleep, physical activity, and the daily sleep-wake rhythm (i.e., circadian rhythm), are associated with autism spectrum-related traits. Accelerometer-derived sleep-wake parameters were estimated in individuals with autistic spectrum traits and their family members (N = 267). We evaluated autism spectrum traits using the Social Responsiveness Scale (SRS) to assess the presence and severity of social impairment and the Behavior Rating Inventory of Executive Function (BRIEF) to assess executive function. The linear multivariate regression analysis (using SOLAR-Eclipse) showed that in adults, increased core autism spectrum traits and executive dysfunction were associated with disruption of several sleep-wake parameters, particularly related to the daily sleep-wake rhythm, and that executive dysfunction was associated with disrupted sleep quality and level of physical activity. We highlight the interplay between daytime function and disrupted sleep-wake patterns, specifically related to the daily sleep-wake rhythm, that could guide future research into common mechanisms.
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Affiliation(s)
- Stacey D Elkhatib Smidt
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Sleep Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Arpita Ghorai
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sara C Taylor
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Brielle N Gehringer
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Holly C Dow
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Allison Langer
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eric Rawot
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jing Zhang
- Graduate Group in Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jonathan A Mitchell
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel J Rader
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laura Almasy
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Edward S Brodkin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maja Bućan
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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7
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Holingue C, Volk H, Crocetti D, Gottlieb B, Spira AP, Mostofsky SH. Links between parent-reported measures of poor sleep and executive function in childhood autism and attention deficit hyperactivity disorder. Sleep Health 2021; 7:375-383. [PMID: 33461914 PMCID: PMC8205962 DOI: 10.1016/j.sleh.2020.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study sought to assess whether poor sleep is associated with aspects of executive function (EF) among children with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), or typical development (TD), after adjusting for demographic variables, stimulant medications, intelligence, anxiety, inattention, and hyperactivity. DESIGN Cross-sectional. SETTING Children recruited through ongoing studies at the Kennedy Krieger Institute. PARTICIPANTS We studied 735 children (323 TD; 177 ASD; 235 ADHD) aged 8 to 12 years. MEASUREMENTS We investigated associations of parent-reported sleep measures from the Children's Sleep Habits Questionnaire (CSHQ) with parent-report measures of EF and performance-based processing speed with each clinical population. EF was measured using 8 clinical T scores that fall under 2 domains (behavioral regulation and metacognition) from the Behavior Rating Inventory of EF (BRIEF) and the processing speed index from the Wechsler Intelligence Scale for Children-IV or -V. RESULTS Higher CSHQ scores were associated with poorer EF on all BRIEF scales, across all child groups, after adjustment for demographic factors, stimulant medications, and IQ. Among children with ADHD, these associations largely remained after adjusting for anxiety. Among those ASD, anxiety partially accounted for these associations, especially for behavioral regulation EF outcomes. Co-occurring symptoms of inattention and hyperactivity/impulsivity further accounted for the associations between sleep and EF. Poor sleep was not significantly associated with processing speed. CONCLUSIONS Strong links exist between parent-reported poor sleep and executive dysfunction in children with typical development. Targeting anxiety may alleviate executive dysfunction, especially among children with ASD.
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Affiliation(s)
- Calliope Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA; Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA.
| | - Heather Volk
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Deana Crocetti
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Bridget Gottlieb
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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8
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Tesfaye R, Wright N, Zaidman-Zait A, Bedford R, Zwaigenbaum L, Kerns CM, Duku E, Mirenda P, Bennett T, Georgiades S, Smith IM, Vaillancourt T, Pickles A, Szatmari P, Elsabbagh M. 'Investigating longitudinal associations between parent reported sleep in early childhood and teacher reported executive functioning in school-aged children with autism'. Sleep 2021; 44:6275587. [PMID: 33987680 DOI: 10.1093/sleep/zsab122] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/05/2021] [Indexed: 11/14/2022] Open
Abstract
Up to 80% of children with autism spectrum disorder (ASD) experience sleep disturbance. Poor sleep impairs executive functioning (EF), a lifelong difficulty in ASD. Evidence suggests EF difficulties in ASD are exacerbated by poor sleep. We examine whether early childhood sleep disturbances are associated with worsening EF trajectories in school-aged children with ASD. A subsample (n=217) from the Pathways in ASD longitudinal study was analyzed. The Children's Sleep Habits Questionnaire captured sleep duration, onset, and night awakenings before age 5 (Mean=3.5years). 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 (7.8-11.8years). We applied latent growth curve models to examine associations between sleep and EF, accounting for relevant covariates, including school-age sleep (Mean=6.7years). Sleep traits had different age-related impacts on behavioral regulation, but not metacognition. Longer sleep onset at 3.5 years was associated with a worsening BRI difficulties slope (b=2.07, p<0.04), but conversely associated with lower BRI difficulties at 7.7 years (b=-4.14, p=0.04). A longer sleep onset at 6.7 years was related to higher BRI difficulties at 7.7 years (b=7.78, p<0.01). Longer sleep duration at 6.7 years was associated with higher BRI difficulties at age 7.7 (b=3.15, p=0.01), but subscale analyses revealed shorter sleep duration at age 6.7 was linked to a worsening inhibition slope (b=-0.60, p=0.01). Sleep onset is a robust early correlate of behavior regulation in children with ASD, whereas sleep duration is a later childhood correlate.
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Affiliation(s)
- Rackeb Tesfaye
- Montreal Neurological Institute, Azrieli Centre for Autism Research, McGill University, Montreal, Canada
| | - Nicola Wright
- King's College London, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Anat Zaidman-Zait
- Tel Aviv University, Department of Educational Sciences, Tel Aviv, Israel
| | - Rachael Bedford
- King's College London, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,University of Bath, Department of Psychology, Bath, UK
| | | | - Connor M Kerns
- University of British Columbia, Department of Psychology, Vancouver, Canada
| | - Eric Duku
- McMaster University, Psychiatry and Behavioural Neurosciences, Hamilton, Canada
| | - Pat Mirenda
- University of British Columbia, Education and Counseling Psychology, Vancouver, Canada
| | - Teresa Bennett
- McMaster University, Psychiatry and Behavioural Neurosciences, Hamilton, Canada
| | - Stelios Georgiades
- McMaster University, Psychiatry and Behavioural Neurosciences, Hamilton, Canada
| | - Isabel M Smith
- Dalhousie University, IWK Health Centre, Pediatrics, Halifax, Canada
| | | | - Andrew Pickles
- King's College London, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Szatmari
- University of Toronto, Department of Psychiatry, Toronto, Canada.,Centre for Addiction and Mental Health, Child and Youth Mental Health, Toronto, Canada.,SickKids Department of Psychiatry, child and adolescent psychiatry, Toronto, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, Azrieli Centre for Autism Research, McGill University, Montreal, Canada
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9
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The Dynamic Differences between Self- and Other-Oriented Mental Inferences: An ERP Study on a False-Belief Task. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 21:960-969. [PMID: 33907991 DOI: 10.3758/s13415-021-00899-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/04/2021] [Indexed: 11/08/2022]
Abstract
Theory of mind (ToM) refers to the ability to infer others' mental states. In our everyday lives, we need to interact constantly and appropriately with others. Not only is ToM involved in understanding others' mental states (other-oriented mental inferences), but it also helps to keep our own mental states (self-oriented mental inferences). In this study, we designed a false-belief task using event-related potential (ERP) measures to investigate the dynamic differences between the two types of mental inferences. In the false-belief task, participants were prompted with a cue to attribute a belief to either themselves (self-oriented) or another person (other-oriented). Results showed that other-oriented false-belief attribution elicited a larger late positive component (LPC; 320~440 ms post-cue onset) than the one elicited by self-oriented attribution at bilateral parieto-occipital electrodes, and also a larger late negative component (LNC; 380~500 ms post-cue onset) at frontal-central electrodes. In addition, the difference in amplitude of LPC between the two types of false-belief attribution was positively correlated with self-reported autistic traits measured by the Autism Spectrum Quotient (AQ). Based on prior literature, we propose that the LPC and LNC reflect the processes of self-other distinction and conflict control, respectively. Moreover, the difficulty in distinguishing other from the self is related to one's degree of autistic traits.
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10
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Gisbert Gustemps L, Lugo Marín J, Setien Ramos I, Ibañez Jimenez P, Romero Santo-Tomás O, Jurado Luque MJ, Ballester Navarro P, Esteve Cruella A, Díez Villoria E, Canal Bedia R, Ramos Quiroga JA. Sleep disturbances in autism spectrum disorder without intellectual impairment: relationship with executive function and psychiatric symptoms. Sleep Med 2021; 83:106-114. [PMID: 33991890 DOI: 10.1016/j.sleep.2021.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 11/26/2022]
Abstract
The autism spectrum disorder (ASD) is a neurodevelopmental condition, frequently accompanied by medical and psychiatric pathology. One of the most commonly found problems associated with ASD is sleep disturbances, which are estimated to affect approximately 80% of the people with ASD, not only during childhood but also in the adolescence and adult stages. Nevertheless, the relationship of these sleep difficulties with autism severity, as well as other associated impairments such as executive functioning and psychiatric disorders (eg, depression), has not yet been widely studied. The main objective of the present study was to explore the relationship between sleep disturbances, subjective measures of executive function, and psychiatric pathology in the ASD population. To reach that goal, a group of 89 participants with ASD (44 children/adolescents and 45 adults) was recruited and evaluated with self-reported measures of executive function performance and psychiatric pathology tests. Multivariate analysis showed a significant association between sleep disturbances and psychiatric symptoms in both ASD groups, with greater sleep disturbances predicting more severe psychiatric pathology. No significant association was found with executive function in any group. Limitations included a small sample size and lack of objective measures. Sleep problems seem to be associated with the severity of psychiatric pathology throughout the lifespan, increasing the chance of developing psychiatric symptoms when they were present. Improving sleep quality in ASD at all ages may result in preventing and/or decreasing psychiatric pathology in this population.
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Affiliation(s)
- Laura Gisbert Gustemps
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Jorge Lugo Marín
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Imanol Setien Ramos
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Pol Ibañez Jimenez
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | | | | | - Pura Ballester Navarro
- Neuropharmacology on Pain and Functional Diversity (NED) Research Group, Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain; Department of Clinical Pharmacology, Organic Chemistry and Pediatrics, Miguel Hernández University of Elche, Elche, Spain
| | | | - Emiliano Díez Villoria
- Centro de Atención Integral al Autismo-InFoAutismo, INICO-Instituto Universitario de Integración en la Comunidad, University of Salamanca. Salamanca, Spain
| | - Ricardo Canal Bedia
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Josep Antoni Ramos Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
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Cremone-Caira A, Trier K, Sanchez V, Kohn B, Gilbert R, Faja S. Inhibition in developmental disorders: A comparison of inhibition profiles between children with autism spectrum disorder, attention-deficit/hyperactivity disorder, and comorbid symptom presentation. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:227-243. [PMID: 32972212 PMCID: PMC7854883 DOI: 10.1177/1362361320955107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Many children with autism spectrum disorder (ASD) also have symptoms of attention-deficit hyperactivity disorder (ADHD). Children with ASD and ADHD often experience difficulties with inhibition. This study had the goal of understanding inhibition in children with ASD, ADHD, ASD + ADHD, and children who are typically developing (TD) using tasks that measured several aspects of inhibition. Results indicate that children with ASD + ADHD had greater difficulty inhibiting behavioral responses than TD children. Children with ASD + ADHD also differed from children with ASD and with ADHD in their inhibition of distracting information and strategic slowing of response speed. The four groups did not differ in their avoidance of potential losses. Children with ASD + ADHD exhibit a unique profile of inhibition challenges suggesting they may benefit from targeted intervention matched to their abilities.
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Affiliation(s)
- Amanda Cremone-Caira
- Division of Developmental Medicine, Boston Children’s Hospital
- Harvard Medical School
| | | | | | - Brooke Kohn
- Division of Developmental Medicine, Boston Children’s Hospital
| | | | - Susan Faja
- Division of Developmental Medicine, Boston Children’s Hospital
- Harvard Medical School
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