Sleep Problems and Behavioral Development in Children With Autism Spectrum Disorder: A Literature Review

Abstract

Sleep problems are common in children with autism spectrum disorder and are associated with problematic behavioral outcomes. The current paper is aimed to provide an overview of the direction of the relationship between sleep problems and behavioral outcomes in children with autism spectrum disorder. Common sleep problems in children with ASD, sleep problems and its related core ASD symptoms, as well as the adverse effects of sleep problems on challenging behavior and adaptive behavior, are well discussed. We argued sleep problems and behavioral problems may be bi-directionally related. Children with ASD are already prone to biological abnormalities, social deficits and repetitive behaviors, which may predispose them to sleep problems. Meanwhile, sleep problems contribute to the development of more intensified ASD symptoms as well as other challenging and maladaptive behavior. We suggested that more longitudinal studies measuring autistic traits and associated sleep problems repeatedly throughout childhood should be conducted to determine if sleep problems and behavioral problems share a common etiology. To treat behavioral problems in children with ASD, clinicians should work with parents to identify sleep problems existed in their children and offer practical guidelines.