Abstract
This study investigated whether sleep problem severity in children with autism spectrum disorder was associated with maternal well-being. Mothers of 234 children reported on their mental health (Kessler Psychological Distress Scale), parenting stress (Parenting Stress Index-4-SF), health-related quality of life (HRQoL; Assessment of Quality of Life-4D) and their child’s sleep (Children’s Sleep Habits Questionnaire–ASD). Analyses revealed sleep initiation and duration problem severity scores were associated with increased mental health difficulties. Specific child sleep problems were not associated with parenting stress or HRQoL. This study revealed the importance of considering sleep and the family system when assessing maternal well-being. Future research considering parent, child and family factors will be important to informing a family focused approach to mental health.
Similar content being viewed by others
References
Abidin, R. R. (2012). Parenting stress index, fourth edition professional manual. Lutz, FL: Psychological Assessment Resources.
American Academy of Sleep Medicine. (2014). International classification of sleep disorders (ISCD-3) (3rd ed.). Darian, IL: Author.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Australian Bureau of Statistics. (2012). Information paper: use of the Kessler Psychological Distress Scale in ABS health surveys, Australia, 2007–08 (4817.0.55.001). https://www.abs.gov.au/ausstats/abs@.nsf/lookup/4817.0.55.001Chapter92007-08. Accessed February 11, 2020.
Australian Bureau of Statistics. (2018a). SEIFA measures. https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/2033.0.55.001~2016~Main%20Features~SEIFA%20Measures~14. Accessed June 21, 2020.
Australian Bureau of Statistics. (2018b). Socio-economic indexes for areas (SEIFA) 2016. https://www.abs.gov.au/ausstats/abs@.nsf/mf/2033.0.55.001. Accessed February 11, 2019.
Bonis, S. (2016). Stress and parents of children with autism: a review of literature. Issues in Mental Health Nursing, 37(3), 153–163. https://doi.org/10.3109/01612840.2015.1116030.
Cohen, S., Conduit, R., Lockley, S. W., Rajaratnam, S. M. W., & Cornish, K. M. (2014). The relationship between sleep and behavior in autism spectrum disorder (ASD): A review. Journal of Neurodevelopmental Disorders, 6(1), 44. https://doi.org/10.1186/1866-1955-6-44.
Corsello, C., Hus, V., Pickles, A., Risi, S., Cook, E. H., Jr., Leventhal, B. L., et al. (2007). Between a ROC and a hard place: decision making and making decisions about using the SCQ. Journal of Child Psychology and Psychiatry, 48(9), 932–940. https://doi.org/10.1111/j.1469-7610.2007.01762.x.
Dardas, L. A., & Ahmad, M. M. (2014). Psychometric properties of the parenting stress index with parents of children with autistic disorder. Journal of Intellectual Disability Research, 58(6), 560–571. https://doi.org/10.1111/jir.12053.
Deater-Deckard, K. (1998). Parenting stress and child adjustment: some old hypotheses and new questions. Clinical Psychology: Science and Practice, 5, 314–332. https://doi.org/10.1111/j.1468-2850.1998.tb00152.x.
Delahaye, J., Kovacs, E., Sikora, D., Hall, T. A., Orlich, F., Clemons, T. E., et al. (2014). The relationship between health-related quality of life and sleep problems in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 8, 292–303. https://doi.org/10.1016/j.rasd2013.12.015.
Diaz-Roman, A., Zhang, J., Delorme, R., Beggiato, A., & Cortese, S. (2018). Sleep in youth with autism spectrum disorders: systematic review and meta-analysis of subjective and objective studies. Evidence-Based Mental Health, 21(4), 146–154. https://doi.org/10.1136/ebmental-2018-300037.
Doo, S., & Wing, Y. K. (2006). Sleep problems of children with pervasive developmental disorders: correlation with parental stress. Developmental Medicine & Child Neurology, 48(8), 650–655. https://doi.org/10.1017/S001216220600137X.
Einfeld, S. L., Tonge, B. J., Gray, K. M., Brereton, A. V., Dekker, M. C., & Koot, H. M. (2002). Manual for the developmental behaviour checklist: primary carer version (DBC-P) and teacher version (DBC-T) (2nd ed.). Melbourne, AU: University of New South Wales and Monash University.
Galloway, H., & Newman, E. (2017). Is there a difference between child self-ratings and parent proxy-ratings of the quality of life of children with a diagnosis of attention-deficit hyperactivity disorder (ADHD)? A systematic review of the literature. ADHD Attention Deficit and Hyperactivity Disorders, 9(1), 11–29. https://doi.org/10.1007/s12402-016-0210-9.
Gargaro, B. A., May, T., Tonge, B. J., Sheppard, D. M., Bradshaw, J. L., & Rinehart, N. J. (2014). Using the DBC-P hyperactivity index to screen for ADHD in young people with autism and ADHD: a pilot study. Research in Autism Spectrum Disorders, 8(9), 1008–1015. https://doi.org/10.1016/j.rasd.2014.05.004.
Gartstein, M. A., Bridgett, D. J., Dishion, T. J., & Kaufman, N. K. (2009). Depressed mood and maternal report of child behavior problems: another look at the depression–distortion hypothesis. Journal of Applied Developmental Psychology, 30(2), 149–160. https://doi.org/10.1016/j.appdev.2008.12.001.
Gilson, K. M., Davis, E., Johnson, S., Gains, J., Reddihough, D., & Williams, K. (2018). Mental health care needs and preferences for mothers of children with a disability. Child Care Health and Development., 44(3), 384–391. https://doi.org/10.1111/cch.12556.
Hawthorne, G., Richardson, J., Day, N., Osborne, R., & McNeil, H. (2000). Construction and utility scaling of the assessment of quality of life (AQoL) instrument. Melbourne, AU: Centre for Health Program Evaluation.
Hawthorne, G., Richardson, J., & Osborne, R. (1999). The assessment of quality of life (AQoL) instrument: a psychometric measure of health-related quality of life. Quality of Life Research, 8(3), 209–224. https://doi.org/10.1023/A:1008815005736.
Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: a meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 43, 629–642. https://doi.org/10.1007/s10803-012-1604-y.
Hiscock, H., Canterford, L., Ukoumunne, O. C., & Wake, M. (2007). Adverse associations of sleep problems in Australian preschoolers: national population study. Pediatrics, 119(1), 86–93. https://doi.org/10.1542/peds.2006-1757.
Hiscock, H., Sciberras, E., Mensah, F., Gerner, B., Efron, D., Khano, S., et al. (2015). Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: randomised controlled trial. The BMJ, 350, h68. https://doi.org/10.1136/bmj.h68.
Hodge, D., Carollo, T. M., Lewin, M., Hoffman, C. D., & Sweeney, D. P. (2014). Sleep patterns in children with and without autism spectrum disorders: developmental comparisons. Research in Developmental Disabilities, 35(7), 1631–1638. https://doi.org/10.1016/j.ridd.2014.03.037.
Hodge, D., Hoffman, C. D., Sweeney, D. P., & Riggs, M. L. (2013). Relationship between children’s sleep and mental health in mothers of children with and without autism. Journal of Autism and Developmental Disorders, 43(4), 956–963. https://doi.org/10.1007/s10803-012-1639-0.
Hoffman, C. D., Sweeney, D. P., Lopez-Wagner, M. C., Hodge, D., Nam, C. Y., & Botts, B. H. (2008). Children with autism: sleep problems and mothers' stress. Focus on Autism and Other Developmental Disabilities, 23(3), 155–165. https://doi.org/10.1177/1088357608316271.
Hollway, J. A., Aman, M. G., & Butter, E. (2013). Correlates and risk markers for sleep disturbance in participants of the autism treatment network. Journal of Autism and Developmental Disorders, 43(12), 2830–2843. https://doi.org/10.1007/s10803-013-1830-y.
Honomichl, R. D., Goodlin-Jones, B. L., Burnham, M., Gaylor, E., & Anders, T. F. (2002). Sleep patterns of children with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 32(6), 553–561. https://doi.org/10.1023/A:1021254914276.
Johnson, C. R., Smith, T., DeMand, A., Lecavalier, L., Evans, V., Gurka, M., et al. (2018). Exploring sleep quality of young children with autism spectrum disorder and disruptive behaviors. Sleep Medicine, 44, 61–66. https://doi.org/10.1016/j.sleep.2018.01.008.
Katz, T., Shui, A. M., Johnson, C. R., Richdale, A. L., Reynolds, A. M., Scahill, L., et al. (2018). Modification of the children’s sleep habits questionnaire for children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(8), 2629–2641. https://doi.org/10.1007/s10803-018-3520-2.
Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S.-L., et al. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976. https://doi.org/10.1017/S0033291702006074.
Malow, B. A., Adkins, K. W., Reynolds, A., Weiss, S. K., Loh, A., Fawkes, D., et al. (2014). Parent-based sleep education for children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(1), 216–228. https://doi.org/10.1007/s10803-013-1866-z.
Martin, C. A., Papadopoulos, N., Chellew, T., Rinehart, N. J., & Sciberras, E. (2019). Associations between parenting stress, parent mental health and child sleep problems for children with ADHD and ASD: systematic review. Research in Developmental Disabilities, 93, 103463. https://doi.org/10.1016/j.ridd.2019.103463.
Mayes, S. D., & Calhoun, S. L. (2009). Variables related to sleep problems in children with autism. Research in Autism Spectrum Disorders, 3(4), 931–941. https://doi.org/10.1016/j.rasd.2009.04.002.
Mazurek, M. O., & Petroski, G. F. (2015). Sleep problems in children with autism spectrum disorder: examining the contributions of sensory over-responsivity and anxiety. Sleep Medicine, 16(2), 270–279. https://doi.org/10.1016/j.sleep.2014.11.006.
Mazurek, M. O., & Sohl, K. (2016). Sleep and behavioral problems in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(6), 1906–1915. https://doi.org/10.1007/s10803-016-2723-7.
Meltzer, L. J. (2011). Factors associated with depressive symptoms in parents of children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 361–367. https://doi.org/10.1016/j.rasd.2010.05.001.
Meltzer, L. J., & Mindell, J. A. (2008). Behavioral sleep disorders in children and adolescents. Sleep Medicine Clinics, 3(2), 269–279. https://doi.org/10.1016/j.jsmc.2008.01.004.
Owens, J. A., Spirito, A., & McGuinn, M. (2000). The children's sleep habits questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep, 23(8), 1043–1052. https://doi.org/10.1111/j.1365-2702.2007.02187.x.
Papadopoulos, N., Sciberras, E., Hiscock, H., Mulraney, M., McGillivray, J., & Rinehart, N. (2015). The efficacy of a brief behavioral sleep intervention in school-aged children with ADHD and comorbid autism spectrum disorder. Journal of Attention Disorders, 23(4), 341–350. https://doi.org/10.1177/1087054714568565.
Papadopoulos, N., Sciberras, E., Hiscock, H., Williams, K., McGillivray, J., Mihalopoulos, C., et al. (2019). Sleeping sound with autism spectrum disorder (ASD): study protocol for an efficacy randomised controlled trial of a tailored brief behavioural sleep intervention for ASD. British Medical Journal Open, 9(11), e029767. https://doi.org/10.1136/bmjopen-2019-029767.
Raley, S., Bianchi, S. M., & Wang, W. (2012). When do fathers care? Mothers’ economic contribution and fathers’ involvement in child care. American Journal of Sociology, 117(5), 1422–1459. https://doi.org/10.1086/663354.
Revicki, D. A., Kleinman, L., & Cella, D. (2014). A history of health-related quality of life outcomes in psychiatry. Dialogues in Clinical Neuroscience, 16(2), 127–135.
Rodriguez, C. M. (2011). Association between independent reports of maternal parenting stress and children’s internalizing symptomatology. Journal of Child and Family Studies, 20(5), 631–639. https://doi.org/10.1007/s10826-010-9438-8.
Rutter, M., Bailey, A., & Lord, C. (2003). The social communication questionnaire. Los Angeles: Western Psychological Services.
Saveanu, R. V., & Nemeroff, C. B. (2012). Etiology of depression: genetic and environmental factors. Psychiatric Clinics, 35(1), 51–71. https://doi.org/10.1016/j.psc.2011.12.001.
Schnabel, A., Youssef, G. J., Hallford, D. J., Hartley, E. J., McGillivray, J. A., Stewart, M., et al. (2019). Psychopathology in parents of children with autism spectrum disorder: a systematic review and meta-analysis of prevalence. Autism, 24(1), 26–40. https://doi.org/10.1177/1362361319844636.
Shimada-Sugimoto, M., Otowa, T., & Hettema, J. M. (2015). Genetics of anxiety disorders: genetic epidemiological and molecular studies in humans. Psychiatry and Clinical Neurosciences, 69(7), 388–401. https://doi.org/10.1111/pcn.12291.
StataCorp. (2017). Stata statistical software: release 15. College Station, TX: StataCorp LLC.
Sullivan, P. F., Neale, M. C., & Kendler, K. S. (2000). Genetic epidemiology of major depression: review and meta-analysis. American Journal of Psychiatry, 157(10), 1552–1562. https://doi.org/10.1176/appi.ajp.157.10.1552.
Theule, J., Wiener, J., Tannock, R., & Jenkins, J. M. (2013). Parenting stress in families of children with ADHD: a meta-analysis. Journal of Emotional and Behavioral Disorders, 21(1), 3–17. https://doi.org/10.1177/1063426610387433.
Tilford, J. M., Payakachat, N., Kuhlthau, K. A., Pyne, J. M., Kovacs, E., Bellando, J., et al. (2015). Treatment for sleep problems in children with autism and caregiver spillover effects. Journal of Autism and Developmental Disorders, 45(11), 3613–3623. https://doi.org/10.1007/s10803-015-2507-5.
Tudor, M. E., Hoffman, C. D., & Sweeney, D. P. (2012). Children with autism: sleep problems and symptom severity. Focus on Autism and Other Developmental Disabilities, 27(4), 254–262. https://doi.org/10.1177/1088357612457989.
Ung, D., Johnco, C., McBride, N. M., Howie, F., Scalli, L., & Storch, E. A. (2016). Optimizing the screening of autism spectrum disorders in outpatient clinics: an examination of the social communication questionnaire-lifetime. Research in Autism Spectrum Disorders, 27, 21–28. https://doi.org/10.1016/j.rasd.2016.03.011.
Valicenti-McDermott, M., Lawson, K., Hottinger, K., Seijo, R., Schechtman, M., Shulman, L., et al. (2015). Parental stress in families of children with autism and other developmental disabilities. Journal of Child Neurology, 30(13), 1728–1735. https://doi.org/10.1177/0883073815579705.
Vasilopoulou, E., & Nisbet, J. (2016). The quality of life of parents of children with autism spectrum disorder: a systematic review. Research in Autism Spectrum Disorders, 23, 36–49. https://doi.org/10.1016/j.rasd.2015.11.008.
WHOQoL Group. (1993). Study protocol for the world health organization project to develop a quality of life assessment instrument (WHOQOL). Quality of Life Research, 2, 153–159. https://doi.org/10.1007/BF00435734.
World Health Organisation (2019). Mental health. https://www.who.int/mental_health/en/. Accessed June 21, 2019.
Funding
The data for this study was collected as part of the Sleeping Sound with Autism Spectrum Disorder project at Deakin University, Australia with funding from the Australian National Health and Medical Research Council (APP1101989). Ms Christina A. Martin is supported by an Australian Government Research Training Program Scholarship (0000019042). Associate Professor Emma Sciberras is supported by an Australian National Health and Medical Research Council Career Development Award (1110688) and a veski Inspiring Women’s Fellowship. Professor Harriet Hiscock is supported by a National Health and Medical Research Council Practitioner Fellowship (1136222).
Author information
Authors and Affiliations
Contributions
CAM conceptualised and designed the study, was involved in data collection, conducted the data analysis, interpreted the results, wrote and submitted the manuscript. ES, NP and NJR assisted with study conceptualisation and design, contributed to the interpretation of the data, and reviewed and revised the manuscript. LE, HH, KW, PH and JM reviewed and revised the manuscript.
Corresponding author
Ethics declarations
Conflict of Interests
Professor Nicole Rinehart, Professor Jane McGillivray and Dr Nicole Papadopoulos receive philanthropic funding from Moose Toys, Ferrero Group Australia as part of its Kinder + Sport pillar of Corporate Social Responsibility initiatives, MECCA Brands, Wenig Family, Geelong Community Foundation, and the Grace and Emilio Foundation; and industry partner funding from the Victorian Department of Education, to conduct research in the field of neurodevelopmental disorders and inclusion. They have also previously received scholarship funding from the Australian Football League and industry partner funding from the NDIS. Professor Rinehart has received donations from Vic Health and Bus Association Victoria; previous speaker honorarium from Novartis (2002), Pfizer (2006) and Nutricia (2007); and is a Director of the Amaze Board (Autism Victoria). None of the companies or organizational bodies listed above had a role in this research including the collection, analysis and interpretation of data; in writing of the manuscript; and/or in the decision to submit this abstract for publication. The remaining authors have no potential conflicts of interests to declare.
Ethical Approval
All procedures performed in the study involving human participants were in accordance with the ethical standards of the Royal Children’s Hospital (36154) and Deakin University (2017–130) Human Research Ethics Committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Martin, C.A., Sciberras, E., Papadopoulos, N. et al. Associations Between Child Sleep Problem Severity and Maternal Well-Being in Children with Autism Spectrum Disorder. J Autism Dev Disord 51, 2500–2510 (2021). https://doi.org/10.1007/s10803-020-04726-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-020-04726-7