Calliope Holingue1, Heather Volk2, Deana Crocetti3, Bridget Gottlieb4, Adam P Spira5, Stewart H Mostofsky6. 1. 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. Electronic address: choling1@jhu.edu. 2. 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. 3. Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, USA. 4. 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. 5. 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. 6. 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.
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.
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.
Authors: Terry Katz; Amy M Shui; Cynthia R Johnson; Amanda L Richdale; Ann M Reynolds; Lawrence Scahill; Beth A Malow Journal: J Autism Dev Disord Date: 2018-08
Authors: Matthew J Maenner; Kelly A Shaw; Jon Baio; Anita Washington; Mary Patrick; Monica DiRienzo; Deborah L Christensen; Lisa D Wiggins; Sydney Pettygrove; Jennifer G Andrews; Maya Lopez; Allison Hudson; Thaer Baroud; Yvette Schwenk; Tiffany White; Cordelia Robinson Rosenberg; Li-Ching Lee; Rebecca A Harrington; Margaret Huston; Amy Hewitt; Amy Esler; Jennifer Hall-Lande; Jenny N Poynter; Libby Hallas-Muchow; John N Constantino; Robert T Fitzgerald; Walter Zahorodny; Josephine Shenouda; Julie L Daniels; Zachary Warren; Alison Vehorn; Angelica Salinas; Maureen S Durkin; Patricia M Dietz Journal: MMWR Surveill Summ Date: 2020-03-27