Sleep and Behaviour in Early Autism: Examining Bidirectional Associations Near Diagnosis

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Sadka, N., Richdale, A., Li, X., Date, P., & Barbaro, J. (2026). Sleep and Behaviour in Early Autism: Examining Bidirectional Associations Near Diagnosis. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-025-07170-7

Publication date: 29 Jan 2026 Added to AutiHub: 7 Sep 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
5
Publication authors identified as autistic
1 / 5 (20.0%)
  1. Nancy Sadka
  2. Amanda Richdale
  3. Xia Li
  4. Perrin Date
  5. Josephine Barbaro *

Abstract

Abstract Purpose Sleep problems and behavioural challenges are examined rarely in very young autistic children. We investigated sleep in 173 autistic children, close to their autism diagnosis (M age = 2.49 years at diagnosis), focussing on sleep’s relationship with daytime behaviour and vice versa, and examining if there were specific sleep problem-behaviour relationships in this very young cohort. Methods Caregivers of 173 autistic children (M age = 2.58 years at data collection) provided information on their children’s sleep (CSHQ; written descriptions) and behaviour (BASC-3, VABS-3). Demographic, ADOS-2 and developmental (MSEL) information were also available. Using parents’ written descriptions and normative sleep data, children were categorized as severe (SSP) or typical (TSP) problems sleepers, or good sleepers (NSP) (Roussis et al., 2021). Kruskal-Wallis, correlation and regression analyses examined sleep and behavioural relationships among these three sleep groups. Results Most children (71.9%) had two or more sleep problems. The TSP and NSP groups did not differ on behaviour, showing significantly less hyperactivity, aggression, attention, and atypicality than the SSP group. Night waking/parasomnias, daytime alertness, and sleep initiation/duration for both sleep problem groups strongly correlated with increased hyperactivity, attention, anxiety, depression, and aggression. Sleep explained 38.4% of variance and 61.8% variance in behaviour, and behaviour explained 22.4% of variance and 32.1% of variance in sleep, for the TSP and SSP groups respectively. Conclusion Reciprocal relationships between sleep and behaviour in autism emphasise the importance of addressing sleep problems in young autistic children, at the time of diagnosis, as they can negatively impact behaviour and well-being.

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These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 12 Sep 2026 01:04.

Cited references
53
With a DOI
49
Without a DOI, from raw bibliography text
4
3 / 53 (5.7%) cited references include at least one author identified as autistic.
References with data to complete
2 / 53 (3.8%)
References with detected author names
51 / 53 (96.2%)
Without detected author names
2
Without a structured title
2
Without a stable identifier
4
References with raw author names still to review
2
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
284
From DOI or external metadata
284
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
5
50 / 284 (17.6%) names are linked to an author already present in AutiHub. 234 / 284 (82.4%) names are not yet linked.
Names linked to a person identified as autistic
3 / 284 (1.1%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 3 / 50 (6.0%). Distinct people identified as autistic: 1 / 238 (0.4%).
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