Role of Core Autism Spectrum Symptoms and Social Determinants of Health on Sleep Disturbances in Children and Adolescents

Despite sleep problems being a common complaint in individuals with autism specific sleep phenotypes their relationship to core ASD symptoms and their association with social determinants of health and functional impairment have yet to be explored. This project aligns with the Interagency Autism Coordinating Committee's strategic plan as well as the Maternal and Child Health Bureau (MCHB) Strategic Plan Goals as it focuses on core symptoms of ASD and co-occurring conditions. Furthermore results will enable the personalization of treatment for children and adolescents with ASD with ASD+sleep phenotypes and better assess and treat those with health disparities with the goal of improving health outcomes.

Goals and objectives:

The goal of the proposed project is to better understand the relationship between core ASD symptoms and sleep problems in children and adolescents with ASD and how ASD+sleep phenotypes are related to social determinants of health and functional impairment. - Aim 1 is to identify specific sleep dimensions using the Pediatric Behavior Scale in children and adolescents with ASD. - Aim 2 is to determine phenotypes characterized by core ASD symptoms (problems with social interactions perseveration somatosensory disturbance atypical communication/ development mood and attention/safety) and sleep dimensions (identified in AIM 1) accounting for age gender IQ ADHD anxiety and medication use in children and adolescents with ASD. - Aim 3 is to explore the association of social determinants prenatal complications early childhood temperament and function impairment (more specifically working memory and processing speed) with phenotypes (identified in AIM 2) accounting for age gender IQ and medication use in children and adolescents with ASD.

Proposed data sets and target populations:

The study involves a retrospective analysis of existing clinical data on 1459 children with autism 1-17 years of age M=6.6 SD=3.3) with Full Scale IQs of 9-146 (M=92.1 SD=24.9). Of whom 79% of the children are male 90.6% are white and 34.1% have a parent with a professional or managerial occupation. The children were consecutive referrals to our child psychiatry diagnostic clinic who were diagnosed with autism by a licensed PhD psychologist.

Products:

Our dissemination plan targets scientific patient and healthcare stakeholders. We will disseminate findings from our study with peer-reviewed publications presentations at scientific meetings and patient advocacy groups.

Evaluation:

The study team (PI Co-I and statistician) will meet on a monthly basis to evaluate the project's progress towards achieving its specific goals and objectives.