Behavioral problems in preschool and school-aged autism spectrum disorderchildren; associations with parent functional and psychological health: preliminary study

摘要

Objective: Recently, higher numbers of younger children are being diagnosed with Autism Spectrum Disorder (ASD). Thus, factors that in?uence parenting stress in younger ASD need to be indicated in older children. Therefore, accessible targets for interventions can be modified. Based on existing literature we hypothesized that preschool aged ASD children have more problems about sleep latency, bed time resistance and night waking. Additionally we aimed at disentangling the precipitation of behavior problems and sleep habits on caregivers’ overall psychological well-being in families of ASD children. Method: In this preliminary study, 30 family of children with ASD and 30 families of typically developing children completed Children’s Sleep Habits Questionnaire (CSHQ) and Short Form-36. Parents of ASD children also completed Aberrant Behavior Checklist (ABC). The ASD group was composed of 17 preschool and 13 school-aged children, which have no mood disorder. SCL-90 was administered for mothers and fathers of the sample and the community group. Families were included if they had a child aged between 3 and 11years. For both groups exclusion criteria was the presence of a family member with neurodevelopmental and mood disorder treatment history. Also, none of the ASD children have a mood disorder history. Results: Parents of ASD have a poorer total SF-36 score and physical functioning and higher physical and emotional limitations than controls (p=0.01). Unlikely fathers, mothers have a lower score on 3 domains of SF-36 in comparison with controls (p=0.02). Total SF-36 score has a significant correlation for all domain of ABC, the most prominent one being social withdrawal for both parents. Mothers’ total SF-36 was scores poorer than fathers’ (p=0.05), contrary to the community group.; The whole ABC subscales scores have a positive relation with bedtime resistance, the most powerful ones being social withdrawal and hyperactivity, respectively. Total CSHQ scores are most related with social withdrawal, also hyperactivity has a positive correlation with this variable. In school-aged patients, daytime sleepiness scores are higher (p=0.01), while self-injurious behavior is prevalent in the preschool period (p=0.038). Apart from that, the total CSHQ scores are similar between age groups and in bivariate analysis which takes into consideration all ages. Between age groups, the total SF-36 score is significantly higher in school-aged in fathers. Conclusion: One of this study’s core points is to examine the difference in life quality between fathers and mothers of children with ASD. The results in these studies indicated that mothers tend to have lower life quality levels compared to fathers in the ASD group. Both sets of ratings indicated that behavior problems were strongly associated with parent quality of life. Social withdrawal is the greatest contributing factor. This trait seems to be in relationship with bedtime resistance. As opposed to our hypothesis, ASD’s subscale and total CSHQ scores are similar between age groups except for daytime sleepiness. Finally, we need prospective data to understand the connection between behavior problems, parental stress and sleep habits over time.