Structural Relationships Between Behavioral Problems, Sensory Processing Traits, and Sleep Among Preschoolers.

IMPORTANCE: An association between sensory processing difficulties and behavioral problems among children has been reported in previous studies. Sleep problems among children can lead to both externalizing and internalizing behavioral problems. However, the relationships between sensory processing and sleep among children are not well understood. OBJECTIVE: To develop a structural causal model (SCM) predicated on the hypothesis that sensory processing difficulties and sleep problems are closely related among preschoolers and may contribute to behavioral issues. DESIGN: Cross-sectional study. PARTICIPANTS: A total of 168 children ages 3-5 yr who were enrolled in a preschool or an accredited kindergarten (four facilities in total) in a Japanese prefecture participated in the analysis. OUTCOMES AND MEASURES: After gaining the cooperation of educators, we distributed the following items to the children's parents: an informed consent form, the Short Sensory Profile-Japanese version (SSP-J), the Japanese Sleep Questionnaire for Preschoolers (JSQ-P), and the Child Behavior Checklist for Ages 1.5-5. Through factor analysis of the SSP-J and the JSQ-P, we identified common factors. We developed an SCM using structural equation modeling. RESULTS: Four factors were identified by factor analysis: attention deficit, sensory sensitivity, sleep problems, and restless legs syndrome symptoms. The final structural equation modeling analysis had an acceptable goodness of fit (goodness-of-fit index = .862; root-mean-square error of approximation = .087). CONCLUSIONS AND RELEVANCE: The model suggests that sensory sensitivity and sleep difficulties may contribute to behavioral issues among preschoolers. Plain-Language Summary: The results of this study suggest that relationships exist between behavioral problems, sensory processing, and sleep among preschoolers. The authors developed a model that identified four common factors that contribute to behavioral issues among preschoolers: attention deficit, sensory sensitivity, sleep problems, and restless legs syndrome symptoms. Children's behavioral problems are an important consideration for occupational therapy practitioners working with preschoolers. Sensory processing and sleep must be accurately evaluated to address preschoolers' behavioral issues.

Structural validity of the mealtime behaviour questionnaire for children with autism spectrum disorder in Japan.

[Purpose] Children with autism spectrum disorder (ASD) exhibit many problematic mealtime behaviours. Currently, there is no process for measuring the mealtime behaviours of children with ASD in Japan. Therefore, we developed the ASD-Mealtime Behaviour Questionnaire (ASD-MBQ) using the results of surveys measuring problematic mealtime behaviours in Japanese children with ASD aged 3-18 years. The objective of this study was to analyse the structural validity of the ASD-MBQ in Japan. [Participants and Methods] We recruited 378 children with ASD aged 3-18 years and performed a confirmatory factor analysis on the ASD-MBQ by using a five-factor structure. [Results] The confirmatory factor analysis demonstrated structural validity (χ2=796.5, degrees of freedom=265, comparative fit index=0.901, root mean square error of approximation [90% confidence interval]=0.073 [0.067-0.079]). [Conclusion] We have demonstrated the structural validity of the ASD-MBQ, which provided useful information for planning interventions and evaluations for children with ASD. Further studies need to consider cut-off score by age and inter-rater reliability.

Convergent validity of the Autism Spectrum Disorder Mealtime Behavior Questionnaire (ASD-MBQ) for children with autism spectrum disorder.

There was a growing interest in difficulties with eating as one of the most problematic symptoms in children with autism spectrum disorder (ASD). The purpose of this study is to examine the convergent validity of the Autism Spectrum Disorder Mealtime Behavior Questionnaire (ASD-MBQ) with the Asahide's test for social adjustment skills, the Japanese version of the short version of the sensory profile questionnaire, the Japanese version of the Social Communication Questionnaire, and the Parenting Strain Index in Japanese children with ASD. The final sample contained 294 children who were diagnosed as the ASD based on the DSM-5 criteria, the mean age of children was 10 ± 4 years (range: 3-18 years). The ASD-MBQ is a questionnaire that comprised of 42 items that are classified into five subdomains: selective eating, clumsiness/manners, interest in/concentration on eating, oral-motor function, and overeating. Spearman's rank correlation coefficient revealed that the ASD-MBQ showed the moderate to high correlation coefficient with all four external criteria. Our results in this study supported the sufficient convergent validity in the ASD-MBQ. Therefore, the ASD-MBQ could be a useful tool for research and practice in a wide range of children with ASD aged 3 to 18.