Parental and Child Sleep: Children with Vision Impairment, Autistic Children, and Children with Comorbid Vision Impairment and Autism.

BACKGROUND: Parents report associations between children's sleep disturbances and behaviors. Children with neurodevelopmental conditions (e.g., Williams Syndrome and autism) are consistently reported to experience increased sleeping problems. Sleep in children with vision impairment and children with a dual diagnosis of vision impairment and autism remains understudied. METHODS: Our exploratory study compared sleep profiles in 52 children (aged 4-12 years) and their parents (n = 37), across four groups: children with vision impairment (VI; n = 9), autism (n = 10), comorbid vision impairment + autism (n = 6), and typically developing children (n = 27). Childhood sleep was measured using the parental report Childhood Sleep Habits Questionnaire and sleep diaries. Children's cognitive functioning was measured using digit span, semantic, and phonemic verbal fluency measures. Parental sleep was measured via the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. RESULTS: Clinically disordered sleep was reported in all child groups (p ≤ 0.001), particularly children with VI + autism. Age, not sleep quality/quantity, predicted cognitive task performance in TD and autistic groups, but not in VI and VI + autism groups. The child's diagnosis affected parental sleep, particularly in children with a dual diagnosis of VI + autism. CONCLUSIONS: All participants experienced problematic sleep to varying degrees. Those most affected were children and parents in the VI + autism group, suggesting that autism may be the main driver of sleep problems in our sample.

Semantic fluency in primary school-age children with vision impairment.

PURPOSE: Semantic fluency is potentially a useful tool for vocabulary assessment in children with vision impairment because it contains no visual test stimuli. It is not known whether in the primary school years children with vision impairment perform more poorly on semantic fluency tasks compared to their sighted peers. METHOD: We compared semantic fluency performance of two groups of 5- to 11-year-old British English speaking children-one group with vision impairment and one without. We also investigated within-group differences in performance, based on severity of vision impairment. We administered one category (animals) to children with vision impairment (n = 45) and sighted children (n = 30). Participants had one minute to respond. Responses were coded for accuracy, error type, clusters, and switches. RESULT: Correct responses increased with age within each group. Groups did not differ significantly on any outcome measure. Severity of vision impairment did not impact task performance. CONCLUSION: Results suggested that semantic fluency performance-at least for the category animals-is not different in children with vision impairment compared to sighted children. Findings also suggest that semantic fluency could be a suitable addition to the tools that speech-language pathologists use to assess language abilities in children with vision impairment.

Short Report: Lack of Diurnal Variation in Salivary Cortisol Is Linked to Sleep Disturbances and Heightened Anxiety in Adolescents with Williams Syndrome.

OBJECTIVE: The aim of the current study was to examine the potential relationship between sleep patterns, cortisol levels, and anxiety profiles in adolescents with Williams Syndrome (WS) compared to typically developing adolescents. METHOD: Thirteen adolescents with WS and thirteen TD adolescents (age range 12-18 years) were recruited. Participants were provided with a "testing kit", containing instructions for collecting data through a sleep diary, MotionWare actigraphy, the Childhood Sleep Habits Questionnaire (CSHQ), and the Spence Children's Anxiety Scale, and a salivary cortisol collection kit. RESULTS: Adolescents in the WS group did not show diurnal variation in salivary cortisol. Significantly higher scores were reported for two CSHQ subsections, night wakings and parasomnias, in the WS group. Regarding the actigraphy, only significantly longer sleep latency was observed in the WS group. In comparison to the TD group, the WS group had significantly higher anxiety. As expected, the TD group showed typical diurnal variation in cortisol, whereas the WS group showed a flattened cortisol profile throughout the day. CONCLUSIONS: From the developmental perspective, this study provides new data supporting the conclusion that sleep problems are not transient but continue to persist into adolescence in WS. Future studies ought to consider examining the role of cortisol and its interplay with anxiety levels and sleep problems across the lifespan in individuals with WS.

Impact of sleep on attention in primary school-aged autistic children: Exploratory cross-cultural comparison between Singapore and UK children.

BACKGROUND: There is a growing body of research studying the impact sleep has on attention among typically developing (TD) children, but research is lacking among autistic children. AIMS: The present study aimed to explore, for the first time, differences in (1) attention, (2) sleep parameters among primary school-aged Singaporean autistic children (N = 26) and Singaporean TD children (N = 20), and with UK autistic (N = 11) and UK TD children (N = 16), and (3) the impact of sleep on attention. METHODS AND PROCEDURES: Actigraphy was used to objectively assess sleep, and a Continuous Performance Task was used to measure attentional domains. OUTCOMES AND RESULTS: There were inconclusive findings indicating that autistic children had poorer sustained attention than TD children. Although autistic children did not display more sleep difficulties than TD children, they showed shorter actual sleep duration (Singapore ASD = 7:00 h, UK ASD = 7:35 h, p < .01) and longer sleep latency (Singapore ASD = 30:15 min, UK ASD = 60:00 min, p < .01) than clinical recommendations. Sleep difficulties were also present among Singaporean and UK TD children. Both TD groups had less actual sleep duration than recommended (Singapore TD = 6:32 h, UK TD = 8:07 h). Singaporean TD children had sleep efficiency below recommended criterion (78.15%). Sleep impacted attention across all groups, but effects were different for autistic and TD groups. CONCLUSIONS AND IMPLICATIONS: The study highlighted the importance for practitioners and carers to adopt a child-centred approach to assessing sleep and attentional difficulties, especially among autistic children due to the high variability in performance within the group. The impact of cultural and school-setting differences on sleep was also raised.

Lights Out: Examining Sleep in Children with Vision Impairment.

Sleep is crucial for development across cognitive, physical, and social-emotional domains. Sleep quality and quantity impact domains of daytime functioning, attainment, and global development. Previous work has explored sleep profiles in typically developing children and children with developmental disorders such as Down syndrome and Williams Syndrome, yet there is a complete absence of published work regarding the sleep profiles of children with vision impairment aged 4-11 years. This is the first known study that examines the sleep profiles in children with vision impairment (n = 58) in comparison to 58 typically developing children (aged 4-11 years) in the UK. Sleep was measured using the Childhood Sleep Habits Questionnaire (CSHQ; parental report), actigraphy and sleep diaries. Results showed group differences in subjective CSHQ scores but not objective actigraphy measures. Surprisingly, the findings revealed disordered sleep (namely, poor sleep quantity) in both groups. Discordance between CSHQ and actigraphy measures could represent heightened awareness of sleeping problems in parents/caregivers of children with vision impairment. The implications of this study extend beyond group comparison, examining disordered sleep in 'typically developing' children, exploring the potential role of light perception and the importance of sleep quality and quantity in both groups.