Chapter 6: Impact of Poor Sleep on Daytime Behavior

Children with autism spectrum disorder (ASD) experience behavioral challenges, which can be augmented by sleep disturbance. This association is illustrated in the two cases below. These associations between sleep and behavior in ASD are the focus of this chapter and we will discuss the relationship of sleep to challenging daytime behaviors such as those portrayed by the two cases below.

Wanda White (WW) is a 5-year-old girl with ASD who resists going to bed at night. She states that she needs to line up all of her dolls before she can go to bed, and this process tends to take at least an hour. When her mother gently suggests that she not line up all of her dolls, she gets agitated and throws the dolls against the wall. Once asleep, she tends to wake up frequently and talk to her dolls during the night. Her parents hear her, come to her room, and put her back to bed. The cycle repeats through the night. During the day WW fidgets with a ball continuously bouncing it against the floor. When interrupted she will stop, stare at whomever is stopping her, and return to the bouncing.