The relation among sleep, routines, and externalizing behavior in children with an autism spectrum disorder

The present study examined relations among sleep, routines, and externalizing behavior (based on parent report) in 115 children ages 6 to 12 years in two groups: 58 children with an autism spectrum disorder (age M = 9.0, SD = 2.09) and 57 non-ASD children (age M = 8.25, SD = 1.98). Within the ASD group, sleep hygiene and sleep quality were related to both routines and externalizing behaviors. In the combined sample, a significant interaction was found between diagnostic status and general routines in predicting externalizing behaviors. Specifically, lower levels of routines were related to higher levels of externalizing behaviors for both groups, whereas higher levels of routines were related to lower levels of externalizing behaviors for the non-ASD group. Further research among these constructs may focus on children with an ASD who experience less consistent routines or significant sleep disturbance.