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Combining developmental and sleep health measures for autism spectrum disorder screening: an ECHO study

  • 期刊论文

  • 发表日期：

    2024年6月12日

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  • Lauren C. Shuffrey,
  • Brandon Rennie,
  • Xiuhong Li,
  • Noya Galai,
  • Nicolò Pini,
  • Anahid Akbaryan,
  • Akram Alshawabkeh,
  • Judy Aschner,
  • Julianna Collazo Vargas,
  • Lauren Costello,
  • Viren D’Sa,
  • Sean Deoni,
  • Anne Dunlop,
  • Amy J. Elliott,
  • William P. Fifer,
  • Jonica Hash,
  • Daphne Koinis-Mitchell,
  • Jin-Shei Lai,
  • Bennett L. Leventhal,
  • Johnnye Lewis,
  • Maristella Lucchini,
  • Kristen L. McArthur,
  • Santiago Morales,
  • Sara S. Nozadi,
  • Thomas G. O’Connor,
  • T. Michael O’Shea,
  • Grier P. Page,
  • Cathi Propper,
  • Ayesha Sania,
  • Coral Shuster,
  • Emily Zimmerman,
  • Amy E. Margolis

摘要

Background

Sleep problems are reported for up to 80% of autistic individuals. We examined whether parsimonious sets of items derived from the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) and the Brief Infant Sleep Questionnaire (BISQ) are superior to the standard M-CHAT-R in predicting subsequent autism spectrum disorder (ASD) diagnoses.

Methods

Participants from 11 Environmental influences on Child Health Outcomes (ECHO) cohorts were included. We performed logistic LASSO regression models with 10-fold cross-validation to identify whether a combination of items derived from the M-CHAT-R and BISQ are superior to the standard M-CHAT-R in predicting ASD diagnoses.

Results

The final sample comprised 1552 children. The standard M-CHAT-R had a sensitivity of 44% (95% CI: 34, 55), specificity of 92% (95% CI: 91, 94), and AUROC of 0.726 (95% CI: 0.663, 0.790). A higher proportion of children with ASD had difficulty falling asleep or resisted bedtime during infancy/toddlerhood. However, LASSO models revealed parental reports of sleep problems did not improve the accuracy of the M-CHAT-R in predicting ASD diagnosis.

Conclusion

While children with ASD had higher rates of sleep problems during infancy/toddlerhood, there was no improvement in ASD developmental screening through the incorporation of parent-report sleep metrics.

Impact

Parental-reported sleep problems are common in autism spectrum disorder (ASD).

We investigated whether the inclusion of parental-reports of infant/toddler sleep patterns enhanced the effectiveness of developmental screening for autism.

We reported higher rates of difficulty falling asleep and resisting bedtime during infancy and toddlerhood among children later diagnosed with ASD; however, we did not find an improvement in ASD developmental screening through the incorporation of parent-report sleep metrics.

In our sample, the standard M-CHAT-R had a sensitivity of 39% among children of mothers with government insurance compared with a sensitivity of 53% among children of mothers with employer-based insurance.