What is the research about?

Children with Intellectual Disability (ID) and/or Autism Spectrum Disorder (ASD) are more likely to have sleep and anxiety problems, and episodes of challenging behaviour (CB) than are typically developing children. However, there is not much information about how these conditions are related to each other. The goal of this study was to better understand how sleep problems and anxiety are related to CB.

What did the researchers do?

The parents or guardians of 167 children aged 5 to 18 years with ID/ASD living in Scotland took part in this study. They filled out surveys about their child’s level of sleep problems, anxiety, and CB. The researchers then looked at whether or not sleep and anxiety problems were related to CB in these children.

What did the researchers find?

The authors found that

• higher levels of sleep problems and higher levels of anxiety were related,

• higher levels of anxiety were related to higher levels of CB,

• there was a relationship between sleep problems and anxiety,

• medication use was also related to CB but to a lesser degree.

The difficulty in this study was sorting out which of these factors was actually the “cause” of the challenging behaviour. It could be that the challenging behaviour was related to other factors that influenced sleep and anxiety. For instance, it is not known if problems with communication and understanding and controlling one’s own feelings might also contribute to anxiety, sleep, and challenging behaviour in children with ID or ASD.

Take home message

The causes of CB are complex and not fully understood. Sleep problems and anxiety, as well as some medications, may play important roles in a child’s CB. The authors suggested that future research should involve more participants and focus on sorting out how sleep, anxiety, challenging behaviour, and other factors interact.


The original Research Report was written by H. Rzepecka and associates and was published in Research in Developmental Disabilities, 2011.