The implication of sleep disturbances on daily executive functioning and learning problems in children with autism without intellectual disability

Individuals with autism spectrum disorder (ASD) often have sleep disturbances, executive functioning difficulties, and learning problems. The aim of this study was twofold. First, to examine the quality of sleep in children with ASD without intellectual disability and typically developing (TD) children. Second, to explore the implication of sleep disturbances in the association between daily executive functioning and learning problems in children with ASD without intellectual disability. The sample included 47 children with autism without intellectual disability and 32 TD children. Parent-reported questionnaires were used to assess participants' sleep disturbances, daily executive functions, and learning problems. All statistical analyses performed were adjusted for age, IQ, and medication. As expected, the prevalence of sleep disturbances was significantly higher in the ASD group than in the TD group. Regarding the second aim of the study, the total score of sleep disturbances was significantly associated with learning problems and the metacognition subdomain of executive functioning in children with autism without intellectual disability. In turn, executive functions and learning problems were also significantly associated. Finally, sleep disturbances were found to mediate the relationship between global executive functioning and learning problems in children with ASD without intellectual disability. The findings suggest that sleep disturbances are common in children with autism, and that they play a mediating role in the association between executive functions and learning problems. Therefore, sleep should be a crucial aspect of interventions to improve the learning and academic performance of school-aged children with ASD without intellectual disability.