The relationship between sleep quality of children with a\Autistic Spectrum Disorder between the ages of 3-10 and parental stress, and the effect of self-efficacy, hope and sleep quality of the parents on this relationship

Lilach kibrik

In recent years we are witnessing a dramatic increase in the number of children diagnosed with Autistic Spectrum Disorder (ASD). This increase requires re-examination of the disorder and its effects on the children and their families. One of areas in which children with ASD are struggling with is sleep. Research shows that sleep difficulties have negative effects not only on the children and their functioning, but also on their parents. This research aims to examine the relationship between the children’s sleeping problems and parental levels of stress. In addition, the study examined whether this relationship is mediated by the parents’ sleep quality and whether it is  moderated by two personal resources – the parents’ level of hope and self-efficacy. These resources were shown to be to be protective factors in care-giving situations. Their moderate effects, however, were never examined in regards to the association between the children’s’ sleep quality and their parents’ stress levels.

The hypotheses were:

1. Sleep quality of children with ASD will correlated negatively with their parents’ stress
2. The parents’ sleep quality will mediate the relation between the children’s sleeping problems and their parents’ stress
3. The parents’ hope level will moderate the relation between the child’s sleeping problems and their parents’ stress
4. The parents’ self-efficacy will moderate the relation between the child’s sleeping problems and their parents’ stress

The current research was conducted in collaboration with the research department of the Child Development Unit in “Sheba” hospital. The participants were 110 parents of children with ASD between the ages of 3 to 10 . Data were collected by phone interviews, in which parents were asked to answer six questionnaires: demographic, parenting stress index (PSI), general self-efficacy (GSE), Snyder’s hope index, Pittsburgh Sleep Quality Index (PSQI) and children’s sleep habits (CSHQ).

As hypothesized, the lower the children’s sleep quality was, the higher were their parent’s stress levels. As hypothesized,  more serious child’s sleep problems were associated with  lower parents’ sleep quality, which in turn contributed to an increase in parents’ stress levels. That is, parents' sleep quality partially mediated the link between child's sleep problems and parents' stress. As hypothesized, parental hope levels moderated the relation between the children’s’ sleeping problems and their parents’ stress levels.  This interaction, however, was different than hypothesized.  Parents with low levels of hope exhibited high stress levels regardless their child’s sleep quality, whereas parents' hopes that were higher, did not moderate the relationships between child's sleep and parents' stress.. Contrary to what was hypothesized, self-efficacy of the parents didn’t moderate the relation between the children’s sleeping problems and their parents’ stress levels.

From a theory perspective, this research contributes to existing knowledge on sleep problems among children with ASD and their parents' stress levels. It added the the examination of parents' personal resources of hope and self – efficacy. Moreover, this study examined for the first time the mediating effect of parents’ sleep quality on the relationship between sleeping problems of children with ASD and their parents’ stress levels.

The findings raised several intriguing questions for  future research.. For one, despite signficant sleeping problems among their children,  parents’ sleep quality was good overall. For another, contrary to existing knowledge regarding self-efficacy and hope, in which they are considered as protective personality resources, in current research they did not function as such, and did not help moderate parental stress.

In terms of practical contribution, the current findings suggest that awareness ofr sleeping problems among ASD diagnosed children, should be raised among clinicians. This awareness should lead to better interventions designed to address sleeping problems among children with ASD and their parents. Furthermore, practitioners need to attend to the stress associated with children's sleeping problems and help parents master ways to help their children sleep better, as well as deal with the stress that their children's sleep disturbances are causing them. Since the relationship between sleep quality and parental stress levels was not moderated by hope or self-efficacy, it is also important to locate the resources and means by which parents can reduce the negative consequences of their children's sleeping difficulties.