Le Donne Ilenia, Salfi Federico, Placentino Valeria, Mazza Monica, Valenti Marco, Ferrara Michele, Parma Valentina
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
International School for Advanced Sciences, Trieste, Italy.
J Autism Dev Disord. 2024 Dec 27. doi: 10.1007/s10803-024-06695-7.
Sleep problems are common in children with autism spectrum disorder (ASD), with potential repercussions on neurobehavioral functioning exacerbating socio-communicative impairments and aggressive behaviors. Parent reports are the most used method to assess sleep in pediatric populations and a modified 23-item of Children's Sleep Habits Questionnaire (CSHQ) for ASD has been proposed in the United States. The generalizability of the CSHQ for ASD has yet to be validated across countries, including Italy. To extend the CSHQ applicability to Italian youth with ASD, we back-translated to Italian and revised the 23-item CSHQ, validating its dimensional structure in a sample of children and adolescents with ASD using Explorative Graph Analysis. In addition, we compared the revised scale scores of the ASD group with a typically developing (TD) group. The revised Italian version of the CSHQ (CSHQ-r) consisted of a 15-item tool with a four-dimension structure (Sleep initiation/duration, Sleep anxiety/Co-sleeping, Night awakenings/Parasomnias, and Daytime alertness) with good structural stability. Group comparison indicated significantly higher scores in the ASD group than the TD group, suggesting greater prevalence of sleep disturbances in ASD. The four-dimensional CSHQ-r may represent a useful screening tool to assess sleep disorders in Italian children and adolescents with ASD, with potential implications for clinical practice.
睡眠问题在自闭症谱系障碍（ASD）儿童中很常见，可能会对神经行为功能产生影响，加剧社交沟通障碍和攻击性行为。家长报告是评估儿童群体睡眠情况最常用的方法，美国已提出针对ASD的23项儿童睡眠习惯问卷（CSHQ）修订版。包括意大利在内，CSHQ在ASD群体中的通用性尚未在各国得到验证。为了将CSHQ的适用性扩展到意大利的ASD青少年，我们将23项CSHQ回译为意大利语并进行修订，通过探索性图形分析在一组ASD儿童和青少年样本中验证其维度结构。此外，我们将ASD组的修订量表分数与发育正常（TD）组进行了比较。修订后的意大利版CSHQ（CSHQ-r）是一个包含15个条目的工具，具有四维结构（入睡/睡眠时间、睡眠焦虑/同睡、夜间觉醒/异态睡眠和日间警觉性），结构稳定性良好。组间比较表明，ASD组的分数显著高于TD组，这表明ASD中睡眠障碍的患病率更高。四维CSHQ-r可能是评估意大利ASD儿童和青少年睡眠障碍的有用筛查工具，对临床实践具有潜在意义。
