Schibler Brian M, Kanne Stephen M, Stoddard Gregory J, Carbone Paul S
Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA.
J Autism Dev Disord. 2025 Apr 17. doi: 10.1007/s10803-025-06842-8.
To compare the national prevalence of meeting physical activity, screen time, and sleep guidelines between autistic and nonautistic children and identify factors associated with meeting these guidelines. Prevalences for each health-determining behavior were estimated using the 2022 National Survey of Children's Health, using national guidelines. Complex survey-weighted logistic regression, adjusted for demographic covariates, was used to measure associations between autism and meeting each guideline, and to identify potential child, family, community, and policy-level determinants of each behavior among autistic children. The prevalence of meeting all three guidelines was low among autistic and nonautistic children across age groups. Physical activity guidelines were met at similarly low rates among autistic and nonautistic children; however, autistic children of all age groups were less likely to meet screen time guidelines, and those in the 3-5 and 6-11 years age groups were less likely to meet sleep guidelines. Moderate/severe autism, irregular bedtime, low parental education, and lacking a medical home were associated with lower likelihood of meeting sleep guidelines. Irregular bedtime and high income were associated with lower likelihood of meeting physical activity guidelines. Autistic children meet guidelines for physical activity, screen time, and sleep at a low prevalence and less than their nonautistic peers. Clinicians should develop individualized plans to facilitate adherence to guidelines among autistic children. Interventions should address modifiable factors, including bedtime regularity and access to medical homes. Further research and policy efforts should be made to improve adherence to guidelines among autistic children and subsequently reduce health disparities.
比较自闭症儿童和非自闭症儿童达到身体活动、屏幕使用时间和睡眠指南的全国患病率，并确定与达到这些指南相关的因素。利用2022年全国儿童健康调查，参照国家指南，对每种健康决定行为的患病率进行了估计。使用复杂的调查加权逻辑回归，并对人口统计学协变量进行调整，以衡量自闭症与达到每项指南之间的关联，并确定自闭症儿童中每种行为潜在的儿童、家庭、社区和政策层面的决定因素。在各年龄组的自闭症儿童和非自闭症儿童中，达到所有三项指南的患病率都很低。自闭症儿童和非自闭症儿童达到身体活动指南的比例同样很低；然而，所有年龄组的自闭症儿童达到屏幕使用时间指南的可能性较小，3至5岁和6至11岁年龄组的自闭症儿童达到睡眠指南的可能性较小。中度/重度自闭症、就寝时间不规律、父母教育程度低以及没有固定的医疗之家与达到睡眠指南的可能性较低有关。就寝时间不规律和高收入与达到身体活动指南的可能性较低有关。自闭症儿童达到身体活动、屏幕使用时间和睡眠指南的患病率较低，且低于非自闭症同龄人。临床医生应制定个性化计划，以促进自闭症儿童遵守指南。干预措施应针对可改变的因素，包括就寝时间规律和获得固定医疗之家的机会。应进一步开展研究并做出政策努力，以提高自闭症儿童对指南的遵守程度，从而减少健康差距。
