Relationship Between Health-Related Behaviors and Family Quality of Life in Children with Autism Spectrum Disorder.

Improving family quality of life (FQoL) of families of children with autism spectrum disorder (ASD) is a key priority in clinical research and practice. Previous studies have suggested that certain health-related behaviors in children with ASD, such as sleep or physical activity, may affect FQoL. However, the relative and independent effects of different health-related behaviors on FQoL remain poorly understood. This study investigated the relationship between sleep, mealtime difficulties, screen time, physical activity, and FQoL in ASD. Parents of 65 children with ASD aged four to thirteen years completed a detailed assessment of their children's health-related behaviors and FQoL. A multiple regression framework was used to estimate the independent contribution of each health-related behavior to FQoL. Only sleep and mealtime problems were independently associated with lower FQoL, even after controlling for physical activity, screen time, gender, age, traits of ASD, and intelligence, accounting for a 60, and 3% of the variance, respectively. All categories of sleep and mealtime problems were associated with FQoL, with particularly strong correlations for sleep anxiety (r =.71), daytime sleepiness (r =.70), and food refusal (r =.72). In addition to core autistic features, sleep and mealtime behaviors are associated with FQoL in children with ASD. Interventions aimed at improving sleep habits and reducing mealtime difficulties many enhance FQoL in children with ASD.